Evaluation of a Virtual Reality Simulation to Improve Problem-Based Learning for Neurologic Examination in Nursing Students
Abstract
Background: In the era of the fourth industrial revolution, there is a requirement of innovative strategies to enhance nursing students’ learning transfer. Virtual Reality Simulation Problem-Based Learning (VRS-PBL) has been validated to be an advantageous strategy that can improve knowledge, clinical performance, and self-efficacy. We aimed to identify the effectiveness of VRS-PBL for improving nursing students’ neurologic examination.
Methods: Data were collected in 2021. Seventy-six participants were recruited via the convenience sampling. Students in the control group underwent conventional lecture and demonstration of neurological assessment prior to practicum, whereas students in the experimental group underwent VRS-PBL once a week for 2 weeks (60 minutes per session).
Results: Compared with the control group, the academic self-efficacy (t = -2.80, P = .007) and neurological examination performance (t = -11.62, P < .001) of the nursing students increased significantly in the experimental group. On the other hand, there was no significant difference between the two groups of the transfer motivation (t = -1.76, P = .082).
Conclusion: The nursing students integrated the knowledge and skills learned through VRS-PBL, and improved the effectiveness and efficiency of their learning. VRS-PBL that reflects various clinical situations can be used as a foundation for establishing effective teaching strategies to improve nursing competency from novice to expert nurses.
1. Meyer E, Lees A, Humphris D, Connell NAD (2007). Opportunities and barriers to successful learning transfer: impact of critical care skills training. J Adv Nurs, 60(3): 308-316.
2. Johnston S, Coyer F, Nash R (2017). Simula-tion debriefing based on principles of transfer of learning: A pilot study. Nurse Educ Pract, 26: 102-108.
3. Finn FL, Chesser-Smyth P (2013). Promot-ing learning transfer in preceptor prep-aration. J Nurses Prof Dev, 29(6): 309-315.
4. Larew C, Lessans S, Spunt D, Foster D, Cov-ington BG (2006). Innovations in clini-cal simulation: Application of Benner's theory in an interactive patient care simulation. Nurs Educ Perspect, 27(1): 16-21.
5. Ironside PM, McNelis AM, Ebright P (2014). Clinical education in nursing: Rethink-ing learning in practice settings. Nurs Outlook, 62(3): 185-191.
6. Lim S, Yeom YR (2020). The Effect of edu-cation integrating virtual reality simula-tion training and outside school clinical practice for nursing students. J Converg Inf Technol, 10(10):100-108.
7. Hancock PA, Vincenzi DA, Wise JA, Mou-loua M (2008). Human factors in simulation and training. 1st ed, CRC Press. pp.:201-230.
8. Hooper CR, Jivram T, Law S, Michell A, Somasunderam A (2012). Using virtual patients to teach medical ethics, medical law and medical professionalism. Med Teach, 34(8): 674-675.
9. Maxwell NL, Mergendoller JR, Bellisimo Y (2004). Developing a problem-based learning simulation: An economics unit on trade. Simul Gaming, 35(4): 488-498.
10. Son HK (2020). Effects of S-PBL in Mater-nity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi-Experimental Design. Int J Envi-ron Res Public Health, 17(21): 7866.
11. Dubovi I, Levy ST, Dagan E (2017). Now I know how! The learning process of medication administration among nurs-ing students with non-immersive desk-top virtual reality simulation. Comput Educ, 113: 16-27.
12. Foronda CL, Hudson KW, Budhathoki C (2017). Use of virtual simulation to im-pact nursing students’ cognitive and af-fective knowledge of evidence‐based practice. Worldviews Evid Based Nurs, 14(2): 168-170.
13. Vidal VL, Ohaeri BM, John P, Helen D (2013). Virtual reality and the traditional method for phlebotomy training among college of nursing students in Kuwait: implications for nursing education and practice. J Infus Nurs, 36(5): 349-355.
14. Verkuyl M, Romaniuk D, Atack L, Mastrilli P (2017). Virtual gaming simulation for nursing education: An experiment. Clin Simul Nurs, 13(5): 238-244.
15. Foronda C, Gattamorta K, Snowden K, Bauman EB (2014). Use of virtual clini-cal simulation to improve communica-tion skills of baccalaureate nursing stu-dents: A pilot study. Nurse Educ Today, 34(6): e53-e57.
16. Bremner MN, Aduddell K, Bennett DN, VanGeest JB (2006). The use of human patient simulators: Best practices with novice nursing students. Nurse Educ, 31(4): 170-174.
17. Neequaye SK, Aggarwal R, Van Herzeele I, Darzi A, Cheshire NJ (2007). Endovascu-lar skills training and assessment. J Vasc Surg, 46(5): 1055-1064.
18. Jeong SY, Lee KO (2019). The emergence of virtual reality simulation and its im-plications for nursing profession. Korean J Women Health Nurs, 25(2):125-128.
19. Kim JH, Park IH, Shin S (2013). Systematic review of Korean studies on simulation within nursing education. J Korean Aca-demic Society of Nurs Educ, 19(3): 307-319.
20. Stone J, Carson A, Sharpe M (2005). Func-tional symptoms and signs in neurology: assessment and diagnosis. J Neurol, Neu-rosurg Psychiatry, 76 Suppl 1 (Suppl 1): i2-i12.
21. Han JH, Lee GE, An YH, Yoo SH (2013). Effect of systematic educational pro-gram for the application of National Institutes of Health Stroke Scale (NIHSS) as a neurologic assessment tool in stroke patients. J Korean Clin Nurs Res, 19(1): 57-68.
22. Shin JY, Issenberg SB, Roh YS (2017). The effects of neurologic assessment E-learning in nurses. Nurs Educ Today, 57: 60-64.
23. Eldredge LKB, Markham CM, Ruiter RA, Fernández ME, Kok G, Parcel GS (2016). Planning health promotion programs: an inter-vention mapping approach. John Wiley & Sons.
24. Korean Accreditation Board of Nursing Education (2021). Standard and criteria for accreditation of baccalaureate degree nursing program. Korean Accreditation Board of Nursing, Seoul.
25. Ayres HW. Factors related to motivation to learn and motivation to transfer learning in a nursing population. [PhD thesis]. Graduate School the North Carolina State University, US; 2005.
26. Park SY, Kweon YR (2012). The effect of using standardized patients in psychiat-ric nursing practical training for nursing college students. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 21(1); 79-88.
27. Teasdale G, Jennett B (1974). Assessment of coma and impaired consciousness: a practical scale. Lancet, 304(7872): 81-84.
28. Avner, JR (2006). Altered states of con-sciousness. Pediatr Rev, 27(9): 331-338.
29. Maynard FM, Bracken MB, Creasey G, et al (1997). International standards for neu-rological and functional classification of spinal cord injury. Spinal Cord, 35(5): 266-274.
30. Durks D, Fernandez-Llimos F, Hossain LN, Franco-Trigo L, Benrimoj SI, Sabater-Hernández D (2017). Use of interven-tion mapping to enhance health care professional practice: A systematic re-view. Health Educ Behav, 44(4): 524-535.
31. Soysa RI, Parthiban R, How KB (2012). In-teraction-Oriented System for VITAL Framework. In 2012 IEEE Fourth Interna-tional Conference on Technology for Education, pp. 192-195.
32. Kim Y, Kim WJ (2020). Nursing students' experiences in virtual simulation prac-tice. J Korean Academic Society of Nurd Educ, 26(2): 198-207.
33. Rhodes ML, Curran C (2005). Use of the human patient simulator to teach clini-cal judgment skills in a baccalaureate nursing program. CIN: Comput Inform Nurs, 23(5): 256-262.
34. Atli K, Selman W, Ray A (2021). A compre-hensive multicomponent neurosurgical course with use of virtual reality: mod-ernizing the medical classroom. J Surg Educ, 78(4): 1350-1356.
2. Johnston S, Coyer F, Nash R (2017). Simula-tion debriefing based on principles of transfer of learning: A pilot study. Nurse Educ Pract, 26: 102-108.
3. Finn FL, Chesser-Smyth P (2013). Promot-ing learning transfer in preceptor prep-aration. J Nurses Prof Dev, 29(6): 309-315.
4. Larew C, Lessans S, Spunt D, Foster D, Cov-ington BG (2006). Innovations in clini-cal simulation: Application of Benner's theory in an interactive patient care simulation. Nurs Educ Perspect, 27(1): 16-21.
5. Ironside PM, McNelis AM, Ebright P (2014). Clinical education in nursing: Rethink-ing learning in practice settings. Nurs Outlook, 62(3): 185-191.
6. Lim S, Yeom YR (2020). The Effect of edu-cation integrating virtual reality simula-tion training and outside school clinical practice for nursing students. J Converg Inf Technol, 10(10):100-108.
7. Hancock PA, Vincenzi DA, Wise JA, Mou-loua M (2008). Human factors in simulation and training. 1st ed, CRC Press. pp.:201-230.
8. Hooper CR, Jivram T, Law S, Michell A, Somasunderam A (2012). Using virtual patients to teach medical ethics, medical law and medical professionalism. Med Teach, 34(8): 674-675.
9. Maxwell NL, Mergendoller JR, Bellisimo Y (2004). Developing a problem-based learning simulation: An economics unit on trade. Simul Gaming, 35(4): 488-498.
10. Son HK (2020). Effects of S-PBL in Mater-nity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi-Experimental Design. Int J Envi-ron Res Public Health, 17(21): 7866.
11. Dubovi I, Levy ST, Dagan E (2017). Now I know how! The learning process of medication administration among nurs-ing students with non-immersive desk-top virtual reality simulation. Comput Educ, 113: 16-27.
12. Foronda CL, Hudson KW, Budhathoki C (2017). Use of virtual simulation to im-pact nursing students’ cognitive and af-fective knowledge of evidence‐based practice. Worldviews Evid Based Nurs, 14(2): 168-170.
13. Vidal VL, Ohaeri BM, John P, Helen D (2013). Virtual reality and the traditional method for phlebotomy training among college of nursing students in Kuwait: implications for nursing education and practice. J Infus Nurs, 36(5): 349-355.
14. Verkuyl M, Romaniuk D, Atack L, Mastrilli P (2017). Virtual gaming simulation for nursing education: An experiment. Clin Simul Nurs, 13(5): 238-244.
15. Foronda C, Gattamorta K, Snowden K, Bauman EB (2014). Use of virtual clini-cal simulation to improve communica-tion skills of baccalaureate nursing stu-dents: A pilot study. Nurse Educ Today, 34(6): e53-e57.
16. Bremner MN, Aduddell K, Bennett DN, VanGeest JB (2006). The use of human patient simulators: Best practices with novice nursing students. Nurse Educ, 31(4): 170-174.
17. Neequaye SK, Aggarwal R, Van Herzeele I, Darzi A, Cheshire NJ (2007). Endovascu-lar skills training and assessment. J Vasc Surg, 46(5): 1055-1064.
18. Jeong SY, Lee KO (2019). The emergence of virtual reality simulation and its im-plications for nursing profession. Korean J Women Health Nurs, 25(2):125-128.
19. Kim JH, Park IH, Shin S (2013). Systematic review of Korean studies on simulation within nursing education. J Korean Aca-demic Society of Nurs Educ, 19(3): 307-319.
20. Stone J, Carson A, Sharpe M (2005). Func-tional symptoms and signs in neurology: assessment and diagnosis. J Neurol, Neu-rosurg Psychiatry, 76 Suppl 1 (Suppl 1): i2-i12.
21. Han JH, Lee GE, An YH, Yoo SH (2013). Effect of systematic educational pro-gram for the application of National Institutes of Health Stroke Scale (NIHSS) as a neurologic assessment tool in stroke patients. J Korean Clin Nurs Res, 19(1): 57-68.
22. Shin JY, Issenberg SB, Roh YS (2017). The effects of neurologic assessment E-learning in nurses. Nurs Educ Today, 57: 60-64.
23. Eldredge LKB, Markham CM, Ruiter RA, Fernández ME, Kok G, Parcel GS (2016). Planning health promotion programs: an inter-vention mapping approach. John Wiley & Sons.
24. Korean Accreditation Board of Nursing Education (2021). Standard and criteria for accreditation of baccalaureate degree nursing program. Korean Accreditation Board of Nursing, Seoul.
25. Ayres HW. Factors related to motivation to learn and motivation to transfer learning in a nursing population. [PhD thesis]. Graduate School the North Carolina State University, US; 2005.
26. Park SY, Kweon YR (2012). The effect of using standardized patients in psychiat-ric nursing practical training for nursing college students. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 21(1); 79-88.
27. Teasdale G, Jennett B (1974). Assessment of coma and impaired consciousness: a practical scale. Lancet, 304(7872): 81-84.
28. Avner, JR (2006). Altered states of con-sciousness. Pediatr Rev, 27(9): 331-338.
29. Maynard FM, Bracken MB, Creasey G, et al (1997). International standards for neu-rological and functional classification of spinal cord injury. Spinal Cord, 35(5): 266-274.
30. Durks D, Fernandez-Llimos F, Hossain LN, Franco-Trigo L, Benrimoj SI, Sabater-Hernández D (2017). Use of interven-tion mapping to enhance health care professional practice: A systematic re-view. Health Educ Behav, 44(4): 524-535.
31. Soysa RI, Parthiban R, How KB (2012). In-teraction-Oriented System for VITAL Framework. In 2012 IEEE Fourth Interna-tional Conference on Technology for Education, pp. 192-195.
32. Kim Y, Kim WJ (2020). Nursing students' experiences in virtual simulation prac-tice. J Korean Academic Society of Nurd Educ, 26(2): 198-207.
33. Rhodes ML, Curran C (2005). Use of the human patient simulator to teach clini-cal judgment skills in a baccalaureate nursing program. CIN: Comput Inform Nurs, 23(5): 256-262.
34. Atli K, Selman W, Ray A (2021). A compre-hensive multicomponent neurosurgical course with use of virtual reality: mod-ernizing the medical classroom. J Surg Educ, 78(4): 1350-1356.
| Files | ||
| Issue | Vol 52 No 10 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i10.13851 | |
| Keywords | ||
| Neurologic examination Nursing education Problem-based learning Virtual reality | ||
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How to Cite
1.
Lee J, Son H. Evaluation of a Virtual Reality Simulation to Improve Problem-Based Learning for Neurologic Examination in Nursing Students. Iran J Public Health. 2023;52(10):2128-2137.
