€¦ · web view71% of the graduate nurses held positive opinions of the virtual world as compared...
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1Lisa Otto: Annotated Bibliography
ResearchTopic APA Citation & doi Key Words Methodology Key Findings One Paragraph Summary1VirtualRealityNursingAttitudesDistanceLearning
Puterbaugh, M. D., Shannon M., & Gorton, H. (2010). A survery of nurses’ attitudes toward distance education and the educational use of 3-D virtual environments. Journal of Electronic Resources in Medical Libraries, 7(4), 292-307. doi: 10.3928/02793695-20120605-04
Distance Education
Distance Reference
Gaming
Immersive Learning Environments
Nursing EducationProfessionalizationSecond Life
Socialization
Surveys
Three-Dimensional Learning Environments
Virtual Reality
Virtual Worlds
Qualitative AnalysisSurveyN=77
Survey with 30 questions focus on Experience in
distance education Computer skill level Feeling (attitudes)
regarding online gaming environments
81% (majority) of the respondents indicated they would have interest in SL environment
83% (majority) of the respondents indicated they would interact in the virtual world
88% (majority) of the respondents indicated they would visit a virtual world to find assistance for research or class work
78% (majority) of the respondents indicated they would visit a virtual world where they could socialize outside their institution or organization with other health care professionals
71% of the graduate nurses held positive opinions of the virtual world as compared to 57% of the undergraduate participants positive opinions
The study evaluates a virtual reality environment such as Second Life (SL) as a tool supporting distance education for nursing students. Participating in SL at remote locations provides a means to 1) connect the students with a an expanded professional community and 2) promote professionalization of the nursing student. The purpose of the study was to assess the general feeling (attitudes) of the nursing community toward virtual reality. The study assessed 3 areas 1) distance education, 2) satisfaction regarding social interaction between distance learners, and 3) gaming in a virtual environment and the corresponding social and professional interaction. The limitations of the study ae the questions on the survey. While the questions were intentionally vague to
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illicit responses depicting attitudes, the responses were based more on previous experiences than the information provided in the study. The preconceptions of the participants may have affected the outcomes. In addition, the participants sampling number was low impacting generalizability.
2VirtualRealityNursingTeamwork
Kalisch, B.J., Aebersold, M., McLaughlin, M., Tschannen, D., & Lane, S. (2015). An intervention to improve nursing teamwork using virtual simulation. Western Journal of Nursing Research, 37(2), 164-179. doi: 10..1177/0193945914531458
Systems/Management/Leadership
Nurses as Subjects
Nurses
Nursing Education
Statistical Analysis
Methods
Acute Care
Location of Care
Quasi-experimentalN=43
NTS and Teamwork Knowledge Survey measured teamwork
NTS 33 Item
questionnaire 5 Point Likert-
type scale
Teamwork Knowledge Survey
8 Item test Correct answers
calculated Questions
drawn from TeamSTEPPS
Team work overall score after the intervention was statistically significantly higher than pre-test
Team work behaviors improved, while the actual knowledge of team work did not improve
In health care today, teamwork is a central focus as a major contributing factor to quality health care. The focus of the study is exploring the development of team work in virtual reality. The purpose of the study was to determine the effectiveness of virtual simulation for improving teamwork among nursing staff in an inpatient setting. During the study, podcasts were used to teach the participants about SL and team work. The participants were assigned avatars in SL to experience the scenario. One limitation of the study was the design of single group and single
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nursing unit. Another limitation was the attrition rate of the participants due to the vacations of the staff on the unit, which affected participation.
3VirtualRealityNursingInclusivity
Tiffany, J.M., & Hoglund, B.A. (2016). Using virtual simulation to teach inclusivity: A case study. Clinical Simulation in Nursing, 12(4), 115-122. doi: 10.1016/j.ecns.2015.11.003
Simulation
Virtual Reality Simulation
Second Life
Avatar
Inclusivity
Diversity
Cultural AwarenessNursing EducationInnovative Teaching/Learning Strategies
Role-Play
Qualitative AnalysisCase Study
N=15 Graduate nurses studying to be a nurse educator.
Two written assignments Each participant
completed 2 written assignments which were analyzed using simple qualitative analysis
Students expressed SL offered a glimpse into the lives of disabled persons who are marginalized because of disabilities, age, or other differences.
Students shared that self-reflection is central to dismantling biases and promoting awareness of stereotypes in society.
Student understanding of inclusivity was expanded in an innovative way, never experienced by students previously enrolled in the course at the school.
Students engaged in the SL experiences demonstrated higher order thinking skills
Students participating in the SL experience were better able to construct new meaning out of the experience and what was taught
Cultural diversity and inclusivity are difficult concepts to address in the classroom and clinical settings. The innovative approach of second life was implemented to address these concepts. The focus of the study was to allow students to 1) make connections with the background stories of the avatars and 2) acquire a sense of what it is like to be a person within a marginalized population. Each participant was randomly assigned to an avatar representing a marginalized person for use in role play in a SL simulation environment. Marginalized persons included 1) homeless veteran, 2) overweight mother, 3)young man immigrant/refugee displaced, and 4) athlete who became paraplegic after a serious accident. The purpose of the
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interactive virtual reality environment provided a setting for graduate nurses to explore 1) cultural awareness, 2) inclusivity, diversity, personal bias, racism, and sexism as these topics relate to nursing practice. The SL experience allows the participant to experience what a minority or marginalized individual experiences. The framework of the teaching approach is constructivism. In comparison, complex topics such as inclusivity requires engagement through listening and honoring a student’s development regarding their personal, professional, and educational journey. Three concepts were experienced by the participating students including projective identity, recognizing bias, and, microaggression. The other topic addressed was application of the concepts to culturally competent care.
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Limitations of the study were the number of participants and the generalizability of the findings.
4VirtualRealityProcedureBronchoscopy
Colt, H.G., Crawford S.W., & Galbraith, E.O. (2001). Virtual reality bronchoscopy simulation: A revolution in procedural training. Chest, 120(4), 1333.
Bronchoscopy Training
Computer Simulation
Medical Education
Virtual reality
ExperimentalGroup 1: N=5Group 2: N=5
Student t testsPaired t-tests
Pre-training and posttraining score comparisons using paired t tests
There were no statistical significant differences between novice scores after training and physician scores.
After training the novice physicians examinations were more thorough than the skilled physicians
Novice physicians equaled or surpassed the experienced physician
Novice trainees significantly improved dexterity, accuracy, demonstrated fewer contacts with the bronchial wall, and missed less segments after training.
The novice trainees did NOT demonstrate an increase in speed of the procedure.
The authors argue that with the availability of simulation training that it is not reasonable for patients to be used for invasive procedural training. Currently there are no standards for basic skills or procedure guidelines for bronchoscoy. There is a need for improved training and determination of competency. The purpose of the study was to determine if novice physicians could gain basic technical skills to perform a common diagnostics endoscope procedure such as flexible fiberoptic bronchoscopy (FFB) using a virtual bronchoscopy skill center as compared to more experienced senior trainees (third year fellows) from the same training program. The two participant groups were as follows. Group 1 posttraining novice
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traninee. Group 2 more experienced senior trainees (control group). The use of simulation for the training of bronchoscopy is revolutionary in pulmonary procedural training, thus moving from see one, do one, teach one to acquiring skills through virtual simulation experience. The limitations include the small number of participants and generalizability of the findings.
5Virtual RealityProcedureEndobronchialUltrasound
Konge, L., Annema, J., Clementsen, P., Minddal, V., Vilmann, P., & Ringsted, C. (2013). Using virtual-reality simulation to assess performance in endobronchial ultrasound. Respiration, 86(1), 59-65.
Endobronchial Ultrasound
Transbronchial Needle Aspiration
Virtual-Reality-Simulator
ExperimentalSPSS; PASW, version 18.0, GENOVA version 3.1Respiratory physicians N=22
All experienced operators passed the test
One outlier novice passed the test
The novices that had a brief simulator training did not achieve a significantly higher score compared to the novices without training—none passed the test
Experienced operators sampled more lymph nodes and completed the procedure in less time
Experienced operators seemed to be determined to obtain good biopsy samples (non-optimal position or risking blood vessel puncture) and were willing to risk error to obtain the samples
The Focus of the study was the determination of endotracheal ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) certification requirements. The purpose of the study was to explore the validity of EBUS simulator metrics and the reliability of different test set ups to create a credible pass/fail standard and determine if a limited amount of simulator training (2 hours) would allow novices to pass the simulator tests. The study participant groups were
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as opposed to novices. 2 hours of training did not allow
trainees to reach expert level performance therefore the QS is an appropriate measure of competence and important in determining when a provider is competent to perform the skill on patients.
as follows. 1) experienced physician. 2) Novice. 3) Simulator trained novice group. There were 4 research questions focused on 1) discrimination between novice and experienced operators, 2) number of procedures needed to achieve acceptable reliability, 3) credible standard for pass/fail., and 4) determining the pass/fail rate for novices after 2 hours of practice. One limitation of the study was that the simulator metrics could not capture or record the completeness of the diagnostic examination including the 6 anatomical landmarks. A second limitation was that only technical abilities are assessed in the study. Other aspects such as interpretation of patient assessment data and determination of actual need for procedure were not addressed in the study.
6VirtualRealitySecond Life
Kidd, L.I., Knisley, S.J., & Morgan, K.I. (2012). Effectiveness of a second life® simulation as a teaching
Mental health
Second Life
QuantitativeDescriptive StudyN=126Descriptive statistics
SL simulation moderately effective as a teaching strategy
SL slightly difficult technical program
The focus of the study was applying virtual reality as a teaching strategy for mental
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strategy for undergraduate mental health nursing students. Journal of Psychosocial Nursing and Mental Health Services, 50(7), 28. doi: 10.3928/02793695-20120605-04
Virtual Reality
Simulation
Nursing Students
SPSS Version 19.0
InstrumentSL Simulation evaluation survey developed by the researchers
Students with older computers tended to rate the SL as less educationally effective
Age not a factor in students’ perception of technical difficulty during the SL
health nursing students providing an opportunity to practice communication and assessment skills. Positive aspects of the SL setting were no consequences for errors, implementation of a new learning tactic, and students accessing the learning program from home. The purpose of the study was to measure the effectiveness of a SL virtual simulation as a teaching strategy. The limitations of the study were 1) no control group and 2) survey was newly developed. Future applications include use in nursing courses, as clinical sites are less available. The study highlighted the need to train faculty so they are comfortable with new technologies. Second life is accessible, convenient, and safe for student skill experimentation. The framework was the community of inquiry with the core elements of collaborative constructivist learning environment including 1)
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teaching presence, 2) cognitive presence, and 3) social presence.
7VirtualRealitySimulationIPE
Nicely, S., & Farra, S. (2015). Fostering learning through interprofessional virtual reality simulation development. Nursing Education Perspectives, 36(5), 335-336.
IPE
Collaboration
Disaster
Management
Virtual Reality Simulation
Nursing Students
QualitativeOpen-ended survey questionsN= not known
KidSim ATTITUDES questionnaire-measured perceptions/attitudes toward IPE
The survey question responses demonstrated that the teaching strategy promoted communication and collaboration
The student perceptions indicate the experience was strongly positive regarding attitudes toward:
o Interprofessional education
o Teamworko The modality of
simulation learning
The virtual simulation flipped class room approach is unique in that the learning gained by the simulation development processes was assessed in lieu of the experience of a virtual reality simulation. Student participants developed the simulation experience by 1) developing objectives 2) defining and depicting the simulation in a story board, and 3) incorporating the setting and victims into the story board. The students developed the simulation over 5 weeks using numerous collaboration tools such as google doc, google hangout, and google groups . Realism was enhanced by images and 3D scenery. The groups involved in the development of the simulation were nursing students and students from the department of interactive media.
8 Josephsen, J., & Butt, A. Multipatient Qualitative Students identified The multipatient scenario
10Lisa Otto: Annotated BibliographyVirtual RealityMulti-patient Simulation
(2014). Virtual multipatient simulation: A case study. Clinical Simulation in Nursing, 10(5), 235-240.
Simulation
Electronic Health record
Delegation
Prioritization
Collaborative Practice
Pilot ProjectN=68
The data was examined for themes
Prioritization Patient
identification Delegation Care
coordination Care planning
competencies in safety and delegation
Students ability to identify competencies were less evident in collaborative practice and prioritization
Comments regarding clinical reasoning generally focused on
o Seeing the most critical patient first
o Assessing chest paino Obtaining assistance
from the charge nurseo Delegationo Timely assessment of
patient
addresses the Quality and Safety Education for Nurses (QSEN) foci including patient centered care, teamwork, collaboration, safety, and informatics. The theoretical framework of the study was constructivism with a focus in active learning. The purpose of the study was to explore aspects of nursing practice and QSEN competencies using social learning and self- reflective practice in a virtual simulation setting. One limitation is the design of the study in that the RN as a leader and delegator is briefly explored. Another limitation is the omission of the interdisciplinary team’s role in the provision of patient care.
9VirtualRealitySimulationDisasterTriage
Foronda, C.L., Shubeck, K., Swoboda, S.M., Hudson, K.W., Budhathoki, C., Sullivan, N., & Hu, X. (2016). Impact of virtual simulation to teach concepts of disaster triage. Clinical Simulation in Nursing, 12(4), 137-144. doi: 10.1016/j.ecns 2016.02.004
Virtual Simulation
Disaster Simulation
Disaster Triage
Mixed MethodsQuantitative and QualitativePilot StudyN=6
QuantitativePre-test/pot-test designSPSS version 22 Pretest scores were
compared to post-
4 participants demonstrated a higher score on the post-test
2 participants demonstrated a lower score on the post-test
Wilcoxon signed rank test demonstrated no statistical difference between the group of participants pre and post-test.
The qualitative data was organized into 3 themes
The purpose of the study was to determine the impact of using a virtual simulation to teach Bachelor of Science in Nursing students the concepts of disaster triage implementing the Sort, Assess, Lifesaving Interventions, and Treatment/Transport
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test scores using the Wilcoxon signed rank test
Qualitative data was aggregated
Thematic analysis my nurse researchers
o Funo Appreciation for
immediate feedbacko Better than readingo Technical issues
All students expressed the simulation was fun and better than reading
(SALT) model. The limitations of the study were 1) The small participant number reduces the tatistical significance of the results, 2) the same pre-test and post-test were used, 3) some of the participants had previous triage training, and 4) results have limited generalizability because the number of study participants was low. While the study sample size was small the qualitative data exhibits 1) positive feedback from participants regarding virtual simulation experiences, and 2) the virtual simulation was web based, easily accessible, fun, and provided immediate feedback.
10VirtualRealitySimulationStudentsChronicIllness
Tilton, K.J., Tiffany, J., & Hoglund, B.A. (2015). Non-acute-care virtual simulation: Preparing students to provide chronic illness care. Nursing Education Perspectives, 36(6), 394-395. doi: 10.5480/14-1532
Virtual Simulation
Second Life
Non-Acute-Care Clinical
Chronic Illness
Nursing Education
Mixed methodsPilot StudyN=79
Survey: The Learner HPS Evaluation survey
15 Likert-type items
De-briefing sessions facilitated by an experienced instructor received higher mean scores
De-briefing sessions facilitated by a nursing education graduate student received lower mean scores
Students favored the simulator facilitator in role play as the avatar
Students liked the opportunity
A virtual simulation was constructed in SL with a setting of non-acute care focusing on adult chronic care. The purpose of the study was to demonstrate the potential use of non-acute-care virtual clinical simulation in nursing education specifically in chronic care
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to practice communication with a patient in SL
The pilot study demonstrated the potential use of virtual simulation in nursing education focusing in chronic care management
The item focusing on de-briefing helping to put information together in a way that makes sense had the highest mean
management. The SL virtual simulation experience encompassed 5 patient encounters including 1) simulator facilitator role play within SL, 2) avatar with pre-programmed responses to assessment questions, and 3) 2 case studies containing patient information and questions centering on clinical reasoning. The study participants identified de-briefing as an essential activity. The study results highlight the importance of relevant preparation of nurse educator facilitators as simulation experiences. One limitation of the study may have been using a graduate student to conduct half of the de-briefing sessions.
11VirtualRealityHapticsIV
Jung, E., Park, D.K., Lee, Y.H., Jo, H.S., & Park, R.W. (2012). Evaluation of practical exercises using an intravenous simulator incorporating virtual reality and haptics device technologies. Nurse Education Today, 23(4), 458-463. doi: 10.1016/j.nedt.2011.05.012
Virtual System
Venipuncture
Computer
Simulation
Medical Education
ExperimentalRandomized controlled trial.N=113SPSS 12.0t-testMann-Whitney U testPaired t-testANOVA
Anxiety felt by each group: No statistical difference between the groups
Evaluation of IV performance: Group C score was higher but not statistically significant.
Success in venipuncture: group B had the highest score (not statistically significant)
Group C performed the venipuncture with a
Haptics IV simulators use realistic 3D photographic images observed using polarized glasses in simulated environments. The haptics IV simulator offers more of a variety of content anatomy, physiology, complications varying methods of injecting solution, surgical
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performance (task) time that was significantly shorter than group B
Group C performance procedure scores were higher than other groups
Group C had a statistically significant higher satisfaction rate for learning the procedures
complications, varying instructor approaches, and so on. The focus of the study was the educational effectiveness of practical exercises using IV simulators and virtual reality haptics. The goal was to identify the educational effectiveness of PE utilizing simulation process vs conventional methods when the venipuncture method is learned through the virtual reality techniques and haptics devices of the simulators. There were three groups of study participants as follows. Group A Mannequins of human arms. Group B IV virtual reality/haptics injection simulators. Group C both mannequins and IV simulators. The purpose was to investigate the effectiveness of simulators incorporating virtual reality techniques to identify the most effective training methods and aids for PE. Some limitations were 1) sufficient time to achieve the educational goal may not have been allocated
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to the experience, 2) proficiency of the training material. 3) first study to compare combined approach of haptics and mannequins to each individual method of teaching, and 4) group B members were on average older. Some strengths of the haptics IV arm were 1) sense of physical resistance during the procedure, 2) use when patients are unavailable, 3) reducing student anxiety, and 4) decreased use of supplies and reduced economic burden.