International Journal of Healthcare Simulation

Background:

Within a rural county, student placement locations are geographically scattered. Student feedback revealed that only students in one placement were able to benefit from the high-fidelity simulation suite resources situated at the lead hospital. Research shows students value co-created and personalized resources. Working with our practice partners we identified a cost-effective, accessible and inclusive solution, using 360 videos. Clinical simulation has been found to be effective ^[1] for teaching nursing skills. One limitation is the number of participants who can be involved at one time and in one place. A pilot study ^[2], with nursing students (n = 217), using low-cost virtual reality headsets, demonstrated that learning via immersive approaches aided understanding of the complex concepts, provided immediate feedback about clinical decisions, and could be completed multiple times. It provided additional opportunities for safe practice and complimented their ward and clinical skills experiences. Simulation technicians and lecturing staff recognized these benefits but identified time and cost constraints as challenges. Building on this research, we designed and evaluated a small-scale pilot to improve processes.

Aim:

To use 360 videos accessed via low-cost VR headsets to scale the clinical simulation experience for paediatric nursing students.

Method/design:

Working with our local hospital and our second-year paediatric nursing students, we used agile design methods and co-creation to develop two ABCDE assessment clinical simulations (sepsis and acute respiratory illness), using a 360 camera. These videos were accessed using low-cost virtual reality headsets, Oculus Quest™, mobile devices and Microsoft HoloLens™. Qualitative evaluation sought views of students, nursing staff/academics and simulation technicians through focus groups (n = 10). Thematic analysis revealed emergent themes of flexibility of access, repetition of learning opportunity and strengthening or the practice-theory link. Challenges included user familiarity with the technology and time investment. The main impact of this project was wider and longer-lasting learning compared with traditional methods.

Implementation outline:

Bite size learning chunks embedded strategically into our new nursing curriculum, for 300 student nurses studying at level 5. Harnessing the full potential of the clinical simulated experience permits students and staff to learn at a time and place of their own choosing. The ABCDE assessment will be expertly demonstrated through 360 videos, which will better prepare students for in-person simulations, saving face-to-face time explaining how to carry out the simulation. Learning from this project will feedforward to a faculty-wide multi-disciplinary clinical simulation event, informing guidelines.