VR pilot program for nursing students yields real benefits

In virtual reality simulations, they learn how to interact with patients in realistic scenarios.

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Emma Brown, a first-year UNC School of Nursing student, is already seeing patients in an emergency department. 

A virtual emergency department, that is.  

Brown is one of 111 students in a mental health nursing class who are part of a pilot program for assessing if the school should officially incorporate virtual reality simulation into its curriculum. In small groups, the students have fulfilled some clinical hours by trying the VR training.  

On this day, eight students wear Oculus Quest 2 headsets to immerse themselves in an exam bay with a patient. Through modules created by Oxford Medical Simulation, they learn how to connect with, assess and learn about patients in a professional way.     

“I really felt like I was in a hospital emergency department,” said Brown. “The headset blocks out all the outside sounds and that helps. It’s a low-pressure environment to learn.”   

Sharon Jackson, an assistant professor, teaches the course.  Elizabeth Stone, an associate professor and certified health care simulation educator, leads the VR trials. The trials, done with colleagues from Carolina’s health affairs schools and the Office of Interprofessional Education and Practice, are funded by a UNC Center for Faculty Excellence/Lenovo Instructional Innovation Grant. Stone applied for the grant with Dr. Sofia Aliaga, director of the UNC School of Medicine’s Simulation, Experiential Learning and Training Center and a clinical professor in the neonatal-perinatal medicine department. 

“VR simulations can address the current nursing shortage and issues such as nurse burnout by helping nursing programs enroll more students and ultimately provide more nurses to the health care workforce,” Stone said.  

In the U.S., high-quality simulation can substitute for up to 50% of clinical, in-person patient care training hours. “VR simulations done in an evidence-based manner and facilitated by expert faculty according to international best practices offer focused learning. It’s just one simulation tool among many,” Stone said.  

Clinical instructor LaTonia Chalmers tells the eight students what they’ll be doing in the class. She and Jackson, who are mental health nursing experts, will debrief students after each virtual scenario. The two prompt students to share what they learned and felt. 

“A great, expert-facilitated debrief is where the magic happens,” said Stone. 

The students, wearing scrubs as they do in a clinic, listen to Stone’s instructions. They put on the headsets, adjust the fit, and enter an emergency department exam room for the first scenario. 

Each student meets the same patient, an elderly woman named Maria who shows signs of generalized anxiety disorder. Maria sits on the exam bed. She says that her daughter is moving away and that she’s feeling afraid and helpless. She wants to know what’s wrong with herself. 

The second scenario involves a 15-year-old with gender dysphoria – the distress someone feels when their gender expression does not match their gender identity.  The teenager has a history of depression and has attempted suicide.   

As students talk with the patients, a virtual nursing assistant is nearby so that they can learn to delegate tasks. Students can turn 360 degrees in the room to see drop-down menus listing their options. These include washing hands, taking blood pressure, using a computer, administering an EKG, ordering blood work and many other tasks. At each step, they receive modeling on how to interact in a patient-centered way. A heart monitor beeping in the background adds to the realism. 

DeYonna Brodie, a junior, said that VR training provides confidence when interacting with live patients. “When you get to the point ofseeing live patients, you already know how to assess the patient and what to do,” she said. “That makes the patient feel better about the situation and builds trust.”