Nursing education, virtual reality and empathy?

Students' perceptions of empathic instruction in a remote psychiatric nursing class: a phenomenological study

BACKGROUND

Psychiatric nursing is operated by nursing college students as it introduces abstract concepts and complex materials. The educational environment has undergone extreme changes due to the expansion of remote learning. Thus, it is important to devise strategies for operating psychiatric nursing classes.

METHODS

In this study, students attended a psychiatric nursing class that used empathic instruction in a virtual space to examine their learning experiences employing a phenomenological research design. Eleven nursing students completed a remote 2-credit psychiatric nursing class offered in a college in Chungbuk, South Korea that used empathic instruction. Data were collected through individual interviews and analyzed using Giorgi's phenomenological method of analysis.

RESULTS

The following four themes were derived from the participants' learning experiences: "Interaction as a tool for learning," "Repetitive learning," "Enjoyable but too detailed feedback," "Chance of self-improvement."

CONCLUSIONS

Our findings suggest that remote psychiatric nursing classes that use empathic instruction are an effective teaching method that can increase students' interest and academic performance in the subject. Thus, they should create a systematic and structured learning environment according to students' academic levels and promote their reflection.

Media-Induced and Psychological Factors That Foster Empathy Through Virtual Reality in Nursing Education: 2×2 Between-Subjects Experimental Study

Background

Virtual reality (VR) has emerged as a promising tool in medical education, particularly for fostering critical skills such as empathy. However, how VR, combined with perspective-taking, influences affective empathy in nursing education remains underexplored.

Objective

This study investigates the influence of VR and perspective-taking on affective empathy in nursing education, focusing on 4 psychological factors: perceived self-location, narrative transportation, emotional engagement, and affective empathy.

Methods

A 2×2 between-subjects design was used, involving 69 nursing undergraduates from two Midwest universities. The participants engaged with a narrative-focused video game, That Dragon, Cancer, in either VR or non-VR conditions and from the perspective of either parents or clinicians.

Results

VR significantly enhanced perceived self-location (P=.01), while adopting a clinician's perspective amplified emotional engagement (P=.03). However, VR did not significantly influence narrative transportation (P=.35). An interaction effect was found between the platform and player's perspective on narrative transportation (P=.04). Several indirect effects of media elements on affective empathy were observed via other psychological factors, though the direct effect of VR on affective empathy was not significant (P=.84).

Conclusions

These findings underscore the potential of VR in medical education, suggesting that perspective-taking should be carefully considered when designing immersive learning experiences. The study advocates for broader integration of VR technologies into medical curricula to enhance instruction quality and patient-centered care.

Immersive solutions: South African community service nurses' perspectives on virtual reality potential in hypertension management

Introduction

With the rapid development of information technology globally and the scarcity of educators in higher education institutions, educational reforms are crucial to prepare students for an advancing and complex work environment. Virtual reality (VR) makes education widely available as it bridges the gap between students and educators, as educators and students enter an immersive world where educators can guide students.

Aim

The researchers' aim for this study was to explore community service nurses' (CSN's) experiences with a VR prototype when managing a hypertensive patient.

Method

The study comprised nine CSN with varied knowledge, skills, experiences, and who have been allocated to certain disciplines within a public hospital. The study was split into three phases: phase one, focus group and individual interviews were used to gain an understanding of the CSN's current knowledge and experiences regarding the assessment and implementation of nursing interventions used in the management of hypertensive patients. In the second phase, participants were exposed to the VR environment, where they were prompted by the programmed patient avatar to perform several nursing diagnostic procedures and interpret the clinical data provided in order to formulate a nursing diagnosis. During the third phase, the researchers conducted focus groups and individual interviews to acquire and comprehend the participants experiences regarding their interaction with the VR prototype and describe the benefits and drawbacks of the prototype they encountered.

Results

Constructive feedback and recommendations were provided by participants regarding the VR program's interactiveness and the accuracy of diagnostic tests. Participants claimed the experience was enjoyable, and based on the researchers' observations, the VR program stimulated critical thinking as well as clinical reasoning as intended. Their feedback was used to alter the VR prototype before the main study's commencement.

Effects of virtual reality application on pain, anxiety, and vital signs due to port catheter needle insertion: Randomized controlled study

PURPOSE

This study aims to examine the effects of virtual reality applications on pain, anxiety, and vital signs during port catheter needle insertion in adult cancer patients.

METHODS

The research followed a randomized controlled design as intervention and control groups. In the intervention group, patients received virtual reality sessions with five images in addition to routine procedures during the port catheter needle insertion. We measured the pain, anxiety, and vital parameters resulting from the port catheter needle insertion. Assessments were measured twice: at baseline (before port catheter needle insertion, T0) and at the end of the proceduce (after port catheter needle insertion, T1).

RESULTS

The virtual reality application significantly reduced the levels of pain (p=0.45) and anxiety (p<0.001) at T1 in the intervention group compared to the control group. The virtual reality application showed no difference between T0 and T1 in the vital parameters of the intervention group.

CONCLUSIONS

Virtual reality application during the port catheter needle insertion procedure reduced pain levels and anxiety levels in cancer patients. The virtual reality applications to reduce pain and anxiety levels during the port catheter needle insertion procedure can be recommended.

Effects of a virtual simulative diabetes care program on learning ability and clinical thinking skills in nursing interns

Introduction

Diabetes is a major global health issue, requiring nursing interns to develop essential diabetes management skills. Traditional teaching methods are limited by clinical settings, hindering the development of comprehensive theoretical and clinical competencies. This study developed a Virtual Simulative Diabetes Care Program to address these limitations.

Methods

A quasi-experimental design was employed. Nursing interns were assigned to an intervention group (virtual simulation) or a control group (traditional face-to-face training). Self-directed learning ability and clinical thinking skills were assessed using the validated Independent Learning Ability Scale and Clinical Thinking Skills Scale. Pre- and post-intervention measurements were conducted, and data were analyzed using independent t-tests and Mann-Whitney U tests, with significance set at P < .05.

Results

The intervention group showed significantly higher self-directed learning ability (104.53 ± 7.75 vs. 99.00 ± 13.77, P < .05) and clinical thinking skills (99.71 ± 12.15 vs. 91.69 ± 17.44, P < .05) compared to the control group. Within the intervention group, both abilities significantly improved from pre- to post-internship (P < .05). Practical skills, including blood glucose monitoring and insulin injection, also improved, with higher scores in the intervention group. The virtual simulation program was rated as effective, with an overall score of 8.37 ± 1.20 and "Excellent" ratings for learning functionality.

Conclusions

The virtual simulation-based diabetes care program significantly improved nursing interns' learning and clinical skills.

Empathy development through game-based learning: An investigative study on nursing professionals

BACKGROUND

Empathy is at the core of patient-centred care. Evidence has continually found that empathy helps foster therapeutic relationships and is essential in the delivery of quality healthcare. In India, many factors are barriers to empathy for nursing professionals.

OBJECTIVES

DESIGN AND METHODS: The IDEO design thinking process was followed to design the game. A focus group discussion with 18 nurses helped identify relevant scenarios and barriers to empathy. A scenario of an interaction between a nurse and a cancer patient was identified to create the game. The game mechanics, rubrics, and scenarios were built based on feedback from diverse professionals consisting of doctors, nurses, and UX designers. A learner feedback form assessing usability, contextual specificity, engagement, and perceived learnability was created and its reliability was tested. The game was tested on 60 nurses, followed by administration of the learner feedback form. To assess changes in empathy, an empathy scale was administered before the intervention and seven days after the intervention on 20 nurses.

RESULTS

The learner feedback form was found to have Cronbach's Alpha >0.70, and therefore reliable. The responses to the learner feedback form were analysed using the Chi Square test and were found to be positive and statistically significant (p-value<0.001). The differences in pretest and posttest empathy scores were analysed using the Wilcoxon Signed Ranks test and were found to be statistically significant as well (p-value<0.001).

CONCLUSIONS

The positive response to the learner feedback form, and the improvement in empathy scores after the intervention, indicates that games have a potential role in teaching empathy to Nursing Professionals.

Pedagogical strategies to improve emotional competencies in nursing students: A systematic review

OBJECTIVES

To reveal the effectiveness of didactic architectures and pedagogical strategies to be implemented in nursing curricula to develop and improve Emotional Competencies (EC) in undergraduate nursing students.

DESIGN

Systematic review of effectiveness conducted according to Joanna Briggs Institute (JBI) guidelines. We followed the PRISMA statement to guarantee the transparency of the review and the GRADE to report the strength of evidence.

DATA SOURCES

Seven databases were searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, EMBASE, PsycINFO and ERIC. Grey literature was also searched through the OpenGrey database.

REVIEW METHODS

Studies focusing on educational programmes and/or activities to develop EC in nursing curricula, published in English or Italian were included. Quality assessment of the studies was evaluated using JBI critical evaluation tools and the Mixed Methods Appraisal Tool (MAAT). Following JBI guidelines, a narrative synthesis was performed.

RESULTS

A total of 19 studies from 8 countries were included. The population varied from first to fourth-year students in relation to the duration of the undergraduate nursing program across the various countries. Most of the students were females. The age of the participants ranged between18 and 56 years. The most common pedagogical strategies were simulation, role playing, and face-to-face lessons. In some cases, studies combined two or three pedagogical strategies in the same intervention. The most effective strategy was simulation, which improved EC, compassion, self-awareness, self-efficacy, empathy, critical thinking, clinical practice skills, and teamwork skills. Furthermore, the combination of lessons, simulation, and literature exploration effectively developed communication skills, and improved students' satisfaction.

CONCLUSIONS

Investing in simulation, role-playing activities, and lessons regarding the importance of EI, empathy and compassion, and the role of an emotionally competent nurse leads to improved nursing care and wellbeing.

Reserving the human touch in nursing education while integrating virtual reality and simulation

In the ever-evolving landscape of nursing education, the integration of virtual reality (VR) and simulation technologies presents both promise and challenges. Although these innovative tools offer unparalleled opportunities for skill acquisition and clinical reasoning, concerns have arisen regarding the potential erosion of compassionate care at the core of nursing practice. The article explores the balance between technical proficiency and compassionate care in nursing education. The importance of comprehensive educator training in utilizing VR and simulation to instill humanistic values, along with the need for curriculum development that seamlessly integrates compassionate care throughout nursing programs, is underscored. By emphasizing the integration of empathy, emotional intelligence, and reflection into VR and simulation experiences, nursing education can ensure that graduates possess the skill sets and values essential for patient-centered practice. The preservation of human touch remains a priority and a cornerstone in the preparation of nursing professionals equipped to deliver holistic and empathetic care in an increasingly technology-driven healthcare landscape.

Use and Design of Virtual Reality-Supported Learning Scenarios in the Vocational Qualification of Nursing Professionals: Scoping Review

BACKGROUND

Numerous reviews advocate using virtual reality (VR) in educational contexts. This medium allows learners to test experiences in realistic environments. Virtually supported scenarios offer a safe and motivating way to explore, practice, and consolidate nursing skills in rare and critical nursing tasks. This is also cited as one of the reasons why VR can significantly increase the knowledge acquisition of nursing students. Nevertheless, studies are limited in their significance owing to the chosen design. Despite great interest, this results in a low level of confidence in VR as a curricular teaching method for nursing education. Therefore, defining concrete design and didactic-methodological parameters that support teachers in the use and implementation of VR is more relevant.

OBJECTIVE

This scoping review aims to provide an overview of significant design aspects for VR scenario conception and its transfer to generalist nursing education to generate value for the development of teaching scenarios and their sustainable implementation in teaching.

METHODS

A comprehensive literature search was performed using the MEDLINE (via PubMed) and CINAHL databases, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist was applied. The search was conducted from May to July 2022, using a specific search principle corresponding to the focus and the growing study corpus. A previously defined "population, concept, and context" scheme was employed as the basis for the double-blind review of all relevant international German and English publications released up to May 1, 2022.

RESULTS

In accordance with the predefined selection procedure, 22 publications were identified. The identified aspects aided in the development of design, didactic, and research recommendations. The intuitive operation of realistically designed VR scenarios, which are standardized, reliable, and modifiable, as well as clear instructions and specific multimodal feedback functions were described positively. The same applied to the linear structure of the sequences with graduated demands and high image quality for increased immersion with low sensory overload. Changes in perspectives, multiuser options, dialogs, and recording functions can contribute to an interactive care practice. On the research side, it is advisable to define VR terminologies. In addition to considering larger samples, varying settings, and financial issues, it is recommended to conduct long-term studies on knowledge acquisition or improved patient outcomes.

CONCLUSIONS

VR scenarios offer high potential in the context of nursing education if teachers and learners develop them co-creatively according to design features and implement them by means of a well-conceived concept. VR enables trainees to develop practical skills continuously in a standardized way. In addition, its deployment supports the sensitization of trainees to digital nursing technologies and the expansion of their digital skills in a practical setting. Furthermore, it allows sustainability issues to be addressed.

Exploring the Educational Value of an Immersive Virtual Reality Method Within a Continuing Education Module in Nursing: A Mixed Methods Study

BACKGROUND

Few studies have explored the potential educational value of immersive 360° video in continuing education. This study explored the potential value of immersive 360° video as an acceptable educational method in a continuing education module in nursing.

METHOD

A convergent parallel mixed methods design was adopted. The setting was a nursing and midwifery school at a university. The 11 participants were RNs. Data were collected at three time points with surveys and focus groups.

RESULTS

Participants found educational value in the triggering of a deep reflective process, supported by a subsequent classroom discussion. Further, there were nuances and complexities to be considered, with a need to tailor material toward high-acuity, low-frequency, or challenging clinical events when considering content.

CONCLUSION

Immersive 360° videos are a potentially useful method for providing continuing education; however, the content must be tailored to students' learning needs. A reflective model may provide a valuable structure for discussions after the use of immersive 360° video. [J Contin Educ Nurs. 2024;55(5):261-268.].

Assessing the effectiveness of virtual reality to promote empathy for patients through a mixed-methods study

OBJECTIVE

To describe the implementation and outcomes of EmpathyVR, an immersive experience using virtual reality (VR) to promote empathy for patients with physical limitations due to chronic diseases.

METHODS

First-year student pharmacists participated in a learning experience that incorporated VR and stiff gloves to simulate physical limitations associated with color-blindness and arthritis, respectively. Students completed pre- and post-intervention surveys that included the Kiersma-Chen Empathy Scale and measures of immersion, user enjoyment, perceived usefulness for learning, and adverse effects of the experience. A focus group was also conducted with 6 students to obtain additional feedback on the learning experience.

RESULTS

Of the 132 students who were enrolled in the program, 131 completed the assigned tasks; 117 of these agreed to participate in the study, and their data were included in the analyses. There was a significant improvement in empathy scores in the cognitive domain from pre- to post-intervention. Post-intervention survey results also demonstrated a high degree of immersion in the experience, high levels of self-reported enjoyment, and high levels of perceived usefulness of the activity to support learning. There was a low to moderate incidence of minor self-reported adverse effects from the activity. Focus group feedback was also positive. One student stated, "… it really allowed you to think and put yourself in their shoes."

CONCLUSION

Implementation of a VR-based learning activity into the first semester of the PharmD curriculum was successful and resulted in improved student empathy scores and a positive learning experience.

Experiencing COVID-19 Through the Patient Lens to Promote Empathy: Pilot Testing a Virtual Reality Learning Opportunity

Understanding the patient's experience with COVID-19 was essential to providing high-quality, person-centered care during the pandemic. Having empathy or being able to understand and respond to the patient's experience may lead to improved outcomes for both patients and clinicians. There is mixed evidence about how best to teach empathy, particularly related to promoting empathy during COVID-19. Literature suggests that virtual reality may be effective in empathy-related education. In collaboration with four patient partners with lived experience, a 360° VR video was developed reflecting their stories and interactions with the healthcare system. The aim of this study was to pilot test the video with interprofessional healthcare providers (HPs) to explore acceptability and utility, while also seeking input on opportunities for improvement. Eleven HPs reviewed the video and participated in one of three focus groups. Focus group data were analyzed using thematic analysis. Data suggest that video content is acceptable and useful in promoting a better understanding of the patient's experience. Building on these encouraging findings, additional iterations of videos to promote empathy will be developed and tested.

The effects of introducing virtual reality communication simulation in students' learning in a fundamentals of nursing practicum: A pragmatic randomized control trials

AIM

This study was conducted to examine the effectiveness of a virtual reality communication simulation (VRCS) in teaching communication skills in fundamentals of nursing practicum.

BACKGROUND

Effective communication skills are an integral part of the nursing profession and the foundation of high-quality nursing care. Effective communication not only addresses the needs of patients but is also necessary for maintaining patient safety. Many studies have reported the inadequacy of nursing students in communicating with patients. Nursing students often experience stress due to their lack of adequate skills to communicate effectively with patients and their family members.

DESIGN

A pragmatic randomized controlled trial research with four within-subjects assessments (at the baseline (T0), 1st week (T1) and 3rd week (T2) of the clinical practice and 1 week after the end of the clinical practice (T3)) and between-subjects assessments.

SETTINGS AND PARTICIPANTS

Eighty-four nursing students at a university of Science and Technology in central Taiwan.

METHODS

The students were randomly assigned to an experimental group (n = 42) and a control group (n = 42). The experimental group received a VRCS, whereas the control group received the nurse-patient communication teaching video. The data were collected from April 2022 to August 2022. The Kalamazoo Essential Element Communication Checklist, Communication Self-Assessment Scale, Learning Satisfaction Questionnaire and Stress Scale for Nursing Students in Clinical Practice were used for data collection.

RESULTS

At baseline, the control group had higher scores on communication ability and confidence compared with the experimental group (t = -3.91, p <.001; and t = -2.35, p =.021). In the first week of clinical practice, the experimental group had significantly higher mean scores for communication ability compared with the control group (β = 15.99, 95 % confidence interval [CI] 13.79, 18.18) and communication confidence and learning satisfaction compared with controls at T1, T2 and T3 of the clinical practice (all, p <.001). The clinical practice stress scores of the experimental group were significantly lower than those of the control group at T1, T2 and T3 of the clinical practice (all, p <.05).

CONCLUSIONS

The newly developed VRCS is acceptable and worthwhile for training nursing students to develop communication abilities. This study suggests that VRCS practice should be arranged as early as possible in fundamentals of nursing practice courses and before the fundamentals of nursing practicum so as to facilitate the learning of effective communication. Follow-up research is needed to evaluate the long-term effects of virtual reality education in nursing practice.

Use of Virtual Reality Simulations to Embody a Patient: Exploring the Impact on Nursing Students' Confidence, Feelings, and Perceptions

BACKGROUND

Using immersive virtual reality (VR), students are able to physically and emotionally embody patients while interacting in simulated environments with family and health care providers.

PURPOSE

This pilot study explored how embodying patients with Alzheimer disease and terminal cancer at end of life using highly immersive VR impacted nursing students' confidence, feelings, and perceptions.

METHODS

A quasi-experimental design was used with a convenience sample of bachelor of science in nursing students who completed pre/posttest scaled and open-ended questions.

RESULTS

Participants (N = 32) reported significant confidence increases; feelings about dying and hospice were also significantly changed. The majority described how the simulations would impact their future nursing care.

CONCLUSION

Using VR, students experienced disease, dying, and health care from the patient's perspective reporting differences in confidence, feelings, and perceptions. Immersive VR simulations warrant further study and have the potential to transform nursing education and impact health care.

New Ways to Help Patients Worst Off

AbstractThis introduction to The Journal of Clinical Ethics highlights and expands four articles within this issue that propose somewhat new and radical innovations to help and further the interests of patients and families worst off. One article urges us to enable historically marginalized groups to participate more than they have in research; a second urges us to allocate limited resources that can be divided, such as vaccines and even ventilators, in a different way; a third urges us to help families find greater meaning when their loved ones are dying; and a fourth urges us to treat patients who illegally use drugs as caringly as is possible, though there may be limits to what providers can do. This piece also addresses the importance of providers bonding with patients, recognizing that some providers may be better at eliciting patients' trust than others, and thus the importance of connecting these patients with these providers since this may be the sole way these patients can optimally respond and do well. Finally, providers taking time away from their patients to oppose and reduce social stigma is considered.

Circadian-like patterns in electrochemical skin conductance measured from home-based devices: a retrospective study

In this study, we investigated the potential of electrochemical skin conductance (ESC) measurements gathered from home-based devices to detect circadian-like patterns. We analyzed data from 43,284 individuals using the Withings Body Comp or Body Scan scales, which provide ESC measurements. Our results highlighted a circadian pattern of ESC values across different age groups and countries. Our findings suggest that home-based ESC measurements could be used to evaluate circadian rhythm disorders associated with neuropathies and contribute to a better understanding of their pathophysiology. However, further controlled studies are needed to confirm these results. This study highlights the potential of digital health devices to generate new scientific and medical knowledge.

Artificial intelligence technologies and compassion in healthcare: A systematic scoping review

Background

Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.

Objectives

The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?

Materials and methods

A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.

Results

Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan-Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.

Conclusion

There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.

Implications

In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.

Effects of a virtual reality intervention on dementia care education among acute care nurses in Japan: A non-randomised controlled trial

This study aimed to evaluate the effects of a virtual reality intervention for dementia care education in Japanese acute care nurses. Non-randomised controlled trial was used to assess the effectiveness of the intervention pre- and post-intervention and at a 1-month follow-up. This study enrolled 20 and 19 nurses in the intervention and control groups, respectively. Generalized estimating equation analyses revealed significant differences in scores on the Dementia Nursing Competency Scale in Acute Hospitals and Staff Experiences of Working with Dementia Residents questionnaire in the intervention group. A post hoc test revealed significantly higher scores on the Dementia Nursing Competency Scale in Acute Hospitals at 1 month after compared with pre-intervention. Staff Experiences of Working with Dementia Residents questionnaire scores were significantly lower at pre- than that at post-intervention and 1 month after intervention. These findings could improve competency of dementia nursing care and attitudes toward people with dementia.

First-year nursing students' initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity

Background

Research shows that the clinical learning environment can affect medical learners’ levels of empathy and formation of professional identity. However, few studies examined the impacts of early exposure to the clinical learning environment on first-year nursing students’ empathy levels and professional identity perceptions.

Aim

This study aimed to explore effects of initial contact with the clinical learning environment on first-year nursing students’ empathy levels and perceptions of professional identity.

Methods

This is a mixed-methods study conducted in a medical university and its affiliated hospital in Northeast China. For quantitative analysis, 220 first-year nursing students finished Interpersonal Reactivity Index (IRI) twice before and after their five-day clinical placement in the hospital in June, 2021. Paired samples t tests were used to explore the changes in first-year nursing students’ cognitive empathy, affective empathy and total empathy levels as measured by IRI before and after the clinical placement. For qualitative analysis, 15 first-year nursing students’ diary recording their clinical learning experiences were analyzed. An inductive thematic analysis approach was adopted to extract themes from the content on professional identity in nursing students’ diary.

Results

After the five-day clinical placement, first-year nursing students’ cognitive empathy, affective empathy and total empathy levels all increased. Five themes emerged regarding nursing students’ perceptions of professional identity: (1) Love for the nursing profession; (2) Multiple roles nurses play; (3) Personal characteristics a good nurse needs to have; (4) Deeper understanding of the nursing profession; (5) New understanding of the relationships between patients and nurses, between patients and doctors, and between doctors and nurses.

Conclusions

First-year nursing students’ initial contact with the clinical learning environment helped them enhance empathy levels and shape professional identity. Nursing educators may consider providing nursing students with opportunities of early exposure to the clinical learning setting to cultivate their empathy and develop their professional identity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01016-8.

A Pilot Study to Investigate the Role of Virtual Reality in the Preservice Training of Nursing Staff in Isolation Wards

Healthcare providers without working experience in isolation wards experience enormous challenges. Traditional ward orientation is constrained by space, time, and even infection risk in particular periods (eg, the coronavirus disease 2019 pandemic). Virtual reality has been used widely, but rarely in wards. This study aimed to explore the experience of utilizing virtual reality for isolation ward training among nurses. In this study, nurses completed virtual reality training via an online platform and were then trained in isolation wards, after which their perceptions were explored by questionnaire and interviews. A total of 1868 participants completed the training. Most participants thought the preservice training was important and believed the virtual reality experience was consistent with the in-person training. Virtual reality was found not only to be convenient and valuable for training but also to have the benefits of occupational protection. However, whereas 50.48% of participants wanted to learn the ward via virtual reality, 87.21% of participants wanted to learn via in-person training before working in the wards. As a substitute for in-person training, virtual reality is a feasible and practical instrument to provide preservice training in particular periods. However, there is room for improvement due to general discomfort and technological problems.

AI-Driven Virtual Simulation for Packaging Customization

Recently, virtual reality technology has been paid attention to by the researchers from various fields. With the help of virtual reality technology, packaging customization environment can be simulated more intuitively. Thus, the workers can understand the structural layout in the packaging process, be familiar with the packaging workflow, and know how to deal with emergencies. These will effectively solve the impact of workers' misoperation on packaging quality and waste, and also avoid a series of issues caused by careless operations. This paper adopts artificial intelligence (AI) technology to simulate the packaging customization environment. Experiments show that the packaging customization environment can be simulated by AI technology effectively.

Non-academic factors influencing the development of empathy in undergraduate nursing students: a cross-sectional study

BACKGROUND

Empathy is described as a core competence of nursing. There is abundant research evidence supporting that empathy varies according to personal characteristics and targeted training. The aim of this study was to characterize non-academic factors (personal and environmental) influencing the development of empathy in undergraduate nursing studies who are not receiving a targeted training in empathetic abilities in their nursing schools.

METHODS

A cross-sectional study was performed in the three nursing schools located in Cusco city, Peru (two private and one public). The Jefferson Scales of Empathy, Attitudes toward Physician-Nurse Collaboration, and Lifelong Learning, the Emotional Loneliness Scale for Adults, and the Scale of Life Satisfaction, were applied as the main measures. Also, information regarding gender, nursing school, and age, were collected. After psychometric properties were assessed, all measures were used in the development of a multivariate regression model to characterize factors of influence in empathy.

RESULTS

In a sample composed by 700 undergraduate nursing students (72 males and 628 females), a multivariate linear regression model was created. This model explained the 53% of variance of empathy and fitted all conditions necessary for inference estimations. Teamwork abilities, loneliness, age, sex, subjective well-being, and nursing school, appeared as factors influencing the development of empathy in patients' care.

CONCLUSIONS

Findings have indicated that, in absence of a targeted training, individual characteristics and characteristics associated with social and family environments play an important role of influence in the development of empathy in nursing students. These findings are also in consonance with others previously reported in different cultural settings including high-, middle- and low-income countries.

Incorporating virtual reality in nurse education: A qualitative study of nursing students' perspectives

BACKGROUND

Recent challenges to nurse education have resulted in an increased use of virtual reality which serves as an immersive and effective medium for skill and knowledge acquisition. Virtual reality technology is being included in nurse curricula at undergraduate level. This technology remains a relatively new experience for many nursing students with limited evidence regarding students' perspectives regarding virtual reality.

OBJECTIVE

To explore nursing students' perspectives of incorporating virtual reality in nurse education.

DESIGN

Qualitative descriptive study using thematic analysis.

SETTING

Public university in Ireland.

PARTICIPANTS

Undergraduate nursing students were recruited using purposive and snowball sampling.

METHODS

Students (n = 26) participated in face-to-face semi-structured individual interviews and focus groups in January and February 2020. Data were analysed using inductive thematic analysis.

RESULTS

Three themes were constructed from the interviews: captivating, innovative, and empowering nature of virtual reality; contextual transfer; and challenges and threats to actualisation. Participants believed that virtual reality affords a novel, fun, memorable, inclusive, and engaging means of learning. Many believed that virtual reality would complement current teaching and learning approaches, help build learners' confidence, and provide nursing students with a safe space for trial, error, and problem-solving. The use of virtual reality was recommended to practise various nursing skills and learn about human anatomy, physiology, problem-solving, and clinical decision-making. Participants identified the resources incurred by the technology as challenges to implementing virtual reality in nurse education and stressed the need for continuous face-to-face feedback.

CONCLUSIONS

Findings suggest that virtual reality technology has the potential to facilitate learning, complement current educational approaches, and provide nurse educators with novel and engaging means of content delivery.

Impact of immersive virtual reality simulations for changing knowledge, attitudes, and behaviors

BACKGROUND

Virtual reality has promise as a training method within the affective domain, but investigation is still needed for intention to change behaviors based on social determinants of health.

OBJECTIVE

The objective of this study was to describe the self-reported changes in knowledge and/or attitudes and planned behavior changes by healthcare workers for their future care of persons with challenges to their social determinants of health following completion of a first-person virtual reality experience.

DESIGN

A descriptive qualitative design was used.

SETTINGS

This study was conducted in clinics and private practice settings in Ohio (United States).

PARTICIPANTS

This study was conducted with 206 healthcare workers.

METHODS

Participants completed a virtual reality simulation followed by qualitative, open-ended questions about changes to their knowledge, attitudes, and behaviors. Responses were analyzed using a content analysis method.

RESULTS

Four overarching themes were derived from the qualitative data: (1) Acknowledgement of Social Determinants of Health, (2) An Improved Provider Experience for Patients, (3) Patient as a Person with Complex Needs, and (4) The Learning Experience.

CONCLUSION

Findings suggest virtual reality has strong merits for impacting affective domain of learning demonstrated by increased empathy. Virtual reality along with increased empathy also helps improve attitudes and behaviors for the betterment of patients.

What place does nurse-led research have in the COVID-19 pandemic?

AIM

Reflect upon the visibility of nursing-led research during the COVID-19 pandemic.

BACKGROUND

The emerging SARS-CoV-2 infection has galvanized collaborative and multidisciplinary efforts in clinical and research practice worldwide. The scarce evidence-base to manage patients with COVID-19 has included limited nurse-led research.

INTRODUCTION

Clinical research nurses have greatly contributed to the delivery of COVID-19 research, yet the number of COVID-19 nursing-led research papers appears to be limited, with even fewer nurse-led research projects funded.

METHODS

Authors' views and PubMed search on 'COVID-19 and nursing'.

FINDINGS

There is a dearth of nursing-led research. Most papers describe the nursing contribution to COVID-19 care, changes in nursing working arrangements and emotional burden. There are opportunities to explore the consequences to vulnerable population groups of public health measures implemented to stop the progress of the COVID-19 pandemic.

DISCUSSION

Workforce gaps, limited integration in research structures and clinical redeployment may have hampered nurse-led research. COVID-19 may exacerbate staffing deficits by disrupting the education pipeline, obstructing the transition from clinical to academic practice, particularly in areas where clinical academic roles are yet to emerge.

CONCLUSION

The absence of nurse-led research in COVID-19 can be explained by chronic, underlying factors and the features of the pandemic response. Emerging models of care, effective staffing and inequalities related to COVID-19 appear obvious research areas. Nursing leadership needs to strengthen its political voice and lobbying skills to secure nurse-led research funding.

IMPLICATIONS FOR NURSING POLICY

Embracing international nursing research, strengthening collaborations and lobbying policymakers for investment in nurse-sensitive research would enhance the response to COVID-19.