Effectiveness of three-dimensional visualisation on undergraduate nursing and midwifery students' knowledge and achievement in pharmacology: A mixed methods study

Quality and impact of pharmacology digital simulation education on pre-registration healthcare students: A systematic literature review

OBJECTIVE

This review aimed to assess the quality and nature of the literature related to digital simulation-based pharmacology education. Specifically, we sought to understand the influence of simulations on the knowledge, satisfaction, and confidence of pre-registration nurses and other healthcare students participating in such educational programs.

DESIGN

Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. This study was registered in the Prospective Register of Systematic Reviews (PROSPERO, reg no: CRD42023437570).

DATA SOURCES

PubMed, MEDLINE, APA PsycInfo, ProQuest, Web of Science, ScienceDirect, and CINHAL databases were searched.

REVIEW METHODS

The review focused on the quantitative findings from the studies published from 2016 to 2023. Only the studies that assessed the impact of digital simulation-based pharmacology education on pre-registration healthcare students' knowledge, satisfaction, and confidence were selected for review. Data were synthesized using a narrative approach. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included articles. This was followed by a narrative synthesis to consolidate the themes.

RESULT

Out of 1587 articles,16 met the inclusion criteria. A wide variety of digital technologies have been utilised, such as virtual simulation, computer simulation (2D/3D), mixed reality, and augmented reality, with the majority using virtual simulation. All studies implemented single-user simulations. The themes emerging from the narrative synthesis suggest that a digital simulation-based pharmacology course is an effective tool for enhancing students' knowledge, confidence, and satisfaction in learning pharmacological concepts. Furthermore, simulation-based teaching with a blended approach was found to be beneficial. However, the integration of the polypharmacy concept and the intra and interprofessional approach to teaching and learning was not evident in these studies.

CONCLUSION

This systematic literature review provides evidence of the potential of digital simulation-based education in pharmacology teaching among healthcare pre-registration students. In future studies, the integration of polypharmacy content with an intra and interprofessional teaching-learning approach is recommended.

Effectiveness of Virtual Reality Simulation Among BSN Students: A Meta-analysis of Randomized Controlled Trials

This study aimed to evaluate the effect of virtual reality simulation in nursing education in five domains: knowledge, skill performance, self-confidence, self-efficacy, and satisfaction. Randomized controlled trials were obtained from the databases SCOPUS, Web of Science, PubMed, and EBSCO from inception until September 2021. The standardized mean differences with 95% confidence intervals were determined for the main variables, and heterogeneity was analyzed using the I2 test. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used. Meta-analysis was performed using the Stata 15.0 software. Among the 2074 records identified, 18 trials were included. The meta-analysis of these trials indicated that virtual reality simulation caused a significant improvement in knowledge with a moderate effect, skill performance with a moderate effect, and satisfaction with a moderate effect compared with the control group. However, virtual reality simulation did not significantly influence self-confidence and self-efficiency. The findings of this study suggested that virtual reality simulation might significantly benefit knowledge, skill performance, and satisfaction but not self-confidence and self-efficiency. Further well-designed randomized controlled trials with a larger sample size are recommended to confirm these findings.

Impact of Virtual Reality on Pharmacology Education: A Pilot Study

Introduction Virtual reality (VR) is a powerful tool in health professional education. It has been successfully implemented in various domains of education with positive learning outcomes. The three-dimensional (3D) visualization offered by VR can potentially be applied to learn complex pharmacology topics. This study aims to investigate whether VR technology can improve the learning of complex pharmacological concepts. Methods A VR learning module on cardiovascular drugs was developed using Kern's six-step framework. 32 medical students participated in the pilot study. Their pharmacology knowledge was assessed using pre- and post-intervention tests. Additionally, feedback from the participants were collected through a post-intervention survey that assessed learner satisfaction, ease of use, perceived usefulness, quality of visual elements, intention to use, and comfort level during the VR experience. Results Participants scored significantly higher in the post-intervention test than in the pre-intervention test (p <0.05). A majority of the participants (90%) were satisfied with the VR module, finding it easy to use, and time efficient. A minority of participants (15%) preferred a traditional learning format while some participants (20%) experienced discomfort in VR. Conclusion Our findings suggest that VR enhances pharmacology knowledge in medical students and is well-received as an innovative educational tool. By providing immersive 3D visualization of complex drug actions, VR has the potential to transform pharmacology education into an engaging and effective learning experience.

Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study

OBJECTIVES

Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education.

METHODS

An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis.

RESULTS

Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)).

CONCLUSION

Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.

Use of virtual reality compared to the role-playing methodology in basic life support training: a two-arm pilot community-based randomised trial

INTRODUCTION

Virtual reality (VR) is a technology that allows us to replace our real environment with one created with digital media. This technology is increasingly used in the training of healthcare professionals, and previous studies show that the involvement and motivation of students who participate in activities that use VR increases compared to those who undergo training with the traditional methodology. The main aim of the study is to evaluate the learning curve of the students using a VR environment, to evaluate the satisfaction with the training activity and the cost, and to compare them with training that uses role-playing methodology.

METHODOLOGY

Two-arm community-based randomised trial. The control arm will base the training on the usual role-playing methodology. The second arm or intervention arm will base the Basic Life Support (BLS) training on a VR programme.

RESULTS

Statistically significant differences are observed in the percentage of correct answers in favour of the group that used VR as a learning methodology in the test taken at the end of the course. These differences disappear when comparing the results of the test performed at six months. The satisfaction rating of the role-playing training activity has a score of 9.37 out of a total of 10 and satisfaction with the VR methodology has a score of 9.72. The cost analysis shows that the cost of training a student by role-playing is 32.5 euros and, if trained by VR, it is 41.6 euros.

CONCLUSIONS

VR is a tool that allows the consolidation of a greater amount of knowledge in the short term and can be used for situations such as pandemics, where traditional formats are not available. In relation to student satisfaction with the training activity, the rating in both groups is very high and the differences are minimal. The results will be directly applicable to the decision making of BLS training in Central Catalonia in relation to the scheduling of training activities that use the VR methodology in an uncertain environment.

Characterizing effective teaching in nursing pharmacology YouTube videos: A mixed methods study

BACKGROUND

Pharmacology is a vital course in nursing involving numerous concepts, making it challenging for educators and students to teach and learn the course, respectively. As YouTube videos become a powerful academic resource in understanding challenging courses, most studies demonstrate that online educational videos effectively improve students' learning process. However, what makes these videos effective in teaching has yet to be discovered.

OBJECTIVES

This paper typified the teaching strategies of nursing pharmacology YouTube videos to manage cognitive load and promote student engagement. Additionally, the use of these strategies was correlated with the videos' Video Power Indexes [VPIs].

METHODS

This study employed a mixed methods design. 52 YouTube videos about nursing pharmacology were used for analysis. Watching these videos generated transcriptions to typify teaching strategies using thematic content analysis. Quantitative parameters such as likes, dislikes, and videos were computed to get the Video Power Index [VPI]. VPI of the videos was correlated with the identified strategies using Pearson's correlation coefficient (r).

RESULTS

With the comprehensive characterization of strategies from the videos, this study uncovered two themes, Infoxication Antagonists and Attention Agonists, as the composition of the V-CAPS: Video's Constructive and Adaptive Pedagogical Strategies. This model describes how nurse YouTubers simplify complex pharmacology concepts while maintaining the viewers' concentration in watching the videos. Results also revealed that Infoxication Antagonists and the duration of the videos have significantly moderate influence, and Attention Agonists have a significantly weak correlation with the VPIs.

CONCLUSION

The study's findings present teaching strategies to reduce cognitive load and promote student engagement. These can provide valuable insights for nursing educators in teaching the course and using videos to promote the students' optimum learning.

Comparing virtual reality, desktop-based 3D, and 2D versions of a category learning experiment

Virtual reality (VR) has seen increasing application in cognitive psychology in recent years. There is some debate about the impact of VR on both learning outcomes and on patterns of information access behaviors. In this study we compare performance on a category learning task between three groups: one presented with three-dimensional (3D) stimuli while immersed in the HTC Vive VR system (n = 26), another presented with the same 3D stimuli while using a flat-screen desktop computer (n = 26), and a third presented with a two-dimensional projection of the stimuli on a desktop computer while their eye movements were tracked (n = 8). In the VR and 3D conditions, features of the object to be categorized had to be revealed by rotating the object. In the eye tracking control condition (2D), all object features were visible, and participants' gaze was tracked as they examined each feature. Over 240 trials we measured accuracy, reaction times, attentional optimization, time spent on feedback, fixation durations, and fixation counts for each participant as they learned to correctly categorize the stimuli. In the VR condition, participants had increased fixation counts compared to the 3D and 2D conditions. Reaction times for the 2D condition were significantly faster and fixation durations were lower compared to the VR and 3D conditions. We found no significant differences in learning accuracy between the VR, 3D, and 2D conditions. We discuss implications for both researchers interested in using VR to study cognition, and VR developers hoping to use non-VR research to guide their designs and applications.

Mixed reality-based online interprofessional education: a case study in South Korea

PURPOSE

The purpose of this study was to explore undergraduate medical and nursing students' satisfaction with their mixed reality (MR)-based online interprofessional learning experience in South Korea.

METHODS

This study used a case study design. A convenience sample of 30 participants (i.e., 15 third-year medical students and 15 fourth-year nursing students) participated in a 120-minute MR-based online interprofessional education (IPE) that consisted of visualization of holographic standardized patient with ischemic stroke, online interprofessional activity, and debriefing and reflection sessions. Following the MR-based online IPE, data were collected through Modified Satisfaction with Simulation Experience Scale survey and were analyzed using descriptive analyses and independent t-tests.

RESULTS

Although medical and nursing students were highly satisfied with MR-based online interprofessional learning experience, nursing students were significantly more satisfied with it compared with medical students.

CONCLUSION

These results suggest that the integration of MR and online approach through the structured clinical reasoning process in undergraduate health professions programs can be used as an educational strategy to improve clinical reasoning and critical thinking and to promote interprofessional understanding.

Experiencia Second Life para la enseñanza de la Educación Física

El artículo que se presenta a continuación ofrece una explicación de la puesta en práctica de una propuesta didáctica innovadora en el aula de Educación Física de la Universidad a Distancia de Madrid con alumnos del Grado de Magisterio en Educación Primaria. Con el objetivo de que los estudiantes de esta materia puedan exponer y realizar de forma práctica ejercicios motrices se utiliza el mundo virtual Second Life como escenario. Los estudiantes que, de forma voluntaria, quisieron participar tuvieron 15 minutos para exponer las tareas en el territorio Sandbox. Las sesiones se realizaron durante el mes de mayo, los lunes y miércoles por la tarde. Durante el mes de abril se realizó un pequeño estudio con el objetivo de conocer la satisfacción de los participantes. Los resultados muestran que la experiencia despertó en los alumnos el interés por la materia, que la inmersión les proporcionó un mayor aprendizaje y que se sintieron más cercanos a la práctica docente. De esta forma se concluye que Second Life es una herramienta válida para tratar algunos contenidos del área de Educación Física en la universidad, proporcionando experiencias divertidas y bien valoradas.

The Use of Virtual Reality to Improve Disaster Preparedness Among Nursing Students: A Randomized Study

BACKGROUND

Disaster response inevitably challenges the capacity and capability of nurses. Nursing students are an important reserve force in disaster response; hence, disaster preparedness is increasingly needed.

METHOD

A two-arm randomized controlled trial was adopted. Forty-nine nursing students were assigned into the virtual reality (VR) groups, and 52 were allocated into the control group. Data were collected at baseline and at the end of the study.

RESULTS

After adjustments for basic characteristics, the effects of VR groups on disaster preparedness (F(1,94) = 11.049, p = .001, ηp² = 0.105), confidence (F(1,94) = 6.992, p = .010, ηp² = 0.069) and performance (F(1,94) = 4.298, p = .041, ηp² = 0.044) were assured.

CONCLUSION

Integrating VR groups into the nursing curriculum on disaster response could enhance disaster preparedness, confidence, and performance among nursing students. VR groups represent a cost-effective modality of simulation in nursing education, which could bridge the gap between the lack of disaster training and the high demands for disaster preparedness. [J Nurs Educ. 2022;61(2):93-96.].

The impact of three-dimensional visualisation on midwifery student learning, compared with traditional education for teaching the third stage of labour: A pilot randomised controlled trial

BACKGROUND

Complex physiological processes are often difficult for midwifery students to comprehend when using traditional teaching and learning approaches. Face to face instructional workshops using simulation have had some impact on improving understanding. However, in the 21st century new technologies offer the opportunity to provide alternative learning approaches.

AIM

To investigate the impact of using three-dimensional (3D) visualisation in midwifery education on student's experience of learning, and retention of knowledge at three points in time.

DESIGN

A pilot study involving a two-armed parallel Randomised Controlled Trial (RCT) comparing the retention of knowledge scores between the control and intervention groups.

SETTING

An Australian University in the Northern Territory.

PARTICIPANTS

The sample included second year Bachelor of Midwifery students (n = 38). All received traditional midwifery education before being randomly allocated to either the intervention (n = 20) or control (n = 18) group.

METHODS

A new immersive virtual environment was introduced to complement existing traditional midwifery education on the third stage of labour. This intervention was evaluated using a demographic survey and multiple-choice questionnaire to collect baseline information via Qualtrics. To measure change in knowledge and comprehension, participants completed the same multiple-choice knowledge questionnaire at three time points; pre, immediately post and at 1 month post intervention. In addition, the intervention group completed a 3D student satisfaction survey.

RESULTS

Baseline knowledge scores were similar between the groups. A statistically significant increase in knowledge score was evident immediately post intervention for the intervention group, however there was no significant difference in knowledge score at one month.

CONCLUSIONS

The results support the creation of further three-dimensional visualisation teaching resources for midwifery education. However, a larger randomised controlled study is needed to seek generalisation of these findings to confirm enhanced student learning and retention of knowledge post 3DMVR, beyond the immediate exposure time.

Virtual reality-based neurological examination teaching tool(VRNET) versus standardized patient in teaching neurological examinations for the medical students: a randomized, single-blind study

BACKGROUND

The conventional methods for teaching neurological examination with real patients to medical students have some limitations if the patient with the symptom or disease is not available. Therefore, we developed a Virtual Reality-based Neurological Examination Teaching Tool (VRNET) and evaluated its usefulness in in teaching neurological examinations for the medical students.

METHODS

In this prospective, randomized, single-blind study, we recruited 98 medical students and divided them into two groups: 1) A standardized patient(SP) group that received the clinical performance examination utilizing standard patients complaining of dizziness was provided neurological findings using conventional method such as verbal description, photographs, and video clips; 2) A SP with VRNET group that was provided the neurological findings using the newly developed tool. Among the 98 students, 3 did not agree to participate, and 95 were enrolled in this study. The SP group comprised 39 students and the SP with VRNET group had 56 students.

RESULTS

There were no statistical differences in VRNET's realness and student satisfaction between the SP and SP with VRNET groups. However, a statistically significant difference was found in the Neurologic Physical Exam (NPE) score (p = 0.043); the SP with VRNET group had higher NPE scores (3.81 ± 0.92) than the SP group (3.40 ± 1.01).

CONCLUSIONS

VRNET is useful in teaching senior (graduating) medical students with SP with a neurologic problem.

Virtual reality teaching in chemotherapy administration: Randomised controlled trial

AIMS AND OBJECTIVES

This study examined the effect of virtual reality (VR)-based documents (VRdocs) on knowledge and attitude towards chemotherapy administration in nursing students.

BACKGROUND

Chemotherapeutic drugs in cancer patients are a complicated and dangerous process. However, despite the high toxicity of the chemotherapeutic drugs, the compulsory or internship courses in nursing schools do not include training in operational chemotherapeutics and its associated safety measures.

DESIGN

A randomised controlled trial based on the CONSORT 2010 guidelines (registry number: NCT03707210).

METHOD

A total of 77 students were randomised to an experimental (VRdocs, n = 38) or a control group (n = 39). Pre- and posttest data were collected. After the pretest, the control group received the education documents, whereas, the experimental group used VR software consisting of an application about chemotherapy administration. Finally, the effectiveness of the intervention was self-evaluated using questionnaires after 7 days.

RESULTS

The posttest scores for knowledge (F = 6.412, p = .013) and attitude in the experimental group were significantly different from those in the control group (F = 8.469, p = .005). Compared with the control group, a significant number of students in the experimental group indicated their higher recommendation score for the VRdocs (p = .0001).

CONCLUSION

Schools must provide a variety of handouts and teaching methods to educate nursing students about high-risk nursing techniques. Methods using VR can address the shortcomings of the traditional documents, and the use of both methods simultaneously can produce better learning results.

RELEVANCE TO CLINICAL PRACTICE

Virtual reality based documents were provided to the participants to understand the preparation, implementation, and safety of chemotherapy. VRdocs allow students to re-learn high-risk care techniques without the influence of time and space and may prove useful for other nursing courses.

The effects of a virtual learning environment compared with an individual handheld device on pharmacology knowledge acquisition, satisfaction and comfort ratings

BACKGROUND

Virtual reality is reported to improve post-intervention knowledge and skills outcomes of health professionals compared to traditional teaching methods or digital online media. However, providing equitable access to high quality virtual reality resources for large, diverse nursing and midwifery student cohorts within multi-campus settings remains challenging.

OBJECTIVES

This study compared the effect on student learning, satisfaction and comfort following exposure to a three-dimensional pharmacology artefact in a virtual facility (CAVE2™)¹ with viewing of the same artefact using a mobile handheld device with stereoscopic lenses attached.

DESIGN

The study used a pretest-posttest design.

SETTING

School of Nursing and Midwifery in a regional university in Southeast Queensland, Australia.

PARTICIPANTS

Two hundred and forty-nine second year undergraduate nursing and midwifery students.

METHODS

Online multiple choice tests were deployed to measure knowledge acquisition. Self-reported satisfaction scores and comfort ratings were collected using questionnaires.

RESULTS

Participants were not disadvantaged in terms of knowledge acquisition by using either CAVE2™ or the mobile handheld visualisation mode (P = 0.977). Significant differences in favour of the CAVE2™ environment were found in between students' satisfaction scores for clinical reasoning (P = 0.013) and clinical learning (P < 0.001) compared to the handheld mode, and there were no significant differences in their satisfaction with debriefing and reflective practice processes (P = 0.377) related to undertaking visualisation activities. A small number of students using handheld devices with stereoscopic lenses reported greater discomfort in relation to the visualisation that negatively impacted their learning (P = 0.001).

CONCLUSION

Three-dimensional artefacts using mobile devices is promising in terms of cost-effectiveness and accessibility for students with restricted access to on-campus teaching modes.