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Jensen RAA, Musaeus P, Pedersen K. Virtual patients in undergraduate psychiatry education: a systematic review and synthesis. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:329-347. [PMID: 37294380 DOI: 10.1007/s10459-023-10247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/28/2023] [Indexed: 06/10/2023]
Abstract
Virtual patients are increasingly used in undergraduate psychiatry education. This article reports on a systematic review aimed at providing an overview of different approaches in this context, describing their effectiveness, and thematically comparing learning outcomes across different undergraduate programs. The authors searched PubMed, PsycInfo, CINAHL, and Scopus databases for articles published between 2000 and January 2021. Quantitative and qualitative studies that reported on outcomes related to learners' knowledge, skills, and attitudes following an intervention with virtual patients in undergraduate psychiatry education were reviewed. Outcomes were thematically compared, and a narrative synthesis of the different outcomes and effectiveness was provided. Of 7856 records identified, 240 articles were retrieved for full-text review and 46 articles met all inclusion criteria. There were four broad types of virtual patient interventions: case-based presentation (n = 17), interactive virtual patient scenarios (n = 14), standardized virtual patients (n = 10), and virtual patient videogames (n = 5). The thematic analysis revealed that virtual patients in psychiatry education have been used for learners to construe knowledge about symptomatology and psychopathology, develop interpersonal and clinical communicative skills, and to increase self-efficacy and decrease stigmatizing attitudes towards psychiatric patients. In comparison with no intervention, traditional teaching, and text-based interventions, virtual patients were associated with higher learning outcomes. However, the results did not indicate any superiority of virtual patients over non-technological simulation. Virtual patients in psychiatry education offer opportunities for students from different health disciplines to build knowledge, practice skills, and improve their attitudes towards individuals with mental illness. The article discusses methodological shortcomings in the reviewed literature. Future interventions should consider the mediating effects of the quality of the learning environment, psychological safety, and level of authenticity of the simulation.
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Affiliation(s)
- Rikke Amalie Agergaard Jensen
- Research Unit of Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Centre for Involvement of Relatives, Mental Health Services Region of Southern Denmark, Vejle, Denmark.
| | - Peter Musaeus
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
| | - Kamilla Pedersen
- Centre for Educational Development (CED), Aarhus University, Aarhus, Denmark
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Kim GM, Lim JY, Kim EJ, Yeom M. Impact of Virtual Reality Mental Health Nursing Simulation on Nursing Students' Competence. J Multidiscip Healthc 2024; 17:191-202. [PMID: 38226028 PMCID: PMC10789577 DOI: 10.2147/jmdh.s435986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/27/2023] [Indexed: 01/17/2024] Open
Abstract
Purpose This study investigates the impact of a Virtual Reality (VR)-based Mental Health Nursing Practice Simulation (MHNPS) on nursing students' competency in caring for individuals with mental disorders. Nursing students often face fear, anxiety, and helplessness during mental health (MH) rotations, impeding the attainment of learning objectives in the MH nursing practicum. Therefore, innovative strategies offering practice opportunities are crucial for their competence development. Methods Using a one-group pretest-posttest repeated measures experimental design, 50 nursing students, having completed at least one MH theory course but not yet engaged in MH clinical practicum, were enrolled. Data collection occurred from October 30, 2022, to January 6, 2023. The VR simulation included six modules covering delusion, hallucination, mania, geriatric depression, adolescent depression with suicidal ideation, and obsessive-compulsive disorder. Pre-simulation questionnaires and post-simulation surveys were administered through provided links. Data were analyzed using descriptive statistics and paired t-tests to assess changes over time. Results Immediate and sustained improvements were observed in mental disorder-related nursing knowledge, communication self-efficacy, critical thinking ability, and MH nursing clinical confidence. Attitudes toward mental illness improved significantly post-intervention (t=-2.22, p=0.031), while the problem-solving process exhibited significant enhancement six weeks later (t=3.87, p<0.001). Conclusion The findings affirm the simulation intervention's effectiveness in enhancing nursing students' knowledge, self-efficacy, critical thinking, and confidence in MH nursing practice, with no compromise to patient safety. Integrating simulation into MH nursing practicum narrows the gap between theory and clinical practice, elevates MH care quality, and instills confidence in nursing students as professionals. Despite potential subject selection bias in this single-group pre-post intervention study, the program's comprehensive impact on knowledge, skills, and attitudes suggests opportunities for expanding psychiatric nursing practice capabilities through subsequent studies. Caution is warranted in interpreting results, but the developed program lays the groundwork for advancing nursing students' capabilities in psychiatric nursing practice.
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Affiliation(s)
- Geun Myun Kim
- Department of Nursing, Gangneung-Wonju National University, Gangwon-do, South Korea
| | - Ji Young Lim
- Department of Nursing, Inha University, Incheon, South Korea
| | - Eun Joo Kim
- Department of Nursing, Gangneung-Wonju National University, Gangwon-do, South Korea
| | - Mijung Yeom
- Department of Nursing, Catholic Kwandong University, Gangwon-do, South Korea
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Hlahla LS, Ngoatle C, Kgatla MN, Mathapo-Thobakgale EM. Challenges Faced by University of Limpopo Learner Nurses during Psychiatry Clinical Exposure: A Qualitative Study. NURSING REPORTS 2024; 14:164-173. [PMID: 38251192 PMCID: PMC10801619 DOI: 10.3390/nursrep14010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Clinical exposure of learner nurses to psychiatric hospitals is a requirement by the South African Nursing Council. Clinical experience helps learner nurses build cognitive and affective skills, cultural acculturation, and professional identity. The clinical placement also aids nursing learner nurses in making decisions regarding future career paths. The goal of psychiatric nursing practice is to enhance mental and physical health and improve the patient's quality of life and rehabilitation. A qualitative research approach was followed, and a descriptive, explorative, and contextual design was used in this study to explore the challenges faced by University of Limpopo learner nurses during psychiatry clinical exposure. The population included learner nurses from level two to level four who registered for psychiatric nursing science practice. Convenience sampling was adopted. Semi-structured interviews were used to collect data, and the data were analyzed using the Tesch open coding method. Measures to ensure trustworthiness were adhered to, and ethical considerations were observed. The findings of this study indicated that learner nurses go through challenges and discomfort in the form of mental health care users, clinical environment matters, and the attitude of clinical staff in the hospital. Proper preparation of the learner nurses and clinical areas can assist in reducing the challenges that learner nurses go through.
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Affiliation(s)
- L. S. Hlahla
- Department of Nursing Sciences, University of Limpopo, Polokwane 0700, South Africa
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Woon LSC, Mohd Daud TI, Tong SF. "It kinda helped us to be there": students' perspectives on the use of virtual patient software in psychiatry posting. BMC MEDICAL EDUCATION 2023; 23:851. [PMID: 37946151 PMCID: PMC10636819 DOI: 10.1186/s12909-023-04834-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND At the Faculty of Medicine of the National University of Malaysia, a virtual patient software program, DxR Clinician, was utilised for the teaching of neurocognitive disorder topics during the psychiatry posting of undergraduate medical students in a modified team-based learning (TBL) module. This study aimed to explore medical students' learning experiences with virtual patient. METHODS Ten students who previously underwent the learning module were recruited through purposive sampling. The inclusion criteria were: (a) Fourth-year medical students; and (b) Completed psychiatry posting with the new module. Students who dropped out or were unable to participate in data collection were excluded. Two online focus group discussions (FGDs) with five participants each were conducted by an independent facilitator, guided by a questioning route. The data were transcribed verbatim and coded using the thematic analysis approach to identify themes. RESULTS Three main themes of their learning experience were identified: (1) fulfilment of the desired pedagogy (2), realism of the clinical case, and (3) ease of use related to technical settings. The pedagogy theme was further divided into the following subthemes: level of entry for students, flexibility of presentation of content, provision of learning guidance, collaboration with peers, provision of feedback, and assessment of performance. The realism theme had two subthemes: how much the virtual patient experience mimicked an actual patient and how much the case scenario reflected real conditions in the Malaysian context. The technical setting theme entailed two subthemes: access to the software and appearance of the user interface. The study findings are considered in the light of learning formats, pedagogical and learning theories, and technological frameworks. CONCLUSIONS The findings shed light on both positive and negative aspects of using virtual patients for medical students' psychiatry posting, which opens room for further improvement of their usage in undergraduate psychiatry education.
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Affiliation(s)
- Luke Sy-Cherng Woon
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Seng Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Pardavila-Belio MI, Moreno-Arroyo C, Romero-Clará O, Tricas-Sauras S, Barroso T, Duaso M, Vilaplana J, Agüera Z, Canga-Armayor N, Demedts D, Elliott R, Godin I, Fernández E, Hawkins S, Marques MID, Lavedan-Santamaria A, Pueyo-Garrigues M, Puig M, Roca J, Sancho R, Torne-Ruiz A, Martínez C. Adaptation, implementation, and evaluation of an online health sciences training program for brief smoking intervention: A pre-post study in four European countries. NURSE EDUCATION TODAY 2023; 130:105924. [PMID: 37677986 DOI: 10.1016/j.nedt.2023.105924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/01/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Tobacco cessation intervention has a positive impact on quality of care. For health professionals, limited competency in this area may be associated with poor training during their academic programs. There is a clear need to further develop and implement training programs to improve tobacco cessation knowledge, skills, and attitudes among healthcare students. OBJECTIVES The aim of this study was to assess the effectiveness of the innovative online training program "Brief Intervention in Smoking Cessation" for healthcare students to improve their knowledge, skills, and attitudes. DESIGN A pre-post evaluation study with a satisfaction assessment tool was used. SETTING Seven universities from four European countries, including Belgium, Portugal, Spain, and the United Kingdom, participated. PARTICIPANTS One thousand and seventy-two (1072) undergraduate students participated, with 851 completing the online program. METHODS All participants completed the "Brief Intervention in Smoking Cessation" online program, which consisted of five theoretical modules, five videos, and three virtual simulation cases between January 2020 and June 2022. Knowledge was assessed by a multiple-choice test, and practical skills were assessed by a simulation algorithm, both of which were developed by education and smoking cessation experts. Competency was achieved when students successfully completed both assessments. Satisfaction was measured using an ad hoc 16-item questionnaire. Pre-post changes in knowledge were assessed using a paired Student's t-test. RESULTS Eighty-six percent of the students achieved smoking cessation competency. Students significantly improved their knowledge score on a scale of 0 to 10 points, with a mean pre-program score of 3.79 vs a mean post-program score of 7.33 ([-3.7 - -3.4] p < 0.001), acquiring sufficient attitudes and skills (simulation mean of 7.4 out of 10 points). Students were highly satisfied with the program (8.2 out of 10) and recommended it to other students (8.4 out of 10). CONCLUSIONS The "Brief Intervention in Smoking Cessation" online training program is effective for the acquisition of smoking cessation competencies among European health profession students.
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Affiliation(s)
- Miren Idoia Pardavila-Belio
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Carmen Moreno-Arroyo
- Department of Fundamental Care and Medical-Surgical Nursing, Faculty of Nursing, University of Barcelona, Barcelona, Spain; Department of Nursing Research Group (GRIN), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.
| | - Olga Romero-Clará
- E-oncologia Virtual Training Unit, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain.
| | - Sandra Tricas-Sauras
- Social Approaches to Health Research Center (CRISS-CR5), School of Public Health, Université Libre de Bruxelles, Brussels, Belgium; Eurocare, The European Alcohol Policy Alliance, Brussels, Belgium.
| | - Tereza Barroso
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
| | - María Duaso
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Jordi Vilaplana
- Department of Computer Science, University of Lleida, Lleida, Spain.
| | - Zaida Agüera
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28015 Madrid, Spain.
| | - Navidad Canga-Armayor
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Dennis Demedts
- BRUCHI Expertise Center, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.
| | - Rebecca Elliott
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Isabelle Godin
- Social Approaches to Health Research Center (CRISS-CR5), School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
| | - Esteve Fernández
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Sian Hawkins
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
| | - Maria Isabel Dias Marques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
| | - Ana Lavedan-Santamaria
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Lleida, Spain.
| | - María Pueyo-Garrigues
- University of Navarra, School of Nursing, Department of Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain; IdiSNA, Navarra Institute for Health Research.
| | - Montse Puig
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Judith Roca
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Lleida, Spain.
| | - Raúl Sancho
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Alba Torne-Ruiz
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Cristina Martínez
- WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, United States of America.
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Moyer JE. Virtual Reality Simulation Applications in Pre-Licensure Psychiatric Nursing Curricula: An Integrative Review. Issues Ment Health Nurs 2023; 44:984-1001. [PMID: 37672766 DOI: 10.1080/01612840.2023.2243330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
The integrative review's objective is to determine the effectiveness of incorporating virtual reality (VR) simulation teaching methods in pre-licensure psychiatric nursing curricula. While the demand for skilled nurses has increased, the COVID-19 pandemic exacerbated nursing educational resource shortages and reduced the number of qualified applicants accepted into nursing schools. Psychiatric assessment and communication skills are difficult to obtain. VR simulation may present an effective solution to enhancing nursing students' psychiatric education. The integrative review was the study design. Tailored search terms were applied to the following databases: PubMed, PsycINFO, ERIC, and CINAHL Plus with Full Text. The databases were searched by title and abstract during the period January 1, 2011, through October 14, 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to search strategies and results. The selected articles were evaluated using the Johns Hopkins research evidence appraisal tool. Eleven studies met the inclusion criteria for the integrative review. Study results were categorized into two main themes: (a) pedagogical approach and (b) usability. Three sub-themes emerged: (a) knowledge, (b) attitudes, and (c) skills. VR was found to be effective in increasing nursing students' knowledge; improving communication and decision-making skills; and impacting attitudes toward patients living with mental illness. VR was found to be the same as or superior to traditional and other simulation methods in teaching psychiatric nursing education to pre-licensure students. While convenient, virtual reality use involves managing technical difficulties and considering safety. VR simulation is an effective pedagogical approach for psychiatric nursing curricula and offers a potentially cost-effective alternative to traditional learning and other simulation methods.
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Affiliation(s)
- Jennifer E Moyer
- MSN Program, Framingham State University, Framingham, Massachusetts, USA
- Massachusetts Department of Public Health, SANE Program, Boston, MA, USA
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Park S, Hur HK, Chung C. Learning effects of virtual versus high-fidelity simulations in nursing students: a crossover comparison. BMC Nurs 2022; 21:100. [PMID: 35473614 PMCID: PMC9042657 DOI: 10.1186/s12912-022-00878-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Simulation is an alternative or complementary method for students who cannot obtain sufficient direct care experience, as they allow students to experience various clinical situations. Mixed learning is becoming increasingly common as a way to provide students with opportunities to experience real-life clinical scenarios. This study compared the learning effects of a virtual simulation and a high-fidelity simulation in a different order of presentation, with a focus on training for premature rupture of membranes in the field maternity nursing. Through this comparison, this study aimed to obtain evidence to support decision-making regarding the most effective way to utilize mixed simulation strategies. Methods A quasi-experimental, crossover-design study was performed with two randomly allocated groups of 26 junior nursing students each. The virtual simulation used the vSim® for nursing, and the high-fidelity simulation used a scenario developed by the research team. The learning effects were measured in terms of the problem-solving process, clinical reasoning, reflective thinking, satisfaction with the practicum, and self-confidence. The data collected with a structured questionnaire were analyzed using the Mann–Whitney test. Results The virtual simulation-first, high-fidelity simulation-second order led to significantly higher scores for reflective thinking (z = 3.53, p < .001) and self-confidence (z = 2.47, p = .013) than the other order. Conclusions The initial application of virtual simulation seemed to improve students’ thought processes, and then high-fidelity simulation seemed to allow them to perform actual practice better. Further trials of mixed learning methods are necessary to maximize learning effects in nursing education. Trial registration KCT0005767 at 2021–01-12 registered.
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Affiliation(s)
- SoMi Park
- Department of Nursing, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, Korea
| | - Hea Kung Hur
- Department of Nursing, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, Korea
| | - ChaeWeon Chung
- College of Nursing, Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Korea.
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Educational Programs and Teaching Strategies for Health Professionals Responding to Women With Complex Perinatal Mental Health and Psychosocial Concerns. A Scoping Review. Nurse Educ Pract 2022; 60:103319. [DOI: 10.1016/j.nepr.2022.103319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/18/2022]
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Hwang GJ, Chang CY, Ogata H. The effectiveness of the virtual patient-based social learning approach in undergraduate nursing education: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 108:105164. [PMID: 34627030 DOI: 10.1016/j.nedt.2021.105164] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/29/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In nursing education, knowledge and competence in conducting physical assessments are crucial. Therefore, physical assessment knowledge has become a fundamental and essential education program for nursing students. However, most of the current nursing courses are taught via a didactic teaching approach, making it difficult for students to think deeply about relevant issues due to the lack of interaction and context. This may, in turn, have an impact on learning effectiveness and clinical judgment. OBJECTIVE A virtual patient (VP)-based social learning approach is proposed to enhance nursing students' performance and clinical judgment in education programs. DESIGN A quasi-experiment method was adopted to evaluate the effectiveness of the proposed approach. PARTICIPANTS A total of 40 senior nursing students participated in the study (VP-based social learning approach group = 20, control group = 20). METHODS The study involved a pre- and post-test to examine students' learning achievements, self-efficacy, and communication skills. The experimental group adopted the VP-based learning approach, while the control group adopted the conventional didactic learning approach. ANCOVA was employed to compare the performances of the two groups. RESULTS The experimental results indicate that using a VP for learning can enhance students' learning achievements, self-efficacy, and communication skills. In addition, based on the analysis of the results, students generally believed that learning with a VP makes learning more enjoyable. CONCLUSION The VP-based social learning approach would be an effective strategy to train nursing students who have limited opportunities to experience real clinical situations, in particular during the COVID-19 pandemic.
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Affiliation(s)
- Gwo-Jen Hwang
- Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taiwan.
| | - Ching-Yi Chang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
| | - Hiroaki Ogata
- Academic Center for Computing and Media Studies and the Graduate School of Informatics, Kyoto University, Japan.
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Guerrero JG, Tungpalan-Castro GM, Al Fergani B, Gomma NH, Hafiz AH, Pingue-Raguini M. Impact of high-fidelity and virtual simulation experiences on nurses’ acquired knowledge and skills for triaging suspected COVID-19 patients. COMPUTERS & EDUCATION: X REALITY 2022. [PMCID: PMC9679401 DOI: 10.1016/j.cexr.2022.100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Reger GM, Norr AM, Gramlich MA, Buchman JM. Virtual Standardized Patients for Mental Health Education. Curr Psychiatry Rep 2021; 23:57. [PMID: 34268633 DOI: 10.1007/s11920-021-01273-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The training of psychiatrists and other mental health professionals requires education on a range of interpersonal, communication, and psychotherapy techniques. Classroom and workshop training must be augmented by experiential learning with feedback for skill implementation with fidelity. Virtual standardized patients (VSPs) are computerized conversational agents that can support experiential learning through standardized, consequence-free training environments at reduced costs. RECENT FINDINGS Research on mental health VSPs is rife with feasibility and acceptability pilot studies across various training populations and settings. Users have generally reported positive reactions to training with VSPs, though frustrations with some VSP speech recognition or VSP response relevance has been reported. Several studies have demonstrated a promising transfer of clinical skills from VSP training to human standardized patients and randomized trials supporting improved skill relative to reading or academic study are encouraging. As technology improves and natural language processing and accurate computer response generation for broad ranging conversational topics emerges, the field would benefit from research on the characteristics of effective VSPs for a range of purposes and trainee populations. Well-designed randomized evaluations of VSPs relative to best practices in education are needed, particularly regarding the impact of VSPs on clinical practice among actual patients.
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Affiliation(s)
- Greg M Reger
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA. .,University of Washington School of Medicine, Seattle, WA, USA.
| | - Aaron M Norr
- University of Washington School of Medicine, Seattle, WA, USA.,VISN 20 Mental Illness Research, Education and Clinical Center, Seattle, WA, USA
| | - Michael A Gramlich
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA
| | - Jennifer M Buchman
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, USA
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Jacklin S, Maskrey N, Chapman S. Shared Decision-Making With a Virtual Patient in Medical Education: Mixed Methods Evaluation Study. JMIR MEDICAL EDUCATION 2021; 7:e22745. [PMID: 34110299 PMCID: PMC8235293 DOI: 10.2196/22745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/11/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Shared decision-making (SDM) is a process in which clinicians and patients work together to select tests, treatments, management, or support packages based on clinical evidence and the patient's informed preferences. Similar to any skill, SDM requires practice to improve. Virtual patients (VPs) are simulations that allow one to practice a variety of clinical skills, including communication. VPs can be used to help professionals and students practice communication skills required to engage in SDM; however, this specific focus has not received much attention within the literature. A multiple-choice VP was developed to allow students the opportunity to practice SDM. To interact with the VP, users chose what they wanted to say to the VP by choosing from multiple predefined options, rather than typing in what they wanted to say. OBJECTIVE This study aims to evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS Preintervention and postintervention questionnaires were administered, followed by semistructured interviews. The questionnaires provided cohort-level data on the participants' views of the VP and helped to inform the interview guide; the interviews were used to explore some of the data from the questionnaire in more depth, including the participants' experience of using the VP. RESULTS The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in both pre- and post-VP consultations, there was a change in the rank position of respecting patient choices, with the median rank changing from second to first. Owing to the small sample size, this was not analyzed for statistical significance. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients, which may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory-focused years of the curriculum to the more patient-focused ones later. CONCLUSIONS The VP was well accepted by the participants. The multiple-choice system of interaction was reported to be both useful and restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behavior or practice.
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Affiliation(s)
- Simon Jacklin
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Neal Maskrey
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
| | - Stephen Chapman
- School of Pharmacy and Bioengineering, Keele University, Keele, United Kingdom
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Havola S, Haavisto E, Mäkinen H, Engblom J, Koivisto JM. The Effects of Computer-Based Simulation Game and Virtual Reality Simulation in Nursing Students' Self-evaluated Clinical Reasoning Skills. Comput Inform Nurs 2021; 39:725-735. [PMID: 33941719 DOI: 10.1097/cin.0000000000000748] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research has shown that nursing students can learn clinical reasoning skills by engaging in simulation games. However, there has been no research regarding the effects of simulation games on clinical reasoning skills when nursing students also engage in virtual reality simulations. Furthermore, by engaging in simulation games, neither game metrics nor their impact on students' self-evaluated clinical reasoning skills has been studied. The purpose of this study was to evaluate the effects of these two kinds of simulation games using a one-group pretest-posttest design. Forty nursing students self-evaluated their clinical reasoning skills in three phases using the Clinical Reasoning Skills scale. Furthermore, the game metrics of the simulation games were analyzed, and the results clearly showed that students' self-evaluated clinical reasoning skills were systematically improved. There was a systematic association between better playing scores and better self-evaluated clinical reasoning skills in playing both kinds of simulation games. Moreover, students engaged more time in the virtual reality simulation than the computer-based simulation game. Overall, the results suggest that the use of a combination of both kinds of simulation games is an effective way for nursing students to learn clinical reasoning skills.
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Affiliation(s)
- Sara Havola
- Author Affiliations: Department of Nursing Science (Ms Havola, Dr Haavisto, Mrs Mäkinen, and Dr Koivisto) and Department of Mathematics and Statistics, School of Economics (Dr Engblom), University of Turku, Turku, Finland; Hospital District of Satakunta, Pori, Finland (Dr Haavisto); and Smart Services Research Unit, Häme University of Applied Sciences, Hämeenlinna, Finland (Dr Koivisto)
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Liu W. Virtual Simulation in Undergraduate Nursing Education: Effects on Students' Correct Recognition of and Causative Beliefs About Mental Disorders. Comput Inform Nurs 2021; 39:616-626. [PMID: 33935205 DOI: 10.1097/cin.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Virtual simulation as an emerging nursing pedagogy can facilitate optimal learning through the use of experiential learning and technology. The purpose of this prospective cohort study was to assess the long-term effects of virtual simulation on undergraduate nursing students' recognition of and causative beliefs about depression and schizophrenia. Students' responses from the simulation cohort (n = 149) and the nonsimulation cohort (n = 150) at a school of nursing in the United States were compared. While students' responses were fairly similar between the two cohorts, students who received virtual simulations more often rated character weakness as an unlikely cause for schizophrenia than those who did not receive virtual simulations. The major difference supports the use of virtual simulation in influencing positive changes in nursing students' perceptions and attitudes toward mental illness.
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Affiliation(s)
- Wei Liu
- Author Affiliation: College of Nursing and Public Health, Adelphi University, Garden City, NY
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Nieto I, Velasco M, Miranda C. Tacit engagement using tablet-mediated learning for social good. AI & SOCIETY 2021; 38:1-5. [PMID: 33487887 PMCID: PMC7814165 DOI: 10.1007/s00146-020-01138-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 12/10/2020] [Indexed: 11/26/2022]
Abstract
We discuss the effectiveness of mediated communication (internet communication via a computer tablet) and tacit engagement in a Project on mental health. The project is aimed at improving the wellbeing of adult women living with chronic mental disorders in long-term psychiatric internment. The computer tablets act as "portals" to provide access and conatct with the outside world for patients who have poor (if any) external social support. This support includes a patient-centred psycho-social care, and accompanying clinical and pharmaceutical treatment. Both patients and their relatives accepted the benefits of internet mediation, for very different reasons. For the patient, this is a flash of contact with humanity, and for the relatives the internet communication this proved to be an alternative to the need for physical proximity. As some patients had no relatives or friends to communicate (even remotely) with the outside world, and because there is a school next door to the clinic, we visualized that the communication between these two communities could provide both a therapeutic and poetic act of learning and compassion. The electronic portal could serve as a virtual bridge between two forbidden domains. Although awareness of students of the nearby school was raised about mental health, the use of internet mediation devoid of physical proximity made the students suspicious of the goal of the mediation. From the patient's side, however, each contact was an instance of joy. Several issues were raised from this exercise.
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Affiliation(s)
- Ignacio Nieto
- Faculty of Arts, Universidad Finis Terrae, Santiago, Chile
| | | | - Christian Miranda
- Faculty of Social Sciences, Department of Education, Universidad de Chile, Santiago, Chile
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Liu W. The Effects of Virtual Simulation on Undergraduate Nursing Students’ Beliefs about Prognosis and Outcomes for People with Mental Disorders. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Havola S, Koivisto JM, Mäkinen H, Haavisto E. Game Elements and Instruments for Assessing Nursing Students' Experiences in Learning Clinical Reasoning by Using Simulation Games: An Integrative Review. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farooq S, Tharani A, Begum S, Parpio Y. Implementation of Simulation: A Contemporary Strategy to Enhance Clinical Skills of Undergraduate Students in Mental Health Nursing. Issues Ment Health Nurs 2020; 41:736-740. [PMID: 32374637 DOI: 10.1080/01612840.2019.1710011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Simulation is an innovative teaching strategy that supports student centered learning. It improves therapeutic communication skills with clients. Additionally, it enhances critical thinking, problem solving, and confidence among students, in a non-threatening and safe environment, without posing a risk to actual patients. This paper describes the process of application of simulation for undergraduate nursing students enrolled in a mental health nursing course. The project aimed to determine the significance of simulation to improve the communication skills and confidence level, and to decrease the anxiety of undergraduate nursing students, prior to attending mental health clinical. The Experiential Learning (ELT), by Kolb in 1984, was chosen as a framework for the simulation strategy. The simulation experience was a stepwise process that comprised a briefing session with students to explain them the process and purpose of the simulation activity, followed by a two-day simulation experience. The experience comprised students' interaction with Simulated Patients (SP), who had been prepared to manifest symptoms of depression, mania, and schizophrenia. The later part of the experience was a debriefing session, in which students were provided an opportunity for self-reflection and for thinking a way forward, to enhance their clinical competency, using their video recording. The students' evaluation regarding the simulation experience was positive and they suggested that it be integrated in the mental health nursing course.
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Affiliation(s)
- Salima Farooq
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Ambreen Tharani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Shamshad Begum
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Yasmin Parpio
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
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Virtual Simulation in Nursing Education: A Systematic Review Spanning 1996 to 2018. ACTA ACUST UNITED AC 2020; 15:46-54. [DOI: 10.1097/sih.0000000000000411] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dahri K, MacNeil K, Chan F, Lamoureux E, Bakker M, Seto K, Yeung J. Curriculum integration of virtual patients. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:1309-1315. [PMID: 31836158 DOI: 10.1016/j.cptl.2019.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/05/2019] [Accepted: 09/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND PURPOSE Virtual patients (VP) offer an enhanced learning experience for students to assume the role of health professional and make therapeutic decisions in a simulated environment. While VPs are valued by students and offer benefits to the learner, little is known about how best to implement them in pharmacy education curricula. The purpose of our study was to investigate students' perceptions of VPs and build understanding about how to optimally implement them in the future. EDUCATIONAL ACTIVITY AND SETTING Four VP cases were implemented over the first three years of the entry to practice doctor of pharmacy program. Each case was focused on a different condition and implemented in one of three settings (i.e. integration activities, large lecture setting, or independent review). Students were invited to complete a survey and participate in a focus group after completing the patient case. FINDINGS One-hundred eighty students completed the survey and six students participated in a focus group. Ninety-four percent of respondents strongly agreed/agreed that VPs were valuable for their learning. Students preferred the VP cases be implemented in small-group settings and be relevantly timed with course material. Students found helpful that cases were realistic, clear, comprehensive, engaging, and incorporated feedback. Perceived benefits included enhanced learning about medical conditions, development of clinical reasoning skills and processes for working through cases. SUMMARY VPs continue to be identified as a valuable learning experience. When implemented it is important to consider the learner setting in order to get the greatest value from their use.
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Affiliation(s)
- Karen Dahri
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada; Vancouver General Hospital, Vancouver Coastal Health, 855 West 12th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Kimberley MacNeil
- Department of Educational & Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Canada
| | - Fong Chan
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
| | - Emilie Lamoureux
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
| | - Mattie Bakker
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
| | - Katherine Seto
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
| | - Janice Yeung
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
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Comparison of the Effectiveness of a Virtual Simulator With a Plastic Arm Model in Teaching Intravenous Catheter Insertion Skills. ACTA ACUST UNITED AC 2018; 36:98-105. [DOI: 10.1097/cin.0000000000000405] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gipson SYMT, Kim JW, Shin AL, Kitts R, Maneta E. Teaching Child and Adolescent Psychiatry in the Twenty-First Century: A Reflection on the Role of Technology in Education. Child Adolesc Psychiatr Clin N Am 2017; 26:93-103. [PMID: 27837945 DOI: 10.1016/j.chc.2016.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Technology has become an integral part of everyday life and is starting to shape the landscape of graduate medical education. This article reviews the use of technology in teaching child and adolescent psychiatry (CAP) fellows, and 3 main aspects are considered. The first aspect is use of technology to enhance active learning. The second aspect covers technology and administrative tasks, and the third aspect is the development of a technology curriculum for CAP trainees. The article concludes with a brief review of some of the challenges and pitfalls that have to be considered and recommendations for future research.
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Affiliation(s)
- Shih Yee-Marie Tan Gipson
- Department of Psychiatry, Harvard Medical School, 25, Shattuck Street, Boston, MA 02115, USA; Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Jung Won Kim
- Department of Psychiatry, Harvard Medical School, 25, Shattuck Street, Boston, MA 02115, USA; Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Ah Lahm Shin
- Department of Anesthesia, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Robert Kitts
- Department of Psychiatry, Harvard Medical School, 25, Shattuck Street, Boston, MA 02115, USA
| | - Eleni Maneta
- Department of Psychiatry, Harvard Medical School, 25, Shattuck Street, Boston, MA 02115, USA; Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
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