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Session Overview
Short Presentation3: The use of virtual reality versus standardized patients: issues and challenges (Ledoux, Isabelle; Turgeon, Nadia; Marie-Hélène, Lemée; Patrick, Charland; Patrick, Lavoie; Jessica, Rassy; Sylvie, Charette; Daniel, Milhomme; Hugo, Carignan; Émilie...)
Wednesday, 31/Aug/2022:
3:30pm - 5:00pm

Location: CHUV auditorium Auguste Tissot

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3:30pm - 4:00pm

The use of virtual reality versus standardized patients: issues and challenges

Isabelle Ledoux1, Nadia Turgeon2, Lemée Marie-Hélène1, Charland Patrick2, Lavoie Patrick3, Rassy Jessica1, Charette Sylvie4, Milhomme Daniel5, Carignan Hugo1, Gosselin Émilie1

1Université de Sherbrooke, Canada; 2Université du Québec à Montréal, Canada; 3Université de Montréal, Canada; 4Université du Québec en Outaouais, Canada; 5Université du Québec à Rimouski, Canada

Background : The use of fully immersive virtual reality (FIVR) in the context of simulation in health sciences has evolved rapidly in recent years (Bryant et al., 2020). These simulations have demonstrated many advantages for nursing students, as it may contribute to developing skills related to clinical assessment and favor the development of clinical reasoning (Chiniara, 2019). While using standardized patients (SPs) makes sometimes difficult to reproduce the simulation environment, FIVR makes it possible decompartmentalize simulation environments by recreating environments better suited to learning needs. Notwithstanding these positive findings, only a few studies compare SPs with FIVR in the context of nursing education. The goal of this presentation is to describe issues and challenges faced during the pretesting of FIVR with baccalaureate nursing students in comparison with SPs.

Methods : A pilot mixed-methods study comparing FIVR with SPs, in the form of a crossover randomized controlled trial, followed by interviews, was carried out among 9 students from the third year of the initial baccalaureate in nursing. The participants took part at random in successive 15 minutes simulations about mental health evaluation (FIVR vs SP). Short semi-directed qualitative individual interviews lasting 15 minutes allowed to assess the participant’s point of view on both types of simulation. Field notes were kept by the research team throughout the project. The focus was on feasibility indicators as described by Sidani and Braden (2011) such as the interventionist’s availabilities, training, material resources, context, intervention’s reliability and the intervention's reach. Descriptive analysis of quantitative socidemographic data was performed with SPSS software and qualitative data were analyzed with concept analysis based on Brown and Clark (2021).

Results : The results make it possible to identify institutional, pedagogical, organizational issues and challenges related to the implementation of FIVR in nursing education. Both simulation types require the presence of facilitators and human resources. Early planning and implications of all actors appear to be a good strategy to ensure the optimal implementation of simulation activities. Extra training needed to be organized for FIVR activities, as they are new in the program. A familiarization session with FIVR lasting 30 minutes was developed, including 15 minutes of home preparation and 15 minutes of experimenting the pre-existing tutorial in the FIVR platform. Many pre-existing scenarios are available in the chosen platform, which facilitates its use and in return imposes certain limits. Material acquisition during the Covid-19 pandemic was challenging and many delays occurred, postponing the implementation of the project. Moreover, constantly changing sanitary measures made it hard to plan simulation activities in presence, specifically with SPs. A cleaning process had to be set up to disinfect the FIVR material between each participant. Institutional and political issues regarding the responsibility for the follow-up and technical support with the FIVR slowed the implementation. Both simulation activities lasted between 10 to 15 minutes and the scenario was very similar from one simulation modality to the other. However, the FIVR’s patient’s expressions were harder to decode than the SP’s expression, which was key information in a mental health evaluation scenario. As this study took place in an extracurricular context, issues in recruitment appeared. Close lashing with student’s schedule and avoiding the internship training period could overcome this difficulty. Overall, the feasibility challenges and issues faced within this study were similar between FIVR and SPs, with the main differences due to the novelty aspect of the FIVR.

Discussion : To improve teaching practices using simulation in nursing education, challenges regarding the use of FIVR and SPs must be considered. This finding is particularly relevant in the context of the implementation of a new simulation modality, such as FIVR. Issues such as, learner preparation and teacher training must be considered when deciding the type of simulation to use in the nursing program. A larger-scale multicenter study will compare the acceptability and the preliminary effects of FIVR and SPs.

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