Investigation of a virtual reality simulation education programme for nursing students.

Introduction
Most health professional pre-registration courses are now making use of simulation-based education (SBE) as a preferred and evidence-based method to educate students(1). Simulation is applied in this context by using either a mannikin or a trained actor to simulate a range of roles. These simulations have been highly successful, but not always scalable with only 10-20% of students actively participating in an immersive simulation. The ability to provide increased opportunities for students to be involved in authentic work-based learning experiences is integral for students to become effective and competent practitioners. Virtual Reality (VR), as an innovative and emerging technology, has the potential to offer increased numbers of students with a fully immersive experience.
JasperVR and its associated software application VirtualU was developed through a collaborative consortium as a unique VR platform specifically designed to expose students to the different and complex situations they are likely to face in their future professional work. Using 360 degree-video and sound technology, JasperVR captured the variations and potential outcomes from common clinical scenarios such as the verbally aggressive person, the deteriorating patient, the cognitively impaired patient and the patient in need of palliative and end of life care.
The aim of the research study was to investigate the outcomes of the JasperVR virtual reality simulation education program for vocational and higher education nursing students.
Methods:
Using a mixed methods quasi-experimental design the study compared educational outcomes from traditional SBE with JasperVR. Data was collected via surveys across three time points. The research involved a convenience sample of all consenting students enrolled in a Bachelor and Diploma of Nursing.
Results and Discussion
There were 675 participating students, from the aggregation of seven distinct teaching cohorts with 282 students in the SBE Control group and 393 in the JasperVR Intervention Group. Significantly (p<0.01) more students in the JasperVR intervention group (95%) actively participated in the VR scenarios than in scenarios using traditional SBE (15%). Most students in the JasperVR intervention group had statistically significant higher knowledge scores; and self-reported scores for knowledge, motivation, preparedness for practice and confidence than the SBE control group, regardless of student status, age, course, module and cohort (p<0.05 or p<0.01 level). Students in the JasperVR intervention group rated the program more highly as a learning experience than students in the SBE control group. JasperVR enabled increased numbers of students to actively participate in an immersive simulated learning environment at their own pace, and in their own time and venue.
References
1. Cook, DA., Hamstra, SJ., Brydges, R., Zendejas, B., Szostek, JH, Wang, AT., Erwin PJ. & Hatala, R. (2013). Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis, Medical Teacher, 35:1, e867-e898. DOI 10.3109/0142159X.2012.714886