Implications For Evaluating Teaching Effectiveness
Introduction
Integrating recent graduates of the BSN program into independent clinical practice can take much work. McGarity et al. (2021) report that the evidence indicates a significant shortfall in preparation for practice; many fresh BSNs are not ready even after passing their licensing tests. The gap between the knowledge acquired on a theoretical basis and the actual ability to put it into practice can potentially result in a compromise on safety for the patients as well as the rise in the unfavorable rates of nurse turnover, which subsequently lowers the standards of healthcare as a whole (Saifan et al., 201). Clinical assignments and classroom instructions are at the heart of a traditional BSN education. However, these engagements could not truly capture the moment-to-moment urgency that is commonly encountered in real clinical statuses. As Saifan et al. (2021) further reiterate, one of the most powerful ways to eliminate this gap is through simulation-based learning that enables students to train in a protected and controlled environment to practice and perfect necessary skills purposefully. Implications For Evaluating Teaching Effectiveness
The application of VR simulation in this technology has created a new frontier. VR technology provides a system of virtual reality (VR) simulations that are completely immersive and very realistic, and that let nursing students practice difficult clinical situations and get feedback in real-time without any risk to patients (Badowski et al., 2021; Yang et al., 2021). It is a transformative technology for nursing education that gives learners the most realistic scenarios to help them increase the depth and quality of their clinical reasoning skills to the maximum (McGarity et al., 2023). VR enables students to gain skills in experimental or secure surroundings that are critically important when transitioning from theory to practice. Recent experiments suggest that new nurses could use VR to develop their skills as far as decision-making and critical thinking are concerned, which will then enable them to do what they are supposed to do in the real-world clinical environment that may sometimes seem to be unbearable to the new nurses (Saifan et al., 2021). The priorities are the same as those of competency-based nursing education—enhancing readiness in simulated VR experience goes before the rest of the evidence-based teaching strategies aimed at creating graduates who are professionally ready for the workforce.
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The Model
This project will introduce and assess a VR technology pilot program using the ACE Star Model of Knowledge Transformation as a theoretical basis. ACE Star Model is a procedural 5-step model introduced by Stevens (2004) that includes knowledge discovery, synthesis, translation, integration and evaluation (Lee, 2021). This model was selected as it places much importance on the strength of the evidence and the context specificity that is essential for projects focused on the translation of research findings into practical and sustainable solutions. The ACE Star Model seamlessly integrates into the VR project due to the foundation created through the review of the literature conducted, the intense focus on knowledge dissemination, and its ability to be validated through a pilot study design. Implications For Evaluating Teaching Effectiveness
A single BSN program serves as the site of the pilot study. Our nursing program will gain from implementing a shared evidence-based practice (EBP) approach in a number of ways. It contributes to the standardization of the results, facilitates teamwork, raises the quality of the research, makes comparative findings easier, and provides projects with greater legitimacy when they are looking for funding or support from stakeholders. However, the selection of an appropriate EBP model may need some reflection on these aspects, such as the EBP relevance, feasibility, and proper result-producing system. The tremendous structure of the model ensures maximum implementation of VR technology not only in the curriculum but also in effectively addressing educational outcomes.
Methodology
This study adopts a rigorous approach in an attempt to determine whether virtual reality simulation techniques supplement the decision-making process in learning clinical reasoning. The possibility of a mixed-methods randomized controlled trial (RCT) is available for the research topic of the PICOT question. The VR groups or traditional simulation groups will be assigned randomly to student participants from sophomore students of the BSN program. The Lasater Clinical Judgment Rubric (LCJR) will be the evaluation tool that will be used to provide similar feedback to the two different groups at the same study stage both before and after (Lee, 2021). The simulation will be a virtual reality (VR) simulation with a high-fidelity portrayal of a deteriorating post-surgery patient showing early signs of sepsis. Implications For Evaluating Teaching Effectiveness
The students will be fully engaged in a realistic hospital environment, where they will be required to perform a concentrated assessment, identify nuanced fluctuations in mental status and vital signs, rank interventions in order of importance, and potentially execute an immediate action when necessary. Simultaneously simulating the progression of sepsis in a 65-year-old male two days after abdominal surgery, the virtual reality environment will feature clinical parameters that fluctuate dynamically. In order to evaluate the clinical reasoning of the student and encourage prompt actions, such as initiating antibiotic therapy, notifying the physician, drawing laboratories, and administering fluids, critical decision points will be incorporated.
The experience of the comparative group will be described for the students in the traditional group. Changes in LCJR scores will be the main focus of quantitative data analysis, which will be done with independent samples t-tests or non-parametric alternatives based on data distribution. Qualitative information will be gathered using focus groups and questionnaires. Common themes will be found, and students’ opinions on the VR experience will be gained using theme analysis. Both teacher disparities and the possibility of self-selection bias are threats to internal validity. The single-site study design may result in restricted external validity. It will take replication in several contexts to ascertain generalizability.
Implications and Sustainability
The maximum effect of this VR simulation project on nursing education depends on its sustainability. Important tactics will be to look for grant money, build solid relationships with nearby healthcare institutions, and record results in detail. With the knowledge from this study, I see myself as a Master’s prepared nurse playing a critical role in promoting evidence-based practice. My objective is to provide research and promote the use of virtual reality (VR) within the nursing curriculum. Implementing sustainable practices encompasses ensuring ongoing institutional support, conducting regular updates to virtual reality (VR) content, and providing ongoing faculty training. In my capacity as an aspiring MSN professional nurse, it will be imperative that I advocate for the incorporation of VR simulations into nursing education. The project was hampered by teacher buy-in, student opposition, and the initial cost of VR technology. Plans for mitigating include open communication with professors, open budgeting, and comprehensive student orientation. This VR effort is feasible because of its pilot study design, emphasis on a particular skill area, expansion of the resources available in the simulation lab, and solid leadership backing. For successful deployment, faculty development time, VR headsets or platforms, and possible future employment to support VR expansion will be needed. Implications For Evaluating Teaching Effectiveness
Outcomes
The main project goal of interest is the enhancement of clinical reasoning abilities among BSN students as assessed by the Lasater Clinical Judgment Rubric (LCJR) (Lee, 2021). The LCJR will evaluate the student’s capacity to spot little indicators of decline, set priorities for interventions, and make wise decisions in the simulated critical care situation. Scores will be gathered both at the pre-simulation baseline and right away after. The project seeks to demonstrate how virtual reality (VR) can close the readiness gap for newly hired nurses, which may improve patient outcomes and reduce nurse turnover (Chen et al., 2020). We shall also take into account doing a follow-up evaluation three months after the simulation. The VR simulation group’s mean LCJR scores rising statistically significantly above those of the traditional simulation group would be considered successful. The primary emphasis is on clinical reasoning, although secondary results will also be assessed. Student opinions of the VR experience will be qualitatively gathered through focus groups and structured surveys. Additionally, offering comments will be faculty members participating in the trial. Faculty members delivering and grading the LCJR will receive training to guarantee the validity and dependability of the result evaluation.
Ethical Considerations
This evidence-based practice effort will maintain the fundamental ethical convictions of beneficence, non-maleficence, autonomy, and justice. All student participants will be given thorough, informed permission to ensure they completely understand the purpose of the study, any possible risks and benefits, and their right to withdraw at any time without penalty. Minor motion sickness or disorientation is one of the possible hazards of VR simulation; it can be reduced with technological orientation and the break option. Should students choose not to use VR, they will be advised of any other methods to accomplish comparable learning goals. Participation offers the possibility of improved learning, the development of clinical reasoning, and better practice readiness. Make sure that taking part in the research is optional. All data will be anonymized and password-protected, and safe methods will be used to safeguard student privacy in compliance with HIPAA regulations. According to Pedram et al. (2024), the risks connected to virtual reality, such as simulator sickness and worries about data privacy, will be adequately controlled to guarantee student safety and HIPAA compliance. Implications For Evaluating Teaching Effectiveness
Future Plan
The future strategy for VR integration in nursing education calls for encouraging the technology’s use by means of strategic dissemination and evidence-based practice. Should the pilot study show encouraging findings, a multidimensional approach will be used to encourage the integration of VR simulation into our BSN curriculum. Through conferences and publications in peer-reviewed journals, nurse educators, simulation experts, and healthcare executives, both locally and nationally, will be essential recipients of the information. A specialized VR simulation lab would be the best environment for a more comprehensive VR simulation application. Getting faculty support, obtaining continuous financing, and resolving any residual student reluctance to use the technology could hinder broader adoption. It will take proactive measures, such as collaborating with the IT department of the university and providing extensive faculty development seminars, to lessen these obstacles. Therefore, creating an online virtual reality simulation scenario repository would promote cooperation and maybe quicken acceptance in other nursing schools.
Conclusion
Patients and nurses alike are seriously in danger because of the mismatch between nursing education and the realities of actual clinical practice. Enhancing nursing students’ clinical reasoning abilities and general readiness for practice, virtual reality simulation has the potential to transform the way we prepare them thoroughly. Based on the ACE Star Model, this study is an essential first step in assessing VR’s usefulness in a BSN program. The results might affect nursing education methods, which would eventually help patients by providing a more competent and self-assured nursing staff. Implications For Evaluating Teaching Effectiveness
References
Badowski, D., Kelly, R., & Nanci, R. (2021). Exploring student perceptions of virtual simulation versus traditional clinical and manikin-based simulation. Journal of Professional Nursing, 37(4), 683–689. https://doi.org/10.1016/j.profnurs.2021.05.005
Chen, F.-Q., Leng, Y.-F., Ge, J.-F., Wang, D.-W., Li, C., Chen, B., & Sun, Z.-L. (2020). Effectiveness of virtual reality in nursing education: Meta-Analysis. Journal of Medical Internet Research, 22(9). https://doi.org/10.2196/18290
Lee, K. C. (2021). The Lasater clinical judgment rubric: Implications for evaluating teaching effectiveness. Journal of Nursing Education, 60(2), 67–73. https://doi.org/10.3928/01484834-20210120-03
McGarity, T., Monahan, L., Acker, K., & Pollock, W. (2023). Nursing graduates’ preparedness for practice: Substantiating the call for competency-evaluated nursing education. Behavioral Sciences, 13(7), 553–553. https://doi.org/10.3390/bs13070553
Pedram, S., Kennedy, G., & Sanzone, S. (2024). Assessing the validity of VR as a training tool for medical students. Virtual Reality, 28(1). https://doi.org/10.1007/s10055-023-00912-x
Saifan, A., Devadas, B., Daradkeh, F., Abdel-Fattah, H., Aljabery, M., & Michael, L. M. (2021). Solutions to bridge the theory-practice gap in nursing education in the UAE: A qualitative study. BMC Medical Education, 21(1). https://doi.org/10.1186/s12909-021-02919-x
Yang, J., Zhou, W., Zhou, S. C., Luo, D., Liu, Q., Wang, A., Yu, S., Zhu, X., He, X., Hu, F., Yang, B. Y. & Chen, J. (2024). Integrated virtual simulation and face-to-face simulation for clinical judgment training among undergraduate nursing students: a mixed-methods study. BMC Medical Education, 24(1). Implications For Evaluating Teaching Effectiveness
