Pi Phi Chapter

Creating Contextual Learning Experiences via Virtual Simulation

Nursing Research on the Green

2011 Abstract

Ramona Yehle RN, MS, Doctoral Learner 
PhD student of Capella University, Employed at Western Technical College 


  • Background: Military virtual simulations in aviation, medical and nursing science have been conducted since the 1970s (Caro, 1977). Medical education has conducted simulations, using mannequins, since the early 1960s (Alinier, Hunt, Gordon, & Harwood, 2006, p. 360). Mannequin simulators are classified on a scale from low-fidelity to high-fidelity. Fidelity is the “degree of accuracy depicted by the simulation, compared to the real experience” (Medley & Horne, 2005, p. 32). Unfortunately, human patient simulators are quite costly; a 3D virtual environment offers an alternative solution for nursing education. 
  • Significance: Classroom patient care simulations are commonly offered and now virtual simulations can offer a similar experience. Educational delivery methods are changing, and educators need to keep abreast of the transformation in the teaching and learning paradigms as well as with the technological changes. Educational virtual patient care simulations offer the most powerful realistic learning situations ever imagined (Aldrich, 2004). In fact, Second Life® (SL), a 3D virtual world, supports interactive experiences found in real life (Boellstorff, 2008). According to Skiba (2007b), SL, offers several attractive features such as promoting interaction within learning situations via audio, text or avatar movement, building environmental content, and learning within an immersive social networking web program. It is unknown if 3D respiratory patient nursing care simulations are beneficial for learning. 
  • Purpose/objective: The purpose of this research study was to determine the measurable difference in knowledge attainment among Midwestern undergraduate nursing students who participated in a Second Life® virtual respiratory patient nursing care simulation. 
  • Methods/project: Methodology: Literature Review In 2008, the NLN recommended that “health care professionals develop knowledge and skills in computer literacy, information literacy, and the use of information technologies” (Jeffries, et al., 2009, p. 1). Today, it is common practice for nursing students to learn critical thinking skills through designed interactive simulation practice scenarios. Online 3D virtual programs offer an exciting learning opportunity for instructional designers and educators, as well as students. This research study is framed from the social constructivist perspective as described by prominent theorists “of this [last] century” (Perkins, 1991, p. 20), Dewey, Piaget, Bruner, and Vygotsky (Driscoll, 2005, p. 386). Constructivists believe that learners “construct meanings for concepts” (Schweitzer & Stephenson, 2008, p. 585), students are not passively attaining knowledge from the instructor’s lecture. Grounded within constructivism are two principles: “knowledge is not passively received but actively built up … [and] the function of cognition is adaptive and serves the organization of the experiential world” (von Glasersfeld, 1989, p. 114). Andragogy incorporates the process of adult learning. Technical and community college adult students are frequently employed females who are returning to school to improve their futures (Brey, 1988; Porter, 1997). Educational simulations premised on the social constructivist paradigm entwine easily with adult learning needs. As “online technologies are gradually decreasing the barriers of traditional distance education comprised of interactive or communication problems” (Huang, 2002, p. 34), futurists believe that 3D virtual worlds can provide the first step to full authenticity in distance/online education. At the moment, there is a strong need to develop safe nursing “practice in the clinical environment” (Jeffries, et al., 2009; Larew, et al., 2006, p. 21). Students frequently ask for further contact with patient nursing care clinical simulations because the practice addresses “their underlying fear, lack of confidence, and lack of exposure to clinical situations” (Seropian, et al., 2004, p. 168) and definitely improves performance. Unfortunatley, due to the high cost of high fidelity mannequins, faculty attendance requirement, and minimal available laboratory space, simulation practice is limited (Laschinger et al., 2008). Research Design The Midwest technical college system has a shared nursing curriculum. Nursing courses are designed with the same program outcomes, course competencies, and learning outcomes. A second semester medical-surgical course in the two-year Nursing-Associate Degree program served as the resource for the research participants. A quasi-experimental research design framed the study. The independent variable was defined as the patient simulated respiratory 3D virtual scenario, whereas the dependent variable was comprised of the one-group, pre-test and post-test. The pre-test and post-test contained the same questions and multiple-choice options. Items on the pre-test and post-test assessed the level of the participant’s respiratory nursing care knowledge before and after the 3D virtual simulation experience. 
  • Results: H0 = There will be no measurable difference in knowledge attainment between the pre-test and post-test respiratory test results of nursing students who participate in the Second Life® virtual respiratory patient-care simulation. A t-test was performed to determine the statistical differences of the mean between the paired dependent sample, pre-test and post-test. The null hypothesis was accepted. No significant difference p> .05. 
  • Clinical Implications: Second Life® offers an immersive, stimulating, collaborative environment for nursing students. Rich opportunities abound for instructors as well as learners (Warburton, 2009). To avoid incurring financial stress from purchasing high-fidelity simulated mannequins 3D virtual worlds offer lower cost patient-care simulations. Perhaps as technical challenges are overcome pedagogy of 3D virtual worlds will improve. Access to expanded network connections and greater bandwidth is a prerequisite for valid learning experiences. Growth in virtual worlds will change the potential for learning; complex situated learning will be transformed. 

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