Tag Archives: education

Virtual Reality for Nontechnical Skills

multiple people in VR hospital room
multiple people in VR hospital room

Across industries, like healthcare and aviation, virtual, augmented, and mixed reality have been used to assess and  progress technical and procedural skills from emergency medicine to pilot training

As a result of VR’s growing use cases, research has expanded to include the use of these new technologies on the development of nontechnical skills, with a focus on skills like: 

  • Communication
  • Critical thinking
  • Teamwork
  • De-escalation
  • Empathy
  • Situational awareness

According to a systematic review of virtual reality and healthcare professionals’ nontechnical skills training – teamwork, communication, and situational awareness were the most frequently studied nontechnical skills, which are often skills necessary for interprofessional teamwork. 

These nontechnical skills, sometimes referred to as ‘soft skills’, are imperative not only for compassionate patient care, but also for the situational awareness and clinical decision making that comes along with the daily requirements of interacting with patients and making swift, sound clinical decisions at a moment’s notice.

Why use VR for nontechnical skills?

There are several emerging factors that indicate the use of VR as a valuable adjunct to healthcare education and training. VR can be a cost-effective way to promote reeducation or facilitate development of new skills, and it offers an added benefit of portability and requires minimal space to set up. 

Another key feature of virtual reality simulation is the individualized practice that learners go through compared to other methods of simulation that often occur in groups. 

Educators, trainers, or simulation technologists may gravitate toward virtual reality, particularly for difficult to simulate situations, like large-scale emergencies, or for conditions and situations that are not often seen in daily clinical practice.

As virtual reality can be engaged with remotely, it opens the door for members of interdisciplinary teams across departments to work together wherever they are, eliminating some of the administrative work of coordinating schedules or reserving a conference room. 

A systematic review looking into the design of virtual patients in medical communication skills noted the strengths and areas of improvement for virtual reality simulation in medical education, and reported that VR remained an area of interest and promise, in part, due to the repeatability and immediate feedback provided by VR. 

Specific nontechnical skills training in VR

Patient Interactions

With AI becoming ever-more advanced, the use of AI-driven virtual patients allows learners to have conversations with patients in the VR world just like they would in real life. This use of voice control, combined with the rich backstories of virtual patients, brings an additional layer of complexity to virtual scenarios and allows learners to stretch their nontechnical abilities. 

Particularly in scenarios focusing on complex communication, such as de-escalation, breaking bad news and motivational interviewing, skills such as communicating in an empathetic and holistic manner are vital – and VR allows this training at scale.

Interprofessional Teamwork 

In many team-based scenarios, learners from multiple disciplines must work together to collect relevant information, form hypotheses, devise and conduct an intervention plan, and monitor the patient to determine the success of treatment or the need to make adjustments. 

Learners can speak directly with one another during the scenario to facilitate timely team decision making and a collaborative interdisciplinary environment.

Additionally, interprofessional scenarios allow multiple disciplines to learn from one another, providing insights into the roles of other professionals, and with team-based feedback, learners can gain a deeper understanding of how their actions, and the team’s actions as a whole, impact patient care.

VR simulation with defib

Clinical decision-making

Independent of the type of scenario, learners can engage in critical thinking and situational awareness, informing their clinical reasoning and decision making skills.

By engaging in observational skills, learners can monitor patient status changes or fluctuations, like an onset of pallor or clamminess. Performing assessments, like vital signs or auscultation, can provide learners with pieces of information that help them put together a holistic picture of the patient’s status.

In taking on a lead role, learners become responsible for the collation of data provided by the patient and medical chart that, together, help to inform a clinical diagnosis. As this diagnosis becomes clearer to the learner, actions must be taken in order to address the underlying problem, meaning learners must know how to collect relevant information, interpret it, and how to intervene in the best interest of the patient. 

The development of nontechnical skills is essential for both future and current healthcare professionals, which give clinicians a foundation from which to make appropriate decisions and communicate effectively, both interprofessionally and with patients. 

The use of virtual reality for training nontechnical skills is a growing and exciting area of healthcare, demonstrating yet another possibility for using VR to supplement and innovate healthcare education and training.  

Interested in trying VR sim? Arrange a free demo with us today.

Clinician Decision Making in Virtual Simulation

Oxygen placement virtual simulation
Oxygen placement virtual simulation

Healthcare professionals, like nurses, doctors, or occupational therapists, make an incredible number of decisions per day. In fact, nurses working in critical care actually make decisions almost every 30 seconds, adding up to about 960 decisions made in a single shift of work. 

This inordinate amount of decision-making directly impacts patient care, so it’s vital that clinicians are not only making and acting on these decisions, but also that they’re taking into account a multitude of factors given the context of the case to make the best possible decision for their patients. 

In order to build a skill, even complex and nuanced ones, repetition is a key component of success. Healthcare professionals and students alike need to continually leverage the knowledge they have to apply their skills and put it all together to make sound clinical decisions, and the use of new digital tools is one way to allow for consistent and flexible repetition to maintain or build skills. 

Clinical decision making

There are lots of terms used to describe a part of the whole process of making a clinical decision, and while they are all a piece of the puzzle, they’re not necessarily interchangeable. 

The term ‘clinical reasoning’, for example, was studied in a scoping review which found that across several hundred papers across health professions, 110 different terms were used to describe or to reference the concept of clinical reasoning. 

Within the context of physical or occupational therapies, there are explicit definitions in clear frameworks that use this term to describe the process of clinical reasoning, however, not all disciplines use the same definition or frameworks. 

‘Clinical judgment’ is a term becoming more quantifiable thanks to the National Council of State Boards of Nursing (NCSBN) who created a working model to measure clinical judgment in the Next Generation NCLEX. 

There are several models or frameworks used to describe the process of clinical decision making in nursing, and there are multiple factors that can influence the decision-maker, both intrinsic to the decision-maker, e.g. experience level, and extrinsic, i.e. environmental factors. 

virtual patient headache

Clinical decision making is context-dependent and often time-sensitive, meaning all of the factors that go into a decision and action require high-level cognitive skill to efficiently assess and analyze the entirety of the situation, then form a judgment, make a decision, and act. 

Methods like simulation-based education have been used to bolster the connection between theoretical knowledge and practice, and as virtual reality has been adopted into the healthcare industry, it’s gaining more traction in its use for the development and assessment of harder-to-test concepts like critical thinking, clinical reasoning, and clinical decision making. 

Virtual simulation supporting clinical decision making

Virtual simulation, often used as an umbrella term to include in-headset & immersive virtual reality (VR) and virtual screen-based simulation (VS) has become an accessible and flexible way to have learners work on skills and knowledge transfer in and outside of the classroom or clinical setting.

A systematic review spanning 1996-2018 found that 86% of included studies reported that virtual simulation had a positive effect on students’ learning outcomes, which included critical thinking and decision making, as well as knowledge and skill performance, among others.

For undergraduate nursing students, in particular, virtual simulation has been used to bolster the development of clinical decision making skills, and while more extensive research is needed in this rapidly-evolving field, virtual simulation appears to be promising for cognitive skill-building in future healthcare professionals.  

Virtual simulation offers a means by which learners can engage in simulation-based education at any time, anywhere, with unlimited opportunity to repeat and practice skills at their own pace.

virtual patient hand tremor

As virtual simulations are standardized, they’re able to be used to both practice conceptually-driven skills like clinical reasoning and for procedural skills like catheterization. 

By placing learners in a lead role, it’s easy to see how virtual simulation can encourage and challenge cognitive skills like clinical reasoning and judgment. 

In these scenarios, learners can assess the situation and gather relevant information through a variety of methods and use context-dependent reasoning and observational skills to inform hypotheses and implement interventions, without ever placing patient safety at risk. 

Learners are able to practice making decisions in a timely manner in a safe environment where mistakes are encouraged and used as a learning opportunity. 

Automated feedback can reinforce well-understood concepts and skills while providing evidence-based rationale to bolster acquired knowledge and bridge the gap for skills or concepts that prove difficult to transition to practice. 

In addition, virtual simulations can be used to assess these types of skills – University College Birmingham has utilized VR in this way with plans to expand its use in their programs, and Stamford Health has used VR to assist their entry-level nurses in the transition to practice. 

Virtual simulations continue to show promise for their use in the development of skills like clinical reasoning and decision making. To learn more about implementing VR into a curriculum or training program, set up a time to discuss in more detail here.

Interested in trying VR sim? Arrange a free demo with us today.

Understanding and Preparing for the Next Generation NCLEX

Laptop and VR headset on desk
Laptop and VR headset on desk

As of April 1st of this year, the Next Generation NCLEX (NGN) is in effect!

That means new item types, cascading questions, and greater emphasis on critical thinking and clinical decision making. 

These cascading questions involve a set of six questions, with a combination of different item types, that all relate to one case study. Test-takers will need to complete three of these case studies throughout the NGN, however, two will be scored while the third will be validated for future use. 

An exciting time for many in the nursing profession, both in clinical practice and in education, it’s also likely to be somewhat daunting for the first waves of test-takers. 

What is this new version of the NCLEX, and why should it be embraced, not feared? 

Why was the NCLEX updated? 

The National Council of State Boards of Nursing, or the NCSBN, noted the rising responsibilities of new nurses and the idea that they must make increasingly complex decisions during patient care. 

This points to the expectation for new nurses to utilize clinical judgment, which is a concept that encompasses both critical thinking and decision making skills.

What’s more is that recent data has shown concerning rates in terms of readiness to practice. Of those assessed, 91% of new nurses were outside of the acceptable range for competency.