Tag Archives: VR

How OMS is Promoting Practice Readiness and Nursing Retention

Stamford Hospital
Stamford Hospital

In the United States, nursing turnover rates average a staggering 27%, and the healthcare system is facing a nursing shortage of up to 450,000 by 2025.

Additionally, recent data shows concerning rates of new graduate nurses’ readiness for practice, with 91% of those assessed landing outside of the acceptable range for competency of new nurses. This, compared to previous numbers of 77% in 2017, shows the seriousness of the situation and the need to prepare and support new grads as they begin their clinical practice. 

Stamford Health, a non-profit independent patient care network in Connecticut, recently began using OMS as a means to address these growing national concerns in their nursing education and training program. 

The Graduates Engaged, Mastering & Succeeding, or GEMS, program is designed to support and guide new nurses through a comprehensive orientation as they transition from schooling to practice.  

Michelle Saglimbene, Stamford Health Simulation Manager, notes that “The use of virtual reality is The Center for Simulation and Learning’s approach to being innovative and connecting with our younger generation of nurses.”

These immersive VR simulations provide a psychologically safe environment for learners to practice, make mistakes, and correct errors in order to bolster confidence and clinical competence.

In-game image of nursing assistant drawing blood cultures

Saglimbene notes that benefits of implementing virtual reality into their training programs include “repeatable scenarios, cost-effective training options and a completely immersive learning experience”. 

She went on to say that “Oxford Medical Simulation offers our learners the opportunity to hone critical thinking and clinical reasoning skills. In a completely safe, virtual environment, each learner can enter a virtual hospital room to interact with and care for a patient”.

Not only do these scenarios provide learners with the opportunity to practice their clinical skills in an interactive environment but, because they are grounded in evidence, they also provide robust feedback and analytics for the learner and trainer to review. 

Evidence-based rationale is recorded for each unique encounter, providing a report of what went well and where there’s room for improvement. “Detailed reports of this nature,” Saglimbene notes, “allows the clinical educators to tailor the education to the needs of that specific learner”.

Looking ahead, institutions like Stamford Health can adapt existing scenarios or create custom scenarios themselves or using the no-code authoring platform, OMS Create.

OMS Create provides the freedom and flexibility for health systems to embed their own institutional protocols, cover specific objectives, and even build their own virtual onboarding programs – delivering any clinical training they need to in order to support the nursing workforce. 

VR authoring platform - OMS Create

As Saglimbene states, “With each immersive experience, the nurse can review their performance, allowing clinical educators and the learner to collaborate and create an individualized, data-based learning plan to track performance. There are unlimited opportunities for learners to improve, using OMS”. 

To learn more about how you can implement OMS for practitioner readiness, set up a time to chat with us here.

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

How VR Simulations are Designed: An Inside Look into the Authoring Process at OMS

In-game screenshot nursing assistant providing oxygen
In-game screenshot nursing assistant providing oxygen

When you’re in the midst of searching for a VR partner, it’s important to understand how their scenarios are built. Not all VR simulations are created equal, and you’ll likely want the scenarios you use to be grounded in evidence and current best practices. 

At OMS, the sentiment is that there’s a responsibility to create consistently high-quality, evidence-based clinical scenarios – which is why we’re giving you an inside look at how we strive to do just that.

Who creates the scenarios?  

Multiple teams at OMS work together to ideate, build, iterate, and update scenarios. 

The Product Management Team, who are clinicians and experts in simulation, work with clients to figure out what needs to be built, what the learning objectives are, and what the roadmap should look like. 

Then, the Clinical Authoring Team and Simulation Engineers work to make it happen. 

The Clinical Authoring Team is made up of clinicians, simulationists, and educators who have deep knowledge to pull from in order to build robust narratives within scenarios. They work hand-in-hand with the Simulation Engineers, who construct the technical elements of scenarios. 

The clients who partner with OMS to create custom content are involved from the very start. They help to decide the core of the scenario, the learning objectives, the initial specifications, and which guidelines are used to build from. 

How do scenarios get built? 

It all starts with a list of questions: 

  • What is the problem we’re trying to solve? 
  • What are the lessons or skills that learners should take away?
  • Which modalities need to be built-in to meet those objectives?
  • What would be most impactful for the learners completing the scenarios and the patients who will ultimately receive their care? 

As the questions above get answered, a roadmap takes shape, at which point Clinical Authors and Simulation Engineers begin their work on the creation of the environment, character(s), and actions or tasks. 

As construction begins, the authors continuously think about the feedback learners will receive, how that fits into the learning objectives, and how the scenario as a whole fits together to achieve those objectives. 

At the same time, Clinical Authors look at the best practice evidence and implement the most up-to-date guidelines to build realistic, accurate simulations. Because the core of the scenario is based in evidence, the actions learners should take and the feedback they receive is grounded in best practices, as well. 

All the while, there’s a continuous iterative process happening between the Clinical Authors, Simulation Engineers, and, if applicable, clients. Clients who are involved in this process receive regular updates and provide feedback to OMS throughout the creation of a scenario. 

Are scenarios reviewed? 

Yes, any scenario that’s created undergoes a structured, multistep review process that begins with a technical peer review. At this stage, the Quality Assurance team ensures the usability and accessibility of a scenario before it moves on to the next phase, the clinical peer review. 

During the clinical peer review process, the scenario goes through a review with another Clinical Author. Depending on the subject, a subject matter expert may be brought in to consult – scenarios with a focus on diabetes management or mental health are good examples of this.

After the scenario has been approved through both the technical and clinical peer review processes, it moves on to the final review process with other team members to ensure it’s ready for release. 

Following its release, team members conduct regular reviews of best practices and clinical guidelines to ensure scenarios are always up-to-date. Additionally, OMS continues to take feedback from clients and adapt the scenario to fit clients’ needs. 

Becoming your own clinical author

Through the use of the no-code platform, OMS Create, you now have the same freedom and flexibility that the internal authors at OMS have in creating scenarios

Here, you can adapt content, with or without the help of OMS teams, meaning you can become a clinical author, too! 

Make immediate changes to the scenario, like with physiology, medications, or new images, guidelines, or audio. 

VR authoring platform - OMS Create

Changes can be made to feedback and scoring, as well. For example, if you work in a healthcare facility, you may want the guidelines listed in the scenario to reflect your hospital’s policies and procedures. You may also choose to weight feedback differently or create benchmarks for passing a given scenario. If you work in education, you may decide to align feedback with a given competency framework to see where your learners are well-prepared and where there’s room for improvement. 

The knowledgeable and supportive teams that create and manage the OMS scenarios are learner and patient-minded, consistently working to ensure scenarios are true-to-life, engaging, and remain grounded in best practices. 

To learn more about how you can work with OMS to create your own scenarios, set up a time to chat with us here

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

Deliberate Practice Makes Perfect?

It was long-thought that education plus experience equals expertise, but nowadays, it’s clear that there’s more to that equation. 

There’s a lot of complexity in mastering a skill and consistently performing at a high level. 

By delving deeper into what it takes to develop expertise, psychologist K. Anders Ericsson seemingly pioneered a new field of study by suggesting that engaging in deliberate practice is what is more likely the key to becoming the best in the world in a given domain.  

What is deliberate practice?

You’re probably already familiar with the tenets of deliberate practice, even if you’ve never heard the term before. 

In short, deliberate practice refers to the self-directed, often isolated, focused practice on a given skill or subject. It’s typically task-oriented, with clear goals or steps to achieve the next level of mastery. It also requires significant focus and concentration, which may be why shorter durations of practice can work better in this context. 

Conditions right for deliberate practice

While there are a few variations to this, the general conditions for deliberate practice include: 

  1. A task with a well-defined goal
  2. Motivation to improve
  3. Challenge is just beyond skill level
  4. Opportunity for expert feedback
  5. Ability to repeat the task and correct errors

Step by step, a learner could theoretically build their skills, progress, and become an expert in their chosen field. 

To get there requires well-defined goals or ‘rungs’ to climb up a given ‘ladder’ of progression to ultimately master a skill. SMART (specific, measurable, achievable, relevant, and timely) goals are a great place to start when engaging in deliberate practice. You need to know exactly what it is you need to accomplish before moving onto the next stage of difficulty.

An ideal learning environment often requires you to be well-rested and motivated to improve with a challenge just beyond your current level of ability.

In many situations, to get better at something, you need feedback and time to reflect for skill mastery. Take in feedback and reflect on your own actions and thought processes. Then, you can repeat the challenge, correct your errors, and refine your ability until you’re able to complete the task successfully and consistently.

Debrief after an OMS scenario

Timing matters here, too. Even experts will tell you how much mental energy can be devoted to mastering a skill – in fact, they typically don’t engage in more than four hours per day of deliberate practice. 

If you’ve found yourself thinking back to your own days of training, a lot of this probably sounds familiar to you. That’s because deliberate practice knows no bounds – from National Spelling Bee competitors to musicians to healthcare professionals – you can apply this concept to just about any field or skill that requires practice to master. 

Acquiring a skill

In thinking about deliberate practice, there are really two types of skills that are included here. 

One set of skills you learn only once – that is to say, once you achieve the skill, more practice doesn’t change your ability. The other includes skills that are perhaps more complex or that require practice to maintain, like performing CPR. 

Think back to a time when you were just learning something new – say, riding a bike or tying your shoes. You certainly spent time practicing, which may have been frustrating at times. 

When you finally got that skill down, you probably never changed your pattern for it – in other words, you became so consistent with your new skill that it became automatic and part of your procedural memory

Do you think about tying your shoes these days? Or do you simply do what you already know how to do? With skills like these, your performance generally doesn’t improve over time or with additional practice. You know how to tie your shoes, so you do that. 

For skills that require consistent practice for maintenance or continual improvement, you’d need to actively counter the automaticity that comes along with skill repetition. Instead, you would set new goals for yourself that are just outside of your current reach and continue that pattern as you become expert-level. 

Simulation-based training

Of course, experience matters, too! It can take years or even decades to become an expert in a given field, especially one that requires consistently high performance for almost any situation – say, healthcare, for example. 

To acquire the necessary knowledge and skills to be an expert clinician takes not only time but also effort and practice. 

One way to do that is through simulation – learners work through a clinical case in real time; they practice, receive feedback, and reflect afterwards. 

Simulation-based training has similar elements to that of deliberate practice. Scenarios can be adjusted to be just outside of a learner’s level. There is ample opportunity for feedback, reflection, repetition, and error correction. In many cases, there are clear and well-defined goals for the simulation and what needs to be done to move onto the next level. 

Deliberate practice in healthcare

As it relates to simulation-based training, there is quite a bit of evidence already out there. In one paper by McGaghie et al., authors reported that “without exception and with very high confidence the CER (comparative effectiveness research) data favor SMBE (simulation-based medical education) with DP (deliberate practice) in comparison to traditional clinical education”. 

Across skills ranging from ACLS (advanced cardiovascular life support) to cardiac auscultation to catheter insertion, the results of their study were “clear and unequivocal” – SBME was superior for the acquisition of a number of medical skills. 

Virtual reality (VR) and computer-based simulations are particularly well-suited for deliberate practice. They offer a recreation of real-life scenarios and provide immediate feedback with time for reflection. Another key advantage of VR simulation is the ability for learners to repeatedly practice, independently, in a psychologically safe environment.

How OMS can support deliberate practice

At OMS, deliberate practice is already a part of the program.

Of course, scenarios can be supervised whenever you’d like, but as scenarios and feedback is completely automated, learners can complete scenarios asynchronously.  Both VR and computer-based simulations allow for faculty-free practice. Learners can engage in scenarios repeatedly and independently to practice their skills and challenge their current level of ability.

Scenarios are evidence-based and undergo a rigorous peer-review process to ensure they are up-to-date and in line with current best practices. 

Because the scenarios themselves are evidence-based, the feedback is, too. After learners complete a scenario, they can review immediate feedback, categorized by the critical, important, and additional. As the learner reviews feedback, they can see the timing of their actions, along with notes on the frequency, prioritization, or delegation of relevant tasks, as well. 

Not only that, learners can also view the rationale behind certain actions. The feedback remains accessible to the learner any time, providing ample time for reflection and giving the learner well-defined goals for future improvement. 

Competency mapping and tracking
Competency mapping and tracking with NCLEX tags

Competency Mapping and Tracking is one feature that can be used to track progress. With this feature, you can toggle on an existing competency framework. For example, if you chose the NCLEX framework, each piece of feedback would be tagged with the corresponding NCLEX competency, aligning learner actions with core principles of the selected framework. This gives you a sense of what’s going well, and you can see exactly where improvements can be made, further providing clear and well-defined goals for progress.

Additionally, OMS has built an authoring platform, OMS Create, which gives you the ability to build your own scenarios from scratch or simply tweak an existing one. With this platform, you can easily adjust a simulation to be the appropriate level of challenge for any learner.

VR authoring platform - OMS Create

As aspiring experts work to progress their skills, it’s important to remember that superior performance isn’t just about getting experience and relevant education. It also requires focused and consistent practice.

With the right conditions, deliberate practice can have a positive impact on learning and skill acquisition. In partnering with OMS, you can ensure that your learners have the opportunity to practice independently and repetitively, all-the-while receiving relevant feedback and clear goals for their future skill mastery. 

Set up a time to discuss how OMS can give your learners what they need – here.

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

What is XR, and How is it Transforming Healthcare?

Johns Hopkins Simulation VR team
Johns Hopkins Simulation VR team

Developments in healthcare technology are now more exciting than ever. With increasing pressure on health services, it’s now crucial to use emerging technologies to support staff, reduce human error, and improve patient outcomes.

Enter XR — a group of technologies, first seen in gaming and education, that are now shaking up all aspects of healthcare.

With the global healthcare market for XR estimated to reach $4.6bn in the US alone by 2025, XR is a game-changer for healthcare systems — and there are surprising possibilities for its use in training, recruitment, and beyond!

What is XR?

XR — or Extended Reality — is an umbrella term for all immersive technologies, including virtual reality (VR), augmented reality (AR), and mixed reality (MR). These all “extend” our reality by blending the real world with computer-generated elements or by creating an entirely immersive virtual experience.

Virtual reality (VR)
is arguably the most well-known of all XR technologies. Using a Head-Mounted Device (HMD), like the Meta Quest 2 or Pico Neo 3, users receive a completely immersive experience. This experience can be simple, like a 360° video of a real-life setting, or a completely interactive, adaptive virtual environment. 

What are the uses of VR in healthcare? There are plenty! On the educational side, platforms such as OMS can deliver virtual clinical experiences to healthcare students and practicing clinicians alike. Were OMS focuses on training for nurses and physicians, other virtual reality platforms serve procedural training for surgeons. Beyond that, VR has direct applications to patient care, such as  gamifying physical therapy sessions to speed up recovery times, and using immersive, controlled scenarios to improve outcomes in mental health patients.

Augmented reality (AR)
superimposes computer-generated content over what you see in the real world and is used mainly with phone apps and smart glasses. Though it doesn’t offer the total immersion of virtual reality, AR is a valuable tool for overlaying additional information in a real-world environment.

Augmented reality offers some fantastic benefits to healthcare training and patient care. For example, institutions have leveraged AR to improve the success rate of intravenous injection by mapping vein structures onto the surface of a patient’s skin.

Mixed reality (MR)
has similarities to augmented reality in that a device projects computer-generated content over the real world. The fundamental difference is that mixed reality content is responsive and spatially aware. For example, a ball dropped in MR could bounce when it hits an object in your space, making the experience more interactive.

In healthcare, mixed reality can extend the impact of more limited training equipment. One application uses MR to provide dynamic feedback on low-fidelity manikins, which helps to maximize manikin functionality and significantly improves learning outcomes.

Learners using a high-fidelity manikin in training
XR offers several benefits over resource-intensive manikin simulation
A cardiac exam taking place in virtual reality sim
VR cardiac examination

What Benefits Does XR Offer Over Physical Training?

XR revolutionizes the traditional approach to healthcare training. Where learners would previously have only had occasional opportunities to practice on manikins, they can now practice whenever and wherever they need with virtual patients in adaptive VR scenarios.

This allows trainees and practitioners alike to practice safely, developing their skills and confidence in a lifelike environment, with improved learner outcomes

The most exciting part about XR technologies in healthcare training? They require fewer resources, reach more learners, and can provide feedback on improvement over time — helping you prove that you’re getting a return on your investment.

Fewer resources

Hands-on experience with real patients is an invaluable way for healthcare trainees and professionals to develop their skills — but it comes with the added risk of putting patients’ lives in danger. Manikin-based simulation was designed to bridge this gap, allowing students to learn from their mistakes safely.

Sadly, there are still drawbacks to this method of training. To anyone familiar with physical simulation, it should come as no surprise that the setup is expensive and resource-intensive. In addition, the equipment requires considerable space, ongoing maintenance, and dedicated faculty to run every session. XR platforms differ in that they’re relatively inexpensive, require a fraction of the space, and many require little-to-no external supervision once configured. Virtual reality allows you to create multiple environments using the same platform — such as maternity labs and outpatient clinics — helping you deliver outstanding healthcare education to as many learners as possible.

More scalable

Because of physical simulation’s resource constraints, scaling up operations to meet demand is rarely workable. Institutions don’t always have the time, money, or faculty needed to give learners on-demand access to the training they need. The good news is that these obstacles don’t apply to XR, so you can facilitate truly flexible learning. Cost-savings, portability, and the possibility of unsupervised practice mean that users can train anywhere, at any time, repeating simulations as often as needed to hone their skills.

Better feedback

Even the best technician will find it impossible to operate a scenario exactly the same way consistently, which makes it challenging to measure cohort performance. Additionally, the debriefing process is rarely recorded, and learners can’t effectively benchmark their efforts. On the other hand, standardized XR platforms give the same experience to each user every time without fail. Even better, platforms like OMS use advanced analytics, so users can track their improvement over time and understand how to improve.

Arrange a free demo to find out how VR sim can meet your institution’s needs.

How Can XR Be Used Besides Education?

We’ve explored why XR is an ideal medium to supplement physical simulation and education in healthcare. Still, there are so many other ways that technology is useful in healthcare. This is especially true of virtual reality.

Ongoing training

Learning shouldn’t stop when students graduate. Up to 57% of new RNs leave their roles because of an inability to ensure patient safety, and a lack of ongoing training plays a key role. The portable, scalable nature of XR lends perfectly to solving this dilemma. Users are free to brush up on existing skills — and learn new ones — in a safe context before transferring their learning to actual patients. A vast library of scenarios with VR means a wide range of staff can access tailored learning opportunities. The flexibility of the tech also means that busy doctors and nurses can fit in training around their hectic schedules without too much prior scheduling.

Recruiting the best staff

With up to $250,000 invested in a single physician candidate (and around $82,000 for a nurse), hiring the right person for the job is vital. This makes virtual reality an ideal medium for hiring managers. It can help remove bias, test skills in a standardized environment, and impress top candidates by using innovative tech to show that institutions are willing to invest in staff development.

Encouraging staff retention

The average US hospital has turned over 80% of its RN workforce in the last five years, and annual physician relocation rates sit at around 11–18%. Healthcare institutions must invest in their workforce to promote a happier, more engaged culture. Integrating novel technologies (such as XR) into training programs can encourage job satisfaction, and analytics feedback from platforms such as OMS can help faculty identify who needs extra support. Virtual reality is also great at expanding user perspectives, which can be crucial for reducing interprofessional barriers and encouraging collaborative environments.

Improving remediation of healthcare professionals

In healthcare, ensuring patient safety is vital, so staff underperformance is a cause for concern. The problem is this: remediation programs lack uniformity, and there’s little research to suggest whether outcomes are successful. XR can help to change this by providing standardized training that easily integrates into remediation programs. Some platforms even offer detailed analytical feedback to suggest whether staff are genuinely making progress. Even better, tracking performance in this way can help to catch issues early so that institutions can proactively address concerns before patients are exposed to potential harm.


Extended reality is at the forefront of the new, exciting innovations in healthcare. It’s widely acknowledged as a formidable tool for its educational applications, but there is so much more to what AR, MR, and VR can offer. 

As champions of virtual reality healthcare simulation, we’re particularly excited about the possibilities that VR provides in training competent nurses and physicians, hiring the best candidates, encouraging retention in valued employees, and supporting healthcare professionals to practice safely and elevate their performance.