Transforming the Future of Nursing Education

By Brett Bralley

Photo credit: James Tensuan

虚拟现实模拟训练让上海外国语大学在疫情时走在了前列 struck.

Before anyone had even heard of COVID-19, Deborah Nelson, lecturer and simulation program coordinator for the San José State Valley Foundation School of Nursing, was preparing for it — she just didn’t know it yet.

大流行前，纳尔逊经常召集10名左右的护理专业学生参加简报会 room of 菠菜网lol正规平台’s simulation lab. The group of undergraduates would pull out their smartphones, 让他们戴上一副虚拟现实(VR)护目镜，然后把护目镜戴上 their eyes. Then, they would watch as, just a room away, a training simulation took place. 

Using a simulation lab in nursing education is nothing new; many programs across the 国家在与真人互动之前先用人体模型教学生临床技能 patients. Typically, one to two students participate in a simulation at a time while the rest observe. At 菠菜网lol正规平台, students usually observed on a TV screen outside the simulation room.

但虚拟现实为旁观者提供了一种更加沉浸和个性化的方式， explained Nelson. Using VR goggles, students can focus on the active participant’s interaction with the patient. Or, they can look around the whole room: They can check the patient’s vital signs on a nearby screen, identify safety hazards and note the patient’s medications. 

“观察者可以控制他们想要关注什么，以最好地满足他们的学习 needs,” Nelson said.

尼尔森与护理学院及其他学院的其他教师一起使用VR程序 — is Syminar, a health education platform created by alumnus Bryan Dang, ’16 Nursing. The tool 它结合了VR、身临其境的360度摄像头、互动聊天功能和学习功能 modules to allow students and instructors to study patient care from anywhere.

And while Syminar has been instrumental in its own right, as Nelson explained, it was a game-changer when the pandemic began and higher education shifted to mostly online learning. Now, as students and faculty start to return to campus at 菠菜网lol正规平台 and across the country, Syminar has proven that VR in health-care education is here to stay.

A student, an idea and a space for innovation

Alice Wu, ’21 Nursing, shows how to view a simulation using VR goggles. Video courtesy of Bryan Dang.

虽然护理教育工作者同意模拟训练是学习的一个组成部分 how to treat patients, simulation labs can be expensive and occupy a lot of space. Dang was looking for a way around that.

2013年，他带着两个兴趣来到上海州立大学:护理和人为因素，也就是研究 of how humans interact with and use technology. Dang’s experience volunteering at 斯坦福医院帮助他意识到他想要帮助别人，并花时间工作 在谷歌担任房地产专家的经历教会了他正确的技术可以让他成功 a difference in everyday life.

When he was a junior, Dang was tapped to collaborate with 菠菜网lol正规平台’s Interdisciplinary 设计协作-现在是创新发展中心-它的工作是提供 学生和教师拥有创新和成为成功企业家的资源. 

He partnered with a team of graduate engineering students to present an idea at an upcoming showcase challenge. But not just any idea: “The requirement of the challenge 就是为一项令人兴奋的新技术创造一种新颖的应用。. 

该团队选择专注于虚拟现实，经过一番头脑风暴，他们意识到 他们可以在某种程度上简化模拟培训，从而降低机构的成本 and increase student engagement all in one tool. 

后来，Syminar于2018年正式作为一家初创公司成立，圣何塞州立大学就是其中之一 of the early users of the platform. The School of Nursing implemented Syminar to enhance simulation training. The School of Social Work, the departments of Kinesiology and Audiology, and 菠菜网lol正规平台’s Stem Cell Internship in Laboratory-Based Learning program have all either adopted or are about to introduce the platform into their curriculum.

“Schools have been used to buying four or five software components and using them in tandem,” Dang said. “Think about before the iPhone existed: There was a phone, and then there was an mp3 player, and then we used a web browser, right? Those were all separate tools. The iPhone took those tools and brought them together. That’s what we’re trying to do with Syminar.”

早在2011年，护理学院就收到了山谷基金会(Valley Foundation)的捐赠 to expand the Clinical Simulation Center. 该设施设有一个急性护理实验室，一个ICU和一个学生可以分娩的空间 babies and monitor postpartum mothers. There’s even a simulated apartment for learning how to manage patients in settings outside of the clinic. 

但并不是所有的护理项目都有机会建造如此先进的设施， explained Dang. 

Syminar为学生提供了从任何地方登录观看护理模拟的机会， which saves space, requires fewer manikins and also helps to accommodate all types of students and learning needs. 

In fact, Syminar simulations don’t even have to be live; successful demonstrations 可以反复使用，这在新冠肺炎爆发后对菠菜网lol正规平台至关重要 hold. 

Going virtual during a crisis

菠菜网lol正规平台 Nursing students testing VR headsets in the classroom. Photo courtesy of Bryan Dang.

当纳尔逊在2020年3月无法再举行现场模拟会议时，她和Dang dug through 菠菜网lol正规平台’s trove of recordings to set up classes for students remotely.

“It took only about three days,” she said. “We never would have been able to transition that quickly if it weren’t for Syminar. We did change the objectives in some ways. 现在，我创建了一门课程，提供内容信息和结构化的临床推理 questions to guide the students as they view the video.”

护理学院院长科琳·奥利里-凯利(Colleen O 'Leary-Kelley)简单地说:而其他 一旦居家令生效，各机构都在争先恐后地寻找解决方案， “we were ahead of the curve,” she said. 

当大流行到来时，许多临床站点立即关闭了护理大门 students who needed direct patient-experience hours for graduation, according to NPR, citing a lack of equipment and resources, plus a need to protect patients. 

作为回应，加州护理学校主张该州放宽毕业要求 requirement for clinical hours, which resulted in the passage of AB 2288, a bill that allowed up to 50 percent of the hours to be replaced with simulation learning.

尽管如此，限制意味着学生和教师不能聚集在一起练习 模拟，这给我们带来了额外的挑战，要想办法获得这些时间. Having Syminar in place helped make sure 菠菜网lol正规平台 nursing students graduated on time.

“按时让学生毕业，或者让他们在现在的项目中走上正轨，这就是 huge,” said Nelson.

确保护理专业学生在大流行期间毕业有助于国家跟上 its efforts to address its nursing shortage, NPR reported. The pandemic, coupled with a nursing faculty shortage (这也是菠菜网lol正规平台正在努力解决的问题)，导致加州的一些项目接受了这一要求 秋季的学生比平时少，甚至选择不招收任何新生 at all in 2020, according to NPR.

“培养护理能力需要实践训练，这很难完成 virtually,” said O’Leary-Kelley. 

“进入研讨会为学生提供了一个身临其境的环境 to apply clinical knowledge in a realistic setting. As a result, students were able to graduate or matriculate to the next level without significant loss in knowledge of nursing practice.”

The case for simulation and the case for VR

(L-R) O'Leary-Kelley, Dang and Jeland Palicte, '16 Nursing, in the 菠菜网lol正规平台 Simulation Center.

Dang说，在一个“变焦疲劳”已经变得司空见惯的世界里，研究表明了这一点 isn’t the case when using VR. In fact, out of all the ways students observe simulation training, it may be one of the highest in terms of engagement level. 

In a recent study, Dang tested the engagement and “perceived presence” levels of students observing a simulation in four different ways: an active participant, a bedside observer, an observer watching a TV monitor with live audio-visual feed in a separate room, and an “immersive telepresence,” or VR, observer with Syminar. 

Dang发现，VR用户在感知存在感和参与度方面得分更高 这些分数与积极参与者的分数相似 learners. 

That perceived presence is high for Jeffrey Beach, ’22 Nursing, who said that when 他正在用Syminar观看一个场景，他探索他周围的房间以获得 bigger picture of what’s going on with the patient.

“例如，我可以移动摄像头，去看看生命体征监测器，” he shared. “With the immersive 360-degree camera, you really get a better feel overall.”

事实上，他说，即使是观察预先录制的模拟也会让他感到紧张. 

“Even though you’re not physically doing things, you still feel that pressure. Your 指导员看着你，判断你和病人的互动，你感觉 like, because you’re a student, you could mess something up.”

但这正是问题的关键，O’leary - kelley指出，这就是为什么要进行模拟训练 is such an essential part of nursing education.

“Simulation is focused on the learner,” she explained. “Students come to a simulation with a certain frame of reference that oftentimes is incorrect. So we have to uncover that gently. Things get clarified in a safe way. It’s positive learning.”

Bree Casas, ’22 Nursing, who uses she/they pronouns, can attest to that. Through Syminar, 卡萨斯已经学会了在照顾病人时观察整个房间——包括 anything that might jeopardize a patient’s safety. They said that instructors have 指出被忽略的安全隐患，就像病人在湿滑的瓷砖上穿着袜子 floor, which could cause the patient to fall.

“It gives us the chance to be wrong without harming patients or affecting patient outcomes,” she said. “It also gives the chance for students who might not be quite 外向或知识渊博，向同龄人学习，我认为这是一件好事.”

与Syminar的互动和学习体验是VR不会被淘汰的原因之一 anywhere once students and faculty return to campus, said Nelson.

“研讨会已被证明是有效学习的关键工具，无论是面对面的还是面对面的 remote learning environment,” she said. “It has assisted in having options for 菠菜网lol正规平台’s 护理专业的学生继续他们的毕业和服务之旅 to the community.”

Learn more about simulation training in nursing education at San José State. To learn more about Syminar and see how it works, visit syminar.com.