New VR Technology Transports Nursing Students to a Busy Hospital Floor

Recently developed vrClinicals for Nursing training platform ramps up the 'day-to-day unpredictability of nursing.'

New immersive virtual reality (VR) technology is transporting Herzing University nursing students to a busy hospital floor where they must handle multiple patients and frequent interruptions—just like the real world.

vrClinicals for Nursing, an immersive, VR nursing education experience, recently was developed by Wolters Kluwer, Health and Laerdal Medical. Students using vrClinicals for Nursing with a Meta™ Quest 2 headset will be engaged in an authentic, virtual clinical environment where they must navigate real challenges nurses encounter on the job: prioritizing multiple patients with varied, complex cases; colleague interruptions; and patient requests.

With the current nursing shortage and limited clinical opportunities, newly licensed nurses are increasingly managing higher patient caseloads and must refine their independent clinical judgment earlier in their careers, according to Wolters Kluwer. Metaverse-related technologies, which are being used in many nursing schools, can provide the experiences to better prepare today’s nursing students for this environment.

The new technology mirrors the “the day-to-day unpredictability of nursing,” says Leila Casteel, DNP, APRN, NP-C, a practicing family nurse practitioner and associate vice president, Curriculum & Innovation at Herzing University, a Milwaukee, Wisconsin-based private university.

Casteel spoke with HealthLeaders about how the new technology is benefiting and preparing the university’s nursing students.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: How much of the current learning is in-person clinical work and how much is virtual simulation?

Leila Casteel: About 45% to 50% of our clinical hours across all of our clinical courses are simulation and of that simulation, there's a component of campus-based high fidelity, which is a smaller component. So I would say overall, about 35% of our clinical hours are completed using a virtual clinical experience.

HL: As a practicing nurse yourself, and also as an educator, how effectively does virtual simulation prepare nurses for the real world of nursing?

Casteel: It may sound a little blasphemous to say, but in many ways it prepares students more so than some of the live placements, and that's for a number of reasons. We've recognized that something has degraded a little bit in new grad nurses, and you think, “How did we get here? How, over the last 20 years have we become less effective at the bedside when we graduate?”

Part of that is the unpredictability of where your students land, and so much is dependent upon not only the strength of the clinical instructor, but the environment itself—the patients, the staff, and the willingness and interest of the nurses. You also have nurses out there who don't know the clinical judgment model because that's not what they learned.

So, we have to ensure that our students are getting that full experience and that we have measurable outcomes. One of the best things about virtual experience is that it can be very intentional and have very specific outcomes that are assigned and aligned with whatever's happening in that course. And you can ensure that all your students are getting that experience from end to end, which feels a lot better than the uncertainty of just sending them out.

HL: Virtual learning seems to provide a less stressful environment where students can make mistakes without endangering a patient. How does this aid in their learning?

Casteel: It’s absolutely a part of their learning. That freedom to fail and the formative assessment that we can complete in this type of environment is so critical to their own self-confidence when they go out and are working with live patients, so it's almost necessary. They need to explore, because at the heart of clinical judgment is decision-making and how we determine next steps. For students to be able to think that way, they have to start thinking about not only the decisions they're making, but why they're making them, what the risks are, and making alternative decisions.

That's exactly what virtual simulation provides is the opportunity to explore and make a decision. Maybe it's not the right one, but now you've got this opportunity, this excellent opportunity, to explore that decision in a more meaningful way, so that you can try again.

HL: What does the new vrClinicals for Nursing technology bring to your students that previous platforms don’t?

Casteel: Primarily, the concept of having multiple patients, diverse patient experiences, and that idea of learning to multitask. So often, virtual products are focused on a single patient at a single time and there's a lot of limits to that. We can do a lot to enhance even those experiences and we do because we love all virtual clinical experiences.

But this is unique because it is much more like what you would expect in an actual facility or on the job: multiple patients, diverse conditions, and things to consider. They’re fully built out, so there's their story, their history, the chart, and everything else, so students get to dive in and learn a lot about the patients before coming into clinical, which is extremely important and something they can’t do currently.

The level of urgency is a little different. With most virtual experiences, the student has a little bit more control over that urgency and that feeling of stress, because they can hit a pause button and they’re focused on one single patient. This experience really does require them to be in a mode of thinking, “What is the next best thing to do if I've got 10 conflicting priorities?” They have to think that through and articulate that to their instructor. It’s so much more complex, but in a positive way.

What’s really interesting about this experience is the way it weaves in and out of clinical urgency and then into contemplation and reflection, and then back into clinical urgency and back out into reflection, contemplation, and discussion. That’s good for a lot of reasons, but mostly for the deeper learning that can occur in that guided experience.

HL: How do the students feel about using virtual simulation technology?

Casteel: For a decade or so, we've had this interesting group consisting of very experienced techies and also some who didn’t want anything to do with it. But what we're seeing now, especially post-pandemic, is even those who were a little late to the game are now accustomed to using technology for everything.

We use our phones for everything, so there’s much less resistance. They’re almost drawn to it because that is now the norm. If the experience itself is meaningful, students report that not only did they learn something, but they were given that brain space to think about what they were learning so it sticks a little bit more. And they're going to be able to go tomorrow and explain that to somebody because it was an experience and not simply following a nurse and trying to mimic behavior. So, when it's done well, students really like it.