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Technology provides nursing students in 100% online programs with practical experience

May 2, 2022

As the COVID-19 pandemic swept through the country and universities shifted to online learning, nursing programs needed a new way of providing clinical experiences to students. Taking a cue from longtime online nursing programs like the RN to BSN, universities turned to technology for assistance.

What is a virtual simulation in nursing?

Throughout the years, traditional nursing programs have utilized in-person clinical simulations, which place students in a real-to-life learning experience using interactive mannequins or standardized patients (actors who portray patients), with many variations in between. However, the pandemic changed all of that and nursing programs came to rely on virtual reality simulations in place of their regular clinical simulations to provide meaningful educational opportunities.

Virtual simulations are valuable educational tools that not only provide nurses with practical experiences in a safe environment – they also allow students to effectively apply critical thinking skills and theoretical nursing care principles to better prepare them for a career in a real-world, acute care clinical setting.

Taking a cue from 100% Online RN to BSN programs

Online programs like Ohio University’s RN to BSN program have been using virtual patient platforms such as Shadow Health for years with great success. Shadow Health is included in two of the nine nursing classes required for the OHIO program.

These RN to BSN simulations allow online learners to participate in lifelike, conversational interactions with a wide variety of virtual patients. Learners advance their clinical and communication skills by interviewing, examining and treating virtual patients. According to Dr. Sherleena Buchman, assistant professor in OHIO’s College of Health Sciences and Professions School of Nursing, A variety of technologies can be used for virtual experiences.

VR simulations or vSim in nursing courses

Often universities have clinical simulation programs built directly into their nursing curriculum. Virtual simulations in nursing (vSim) is a platform that more universities embraced during the pandemic to helps to build clinical judgment skills through a realistic virtual environment, according to Dr. Buchman.

Cine-VR, a virtual reality 360 video simulation experience that uses the same principles of clinical simulation is a popular nursing tool. This way, students are able to see and hear a person in need, rather than using a mannequin.

“One example is the administration of NARCAN to a college student who has overdosed in a dorm setting,” said Dr. Buchman. “The learners are immersed in the virtual dorm room, which is viewed through virtual reality goggles, and are able to turn a full 360 degrees and see what is going on all around them. Additional Cine-VR simulations include two other opioid-related scenarios and a three-part experience related to providing care to a patient with Parkinson’s Disease.”

Why is simulation important in nursing?

Simulation is important to nursing because it provides the needed safe learning environment for students. "They are able to ask questions, make mistakes and learn from them without causing harm to a patient,” Dr. Buchman highlights.

“There are many opportunities for virtual and augmented realities to be utilized in nursing education. Our profession as a whole is just beginning to understand the potential for this type of learning,” Dr. Buchman explained. “vSim helps learners to develop confidence in their knowledge, skills and the attitudes of their profession, which is extremely important in the field of nursing.”

Nursing simulated electronic health records (EHR)

A critical part of simulations are electronic health records. Nursing students earning their BSN degree online or in-person can expect to not only learn about electronic health records, but to put that into practice. Nurses must document everything they do on a daily basis.

“There is a famous saying in nursing, ‘If it was not documented, then it did not happen.’ As vSim and Cine-VR are realistic nursing scenarios, it is important that learners develop the skills of charting and understanding the electronic health record," Buchman said.

What to expect from a BSN curriculum

Course requirements for BSN students, whether online or on-campus, are guided by the National Council of State Boards of Nursing, Quality Safety, Education in Nursing, and are built around the American Academy of Colleges of Nursing’s nine BSN Essentials. Ohio University’s RN to BSN degree is designed for working adults and offers 100% online coursework, 5-week sessions, and affordable tuition at less than $7,600 for the program’s nine required nursing courses.

Q&A with Sherleena Buchman

Q: Why did you decide to pursue your BSN after your ADN, and your MSN after your BSN?

A: I became state tested and started working as a nursing assistant at a long-term care facility directly out of high school.  I loved interacting with the elderly patients that I saw on a daily basis and although I had a personal family, these patients also became my family. I watched the nurses closely and realized that I wanted to become a nurse. As a first-generation college student, I was not sure how to go about going to college. I did some research and found out that I could not afford to go to a four-year school or even a two-year school at that time in my life so I decided to go to a technical school and become a licensed practical nurse. I was successful in my LPN program and received my first nursing degree.  I worked at a long-term care facility until I was able to return to school and I went into an LPN to Registered Nurse bridge program. I learned from the traditional students that were in my class and I was able to share from the experience that I had gained as an LPN. I was fascinated by my nursing faculty members and knew that ultimately, I wanted to educate other nurses.  Upon completion of the associate degree in nursing, I remained employed at the long-term care facility but also knew that I needed to get some acute care experience to achieve my dream of becoming a nursing faculty member. So, I took on a second job working at a local health care facility on a medical surgical unit and immediately decided to go back to school and obtain my bachelor’s degree. I went to the same school where I have received my associate because I knew that they had an associate to bachelor’s program and I also knew that they would work with me, understanding that I had to work due to the needs of my family. After successfully completing my bachelor’s program I was hired as a clinical instructor. I continued to work at the acute care facility and worked as a clinical instructor while I went back to school to start my master’s degree online. Three years later, I completed my master’s degree in nursing education and began my full-time employment as a nursing faculty member. I also started working as a nursing supervisor because I had fallen in love with nursing and I could not completely step away from my patients. Over the next five years, I worked as a faculty member and stayed employed at a local hospital on a per diem basis. At that time I decided to complete the final steps of my nursing education by obtaining a doctorate degree. I decided to complete a PhD from the College of Education in Instructional Technology.

Q: What are the most important resources you needed to prepare to earn your nursing degree?

A: As a first-generation student, the most important resource I needed to prepare me to be successful in my academic career was people. People who worked at the university, people who were able to guide me on the path that I needed to go in order to reach my dreams. I do not remember the names of many people who helped me to be successful, but I certainly remember the feeling of appreciation that I had for each of them.

Q: Can you discuss the value of education and integration of technology, immersive virtual reality and other simulations?

A: Choosing the right educational path is crucial. The path may look different for each person. The value comes from how one is able to apply that education to their life in order to achieve those pivotal moments. Integrating technology into education is a necessity in this modern day and age. Finding ways to integrate technology in meaningful ways for learners is the key. In nursing and other health care related professions, faculty have to focus on the delivery of knowledge, skills and attitudes regarding a vast array of real-to-life situations. Some situations can be brought to the learners by simple technological modalities such as videos, clickers and online databases. However, other topics may be best integrated through the use of immersive modalities such as simulation or virtual or augmented reality. Simulations can vary from basic skills such as hand washing to advanced life or death scenarios. These scenarios have many advantages as the learner is placed in a safe learning environment either with a mannequin or a standardized patient. Simulation faculty have to have specialized training to deliver the same scenario over and over to many groups of students. The outcomes need to be lifelike, therefore while all simulation scenarios will have the same starting point, the outcomes will vary significantly based on the group of participants and their knowledge, skills and attitudes. One of the values with virtual reality is that you can guarantee nearly the same experience for each learner as immersive virtual reality places the learner into a set scenario. The virtual reality can be a short clip or a longer immersive scenario depending on the needs of the learner and the target objectives.

Q: What advantages are there to earning your BSN? 

A: The advantages to obtaining your BSN after an ADN are numerous. Most importantly, it is a known fact that our patients’ clinical outcomes are higher. This makes sense because the more we know, the more we can be aware of, and advocate for, in our patient’s health. A BSN degree will provide a platform for leadership and management positions. Furthermore, there is increased job security with a BSN degree. Many employers and magnet status health care facilities will only hire nurses with a BSN degree or higher. Lastly, I will add that a BSN can be a stepping stone to obtaining a higher degree.

Q:What advice would you tell nurses who are considering getting their next level degree?

A: I would tell any nurse who has a degree, keep reaching for your dreams. If your dream is to be a bedside nurse, then continue your education to help you improve upon your current skillset to become an even better bedside nurse. No matter your current level of degree, continue trying to improve yourself. Nurses are the most trusted and caring professionals, we need to become the best nurses that we can be.