Abstract:

Introduction:
Virtual reality (VR) use is on the rise globally, primarily due to the development of lightweight, affordable, and wireless VR technology. The use of VR in nursing and midwifery education has increased exponentially. Within VR, nursing and midwifery students can practice and learn in a safe environment that allows for trial and error. VR proved successful in various contexts like teaching chemotherapy administration, nursing skill competence training, and peripheral intravenous catheter insertion, among others. Evidence on the usability and feasibility of VR in nursing and midwifery education is lacking. In this study, we describe the usability of VR simulation among nursing and midwifery students, as well as their level of satisfaction with VR simulation, and explore their experiences of engaging with VR simulation.

Methods:
Convenience and snowball sampling strategies were used to recruit undergraduate nursing and midwifery students from a university in the south of the Republic of Ireland. Two VIrtual SImulatiON (VISION) weeks were launched in the university. Posters were displayed and circulated via e-mail. Each poster contained a quick response (QR) code that students scanned to register their interest in participating. Data were collected by four research staff members who were trained in VR use and who were not known to participants. Participants signed informed consent and engaged in a 20-minute VR simulation scenario of their choice. After which, they completed a 21-item survey comprising a sociodemographic questionnaire, the System Usability Scale, a satisfaction questionnaire, and open-ended questions. Descriptive statistics were used to analyse quantitative data. Qualitative data were analysed using content analysis.

Results:
Forty-three students participated in this study. The majority were female (n=39, 90.7%), either in their first year (n=15, 34.88%) or second year (n=16, 37.21%) of study, and reported having never used VR previously (n=24, 55.81%). The mean (SD) System Usability Scale score was 75.87 (13.7), indicating that VR simulation was acceptable. Most participants (n=42, 97.67%) were satisfied with VR simulation. They perceived VR simulation as informative and enjoyable, fostering self-directed learning without causing patient harm. VR was described as immersive and close to real-life, affording students the opportunity to learn various skills in a safe space. It took some participants some time to get used to the VR technology. Others reported minor technical issues and difficulties performing tasks like administering medications. Participants recommended using VR simulation to practice clinical skills, prepare for clinical placements, and learn about clinical situations that are rarely encountered in clinical practice. They suggested incorporating VR into teaching, learning, and assessment as well as making VR accessible in computer/IT labs and libraries.

Conclusion:
Study findings indicate that the development and integration of VR simulation in nursing and midwifery education is worthwhile. A future pilot study would help identify the most effective means of leveraging VR simulation. The space for VR needs to be primed in advance, especially that the development and exploitation of VR simulation are resource heavy. Educators and students need to be trained in VR use a priori. VR-based simulation needs to be underpinned by a strong pedagogy and aligned with learning outcomes.

Keywords:

Education, midwifery, nursing, simulation, undergraduate, usability, virtual reality.