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Virtual simulations like the one pictured here allowed more than 200 nursing students to complete clinical placements cancelled due to COVID-19. *Image courtesy of vSim® for Nursing, Mental Health 2020. Reproduced with permission of Laerdal Medical. 

Faculty use virtual patients to save the day for more than 200 nursing students

May 11, 2020 | Health, Science, Campus Life
In our Moving Online series, we look at the variety of ways faculty members and students quickly shifted to teach and learn digitally – including more than 200 nursing students who were able to complete clinical placements cancelled due to COVID-19. 

Spending time alongside practicing registered nurses in real-word settings is a key part of nursing education. But as in-person classes ground to a halt, so too did nursing clinical placements. With students no longer able to make their way into community and hospital rotations, faculty were quick to look for ways to help students cross the semester’s finish line – especially those expecting to graduate in the spring.

“We knew we had to dig deep and figure out what we could do to help students progress in their program,” says Colette Foisy-Doll, simulation program coordinator with MacEwan University’s Clinical Simulation Centre, who suggested the option of using virtual simulation. “You can not fully replace the experience of being at the bedside with a real patient and their loved ones, but given the circumstances, this has been a timely and valuable alternative. Faculty are now using VR products as one strategy among many to enhance electronic course design and promote more robust learning experiences for students during these challenging times.” 

Simulation – using actors and computer-based mannequins to present different scenarios for students that bring classroom concepts to life – has been a staple in the university's nursing education for years, but virtual simulation, which presents screen-based scenarios on a computer completely online using incredibly life-like patient avatars, is relatively new. For the leadership of the Faculty of Nursing, that meant working with nursing regulatory bodies to obtain permission to deliver clinical rotations in this way and preparing more than 22 faculty members and more than 200 nursing students to quickly adapt and move their clinical rotations online.

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One of the mental health virtual simulation scenarios students in the mental health nursing course completed. Image courtesy of vSim® for Nursing, Mental Health 2020. Reproduced with permission of Laerdal Medical.

In Claudine Dref’s NURS 272: Mental Health Nursing course, for example, second-year students used virtual simulation to learn to ask difficult questions about suicide, self-harm, delusions and hallucinations. Before they ever “spoke” to a virtual patient, students did the same prep work they would in a hospital clinical placement – reviewing skills, reading, watching videos, looking up medications and researching their patient’s condition. When it was time for the simulation to begin, students went into the virtual hospital setting, met their virtual patients – each with different personalities and characteristics – took their vital signs, asked questions and received responses.

“It’s a great place to begin for students having their first exposure to mental health nursing and learning to have those difficult conversations,” says Claudine. “Our students’ biggest fear is always making things worse, and virtual simulation takes that fear away.”

While Jilian Irwin, a second-year student in Claudine’s class, says she definitely appreciated the safe space virtual simulation provides, the thing she appreciated most about this particular clinical rotation was the support she received.

“It was a difficult situation and I appreciate how much our faculty did for us,” she says. “They were understanding of what we were going through, and their transparency and open communication was what really made this a positive experience for me.”

Although, as Colette explained, ideally virtual simulation is not intended to replace in-person simulation or face to face clinical experiences, it does offer an additional powerful tool – one that could have a place in future MacEwan nursing classes.

Right now, the Clinical Simulation Centre is actively working on potential ways virtual simulations could be incorporated into nursing education at MacEwan for the Fall semester and into the future. Cynthia Gundermann and Julie Hoffart, professional resource faculty members in the centre, are mapping competencies in the virtual simulations to ensure they match the requirements of nursing regulatory bodies. They are also exploring the role MacEwan theatre arts alumni, who for the past year have been acting as standardized patients, could play in bringing an even more human feel to the virtual experience – either acting out scenarios live with students and providing valuable feedback from their characters’ perspectives, or recording videos students could use as part of their simulation experience.

“I think there is a huge opportunity for virtual simulation to enhance traditional clinical education models in many ways,” she says. “It’s about integrating it into a pathway of learning that includes clinical and lab courses because, ultimately, helping students progress in their program and have quality learning experiences is what it’s all about.”   

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Practicing skills remotely

Right before MacEwan's campus closed, Lab Supervisor Pamela Maharaj loaded her vehicle with intravenous poles, partial mannequins and anything else she could squeeze in to set up her lab at home. Since then, she has spent most of her time online supporting students learning nursing skills they use in virtual simulations – from practicing injections and medication calculations to priming IV lines.


All hands on deck

When the NURS 252 final simulation was cancelled, Assistant Professor Sue Carlson got creative. She and her son (who live in the same household) acted out cardiovascular and respiratory assessments in the centre while Simulation Technologist Chunyan Zhang filmed them from home. The videos, interspersed with questions, are now a resource Sue hopes to use in the Fall term.

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