Immersed in learning
The UC College of Nursing is transforming curriculum into virtual reality experiences
Imagine walking into a large classroom inside University of Cincinnati College of Nursing’s Procter Hall.
The chairs and desks are lined up along the room’s perimeter, creating an empty, open space, and small L-shaped strips of colored masking tape form 10 squares across the floor’s carpeted surface. Inside each square sits a virtual reality (VR) headset and two controllers. You stand in the middle of a square and put on the VR headset, resting the controllers in your hands.
The boundaries of your square and the space around you transform into a 360-degree view of a hospital room, including a bed where a middle-aged patient sits. You learn that he’s experiencing severe chest pain that has progressed throughout the day. As his nurse, what is your first move?
This is becoming a typical classroom experience for students in their second semester of UC’s Accelerated Direct-Entry Master of Science in Nursing (MSN) program, thanks to the college’s growing initiative to integrate immersive VR experiences into nursing curriculum to enhance learning.
“If it didn’t work for the students, then I wouldn’t be as passionate about it, but the students like it. It gets them out of their seats and out from behind their computers and actively experiencing clinical scenarios in a safe, controlled environment,” says Associate Professor Lori Catalano, PhD, RN, who teaches in the accelerated program. “If I could do this every single day, I would because I really think it’s an amazing way for them to learn.”
Using technology to transform learning
While UC College of Nursing has integrated VR sporadically since 2018, the idea to intentionally implement curriculum-aligned immersive VR experiences in the Accelerated Direct-Entry MSN program stemmed from a casual conversation last summer between Catalano and Matt Rota, PhD, the college’s assistant dean for technology and innovation and director of the Office of Learning Design and Digital Innovation (OLDDI).
“I believe that VR, AI and AR are going to have some of the biggest impacts on education—especially healthcare education,” says Rota, who completed his PhD in instructional design with a specialization in VR, and, as an Apple Distinguished Educator, is recognized for his pioneering of using technology to transform teaching and learning. “We’re meeting students with tech skills where they are. Students don’t see this as a game, they truly feel as if it’s an immersive learning experience.”
UC College of Nursing is one of the few nursing schools using VR for clinical simulation. The initiative bolsters the college’s vision to leverage technology, innovation and inclusive excellence to lead and impact the transformation of healthcare through strategic partnerships. To develop the VR experiences in a sustainable, cost-effective way, Rota, Catalano and the OLDDI team partner with VRpatients, a Columbus, Ohio–based simulation software company that began as a startup partially funded by Cincinnati-based tech incubator CincyTech. Using VRpatients’ no-code authoring tool, Catalano translates case studies she teaches in class into simulated clinical experiences that immerse students into life-like scenarios where they can interview, assess, diagnose and treat patients that are physiologically responsive and medically accurate.
The college’s partnership with VRpatients benefits faculty and students alike. It enables faculty like Catalano to provide efficient, consistent training on a limitless number of clinical scenarios, which they can easily customize and update based on students’ feedback. Meanwhile, students receive objective feedback from the software’s computer-generated assessments of their treatment decisions, and more importantly, the VR simulations improve their comprehension and retention and instill confidence.
Creating equitable learning opportunities
Catalano designs each VR experience to trigger students’ critical thinking skills. A menu visible in the top right corner of the simulated view enables students to figure out how to navigate challenging clinical scenarios. For example, students can choose from a list of questions (written by Catalano) to ask the patient. If they choose a question that isn’t appropriate for the situation — which Catalano purposefully includes — the patient’s response (also written by Catalano) will reflect their dissatisfaction. A tactile component is also part of the experience – to listen to the patient’s lungs, students can click “Assess” from the menu, select the “Stethoscope” option, reach out and grab the stethoscope and hold it up to the patient’s chest to hear their breathing in the headset. Students will even feel the controllers on their hands pulse to the tune of the patient’s heartbeat, which they’ll also hear in the headset.
Simulated clinical experiences are ideal for preparing nursing students on high-risk, low-frequency events — those that don’t happen often but could result in a patient’s death — because only a small percentage of students will encounter one during their clinical rotations. Prior to the college’s integration of VR into the accelerated program’s curriculum, Catalano’s students interacted with a simulated mannequin or a standardized patient in the college’s simulation lab.
“We can’t depend on clinical rotations to give students hands-on experiences for everything they’re learning in class,” Catalano says. “With VR, we can design simulation experiences and every single student gets to experience it as the nurse.”
The VR experiences that Catalano, Rota and the OLDDI team build not only meet nursing accreditation education standards, but they also feature diverse patient avatars, ultimately helping students develop greater cultural awareness. Students can also adjust the focus and zoom of their view in the headsets to meet their needs.
Expanding and enhancing VR integration
Catalano, Rota and the OLDDI team have developed seven VR experiences from case studies and recorded 165 student uses from January to May 2024. They piloted the VR initiative with students during the second semester of the accelerated program due to the smaller class size and after they learn necessary foundational skills. As the team plans to expand its integration of VR, they are focused on mapping VR experiences to the right time in students’ learning journeys. For Bachelor of Science in Nursing students, for example, this means introducing VR during their junior year, after they have gained one year of clinical experience.
“As we look to expand the program, I’m hoping articles such as this will encourage more faculty to look at their curriculum and use this type of technology,” Rota says, who adds that other colleges have reached out to his team for guidance on implementing VR into their curriculum. “Hopefully it will also help funders recognize that we are at the leading edge of curriculum redesign and immersive experiences.”
In addition to applying for grant funding to afford more headsets, Rota and the OLDDI team are excited to continue partnering with VRpatients to improve the user experience through increased integration of AI and haptic technology. As AI gradually enhances the software’s ability to recognize and predict movement and voice commands, and as haptic technology makes the tactile component feel more real, the VR experience becomes more natural and life-like to students.
Although VR will never equal the experience of caring for a patient in real life, Catalano says the critical thinking the VR experiences help foster will prepare students to save lives when they encounter challenging clinical scenarios in their professional careers.
“We’re creating muscle memory in their brain that tells them This is what I do in this situation,” Catalano says. “They still might be scared when they experience a high-risk, low-frequency situation in real life, but they’re going to have at least one experience under their belt, and that could make the difference in saving a life.”
By Katie Coburn
Featured top image courtsey of UC College of Nursing Office of Learning Design and Digital Innovation.
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