Just before the COVID-19 pandemic hit, nursing professor Elizabeth Wells-Beede attended the annual International Meeting on Simulation in Healthcare. It was there that she was introduced to the idea of using virtual reality headsets in the classroom.
“I was going through the vendor hall and was noticing that there were a couple of loan vendors that had the Oculus Quest headset, and they were kind of trying to show people what they were doing with VR,” said Wells-Beede, now the senior associate dean of the College of Nursing at the University of North Texas Health Science Center at Fort Worth. “I came back after that conference and started doing research.”
Inspired by some of the innovations in the K-12 space that have allowed students to have a one-stop virtual home base for learning through standardized hardware and software initiatives, she began thinking of ways to introduce VR into the classroom setting.
Like other professions where there’s a significant chance of harm when mistakes happen, it’s essential that nurses get practice before they start working with patients in a clinical setting. That’s where VR can help: Data shows there’s no significant difference in learning outcomes when up to half of a student’s clinical training is done in a high-quality virtual setting. One study of nursing student errors across more than 200 prelicensure programs in the U.S. found that nearly 60% of errors and near-misses occurred during simulation — meaning students could learn from their mistakes without harming patients.
The VR programs that Wells-Beede and other faculty at the UNT Health Sciences Center facilitate — all via headsets made by Meta (formerly Oculus) — focus on underserved patient care settings and topics of particular relevance amid growing health trends.
One of the early intervention simulations used across several classes helps students practice screening patients for alcohol and substance abuse in a routine clinical setting. Students encounter a patient who has come in for a neck abscess and indicates on his intake paperwork that he’s struggling with alcoholism. One of the challenges with an interaction like this for clinicians can be working with the patient in a way that doesn’t make them feel judged — something simulation facilitators can coach on in a classroom setting.
“It’s really an opportunity to practice therapeutic communication and start minimizing some of those biases because we know this is a very significant problem right now,” Wells-Beede said.
High maternal mortality rates are another urgent issue across Texas. HSC nursing students encounter simulations centered on practicing for better outcomes, including consulting with a teen patient about a high-risk pregnancy and managing postpartum hemorrhage.
The rapid evolution of patient care is another area where simulation shines. Programs can be easily modified to add nuance or reflect best practices where textbooks often fall short.
“We want educators and faculty to be on that forefront of education to show them that there’s the ability to be agile in really their own thought processes and how they’re learning, because then that gives students the opportunity to try and experiment with innovative and new things as well,” Wells-Beede said.
The simulations aren’t just for students. Simple simulations like administering an IV can help clinicians brush up on skills they haven’t used in a while before engaging with patients.
All of the software for the programs is created in collaboration with faculty and students from the School of Performance Visualization and Fine Arts at Texas A&M University, where Wells-Beede was a nursing professor before coming to HSC.
Students also have access to the campus’s Regional Simulation Center for scenarios that might be outside the scope of VR.
As for what’s next, Wells-Beede says the sky’s the limit when it comes to simulation-centered training. She and her team are experimenting with introducing an AI component and looking toward the development of simulations that include text communication for online nursing students.
“There almost shouldn’t be any opportunity where patient care is involved that cannot be simulated before we are actually doing it within the hospital or community setting,” Wells-Beede said. “There are significant medical errors that occur every day, and we want to make sure [the students are] safe before they’re actually out there delivering care.”