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Students Working Together in the VR Environment

Group of students talking

One of the unique strengths of virtual reality (VR) is allowing for the creation of customized simulated scenarios that can replicate the stressful or high yield moments of a clinical experience. Unlike many traditional simulation scenarios, students can be dramatically immersed into a virtual case that takes the form of any number of real-life clinical environments. Improving this quality of realism can elicit more genuine evaluation of decision-making capability, critical thinking, and communication, thereby identifying opportunities for improvement. Providing students with the guidance they need during these simulations in VR can enhance their learning experience and hone in on their clinical skills.

Using VR to Develop Learning

Many students may be unfamiliar with VR simulation, so it is important to set expectations for learning objectives and the user experience as bound by the limitations of the VR environment. This will also be dependent on the software program being used, as some products allow for enhanced physical mobility through a wireless system, or the ability to have multiple learners inside a clinical scenario as available through our offering. The degree of patient interaction is also software dependent and requires adequate orientation to the VR environment.

Depending on the core objectives of the case, students should be able to develop interventions along the way. These interventions can be time-sensitive and may ultimately change the outcome of the case. In general, students can be evaluated on the tasks completed or by the effectiveness of their team-based communication and critical thinking.

Using the Multiplayer Scenario

In a multiplayer scenario, virtual reality provides unique opportunities for collaboration amongst learner populations. These scenarios can empower students to develop a team-based approach in navigating a case, allowing learners to establish lines of communication between students, the patient, and non-playable characters (NPCs), or by delegating certain responsibilities amongst team members. Students should be able to interact with each other as they would in a real-life clinical scenario. This could be as basic as identifying who obtained what type of clinical data including vital signs, physical exam findings, patient history, and point of care testing, or identifying gaps in that data acquisition and ‘fill in the blanks’.

Delegating responsibility in an immersive VR environment can also be advantageous in a multiplayer case. For example, one student may be focused on a clinical intervention, while the second student is attempting to interact with a difficult family member. The ability for interprofessional simulation can enhance this experience. For example, learners in nursing and case management can collaborate within the same case and demonstrate interprofessional communication while also focusing on their core skills. A case that involves a pharmacist and a clinical nurse could evaluate skills in resource utilization and closed loop communication. An advanced learner could collaborate with a novice learner, allowing for assessment of both clinical knowledge and instructor development.

Using VR to Simulate Real Life

Understanding that there are inherent limitations of a virtual environment, students can navigate a clinical case as they would in a real-life scenario, and the high-quality immersion allows learners to better ‘feel’ the stress of the moment. Being able to recall these moments is a core intent of simulation in education. Virtual reality simulation experiences can use repetition to develop core skills, such as by performing each step of a certain procedure, and even troubleshooting common issues that may be encountered along the way. Moreso, this is true for protocols or quality and safety measures that are crucial to clinical practice. Examples include ACLS, preoperative checklists, or questionnaires.

Virtual reality simulation experiences are also very useful for the less common clinical scenarios that students may rarely encounter in practice. More often than not, students will make mistakes in these specific cases that may be less familiar. This provides a unique learning moment for students, both during the course of the simulation case and in the debriefing after the case is completed. When these similar situations arise in real life, the students can refer to their simulation training, and that familiar stress of the immersive VR case, as they have ‘been there before.’

Students can ultimately use these simulation experiences to identify their strengths and weaknesses. Being able to recall specific scenarios, but also broader tendencies, allows students to develop more comprehensive improvement plans vital to their practice in typical clinical settings. This may also hold true in the future for recertification and reevaluation throughout their clinical practice.


SLS with VR allows you to step into a completely immersive virtual reality environment and experience clinical nursing in a whole new way. Partnering with SimX, an industry-leading virtual reality company, Elsevier’s new nursing solution will change the way students learn, and ensure they are ready for practice. Learn more