Nursing Education: Emerging Trends and Challenges

Introduction

Expanding the range of technological developments and effective innovations used in nursing education is an important aspect of successful and productive learning. Digital applications, virtual simulators, and other similar tools contribute to a deep immersion in the care environment and offer unique mechanisms for accumulating valuable experience. As an object of evaluation, this work aims to assess the effectiveness and convenience of such a training tool as virtual simulation. This technique is innovative and insufficiently studied; therefore, in addition to its merits and convenience, possible gaps will be addressed. As a relevant theoretical framework used to determine the feasibility of incorporating such a tool into a continuing educational process, Lewin’s change theory will be utilized. By synthesizing findings from credible academic sources, information about the virtual simulation technique will be collected and analyzed in a literature review section. Also, implementation challenges will be considered, including stakeholder analysis and comparison with another emerging technology applied for educating nurses. The purpose of this proposal is to determine the value of virtual simulation in the context of nursing education and identify potential gaps and ways to address them by using Lewin’s change theory.

Literature Review

Credible Sources

Refer to table 1- Literature Review Summary

The analysis of virtual simulation as an emerging technology in education through a literature review is a convenient approach to identify key scholars’ findings and compare the data obtained. The objectives of the studies will be examined, as well as research contexts, basic findings, the relevance of the work performed, and the credibility of the evidence presented. In Table 1, these data are summarized, and with their help, the synthesis of the extracted information may be conducted to determine the most important findings.

Based on the available data found in the sources reviewed, the use of virtual simulation in nursing education is a technique that has a beneficial effect on knowledge gains and professional development. Nevertheless, while taking into account the goals and objectives of these studies, one can highlight the information that is more relevant in the context of the topic under consideration. In particular, the mechanisms of impacts of this simulation type differ based on certain effects that they have on the academic performance of nursing students.

The evaluation of virtual simulation as a tool that improves the quality of nursing education allows drawing conclusions about the general advantages that this approach to learning has. Foronda, Fernandez-Burgos, Nadeau, Kelley, and Henry (2020) note that basic skills are enhanced, which future nurses should apply in the learning process, in particular, critical thinking, academic performance, self-confidence, and some other attainments. Huun (2018) confirms the value of virtual simulation for honing common care skills and gives arguments based on the multiplicity of practical implications that are individually disclosed and developed. Verkuyl, Romaniuk, Atack, and Mastrilli (2017), in turn, note that the combination of traditional and innovative methods can help increase the outcomes of training nursing students, and the role of virtual simulation is high in the context of optimizing the educational process. Finally, Tiffany and Hoglund (2016) state that the inclusivity factor as an integral element of professionalism is advanced due to the considered educational methodology, which, in turn, expands the knowledge of junior medical specialists about different aspects of their activities.

The evaluation of virtual simulation in nursing education from the perspective of narrower manifestations may also be carried out by using the selected scholarly studies. According to Padilha, Machado, Ribeiro, and Ramos (2018), the involved audience confirms not only the practical benefits of utilizing this method of learning but also notes its simplicity and convenience. Despite a variety of available solutions, the digital simulation technique is implemented easily and does not require special training. In addition, as Padilha et al. (2018) remark, students’ intentions to apply this approach is due to an increased interest in digital learning practices, which also reinforces the value of virtual training programs.

Knowledge Gaps

One of the main knowledge gaps in the technology under consideration is a potentially insignificant difference between the current learning outcomes and those demonstrated when using traditional laboratory simulation. Verkuyl et al. (2017) argue that, according to the results of their analysis, there are no significant distinctive features in the academic results of the two control groups. Of the merits, the authors note higher self-efficacy parameters that students demonstrate through the use of virtual simulation (Verkuyl et al., 2017). Two control groups were asked to complete specific tasks, and based on the results, it was planned to assess the impact of traditional and innovative simulations on students’ professional skills. As a result, Verkuyl et al. (2017) propose to use virtual technology more often due to higher rates in evaluation criteria, although, in general, the combination is possible. Thus, this practice should be evaluated from the perspective of the possibility of improving academic outcomes and the value of possible changes that may be implemented.

Needs Assessment

In order to evaluate the relevance and importance of applying the considered technology in a real educational environment, the need-gap analysis should be conducted, as well as the force fierce analysis assessment. Virtual simulation is chosen as the target method for introducing changes due to the prevalence of the digital learning trend. In addition, it is essential to evaluate how the academic environment is ready to utilize such an innovation. This may help find out what anticipated outcomes are planned, what challenges can be encountered at the implementation stage, and who are the stakeholders.

Gap Analysis Process

The need-gap analysis may be carried out by determining which gaps exist for the effective implementation of the technology in question in the educational process and what steps should be taken to address these omissions. As a background, the current state of the curriculum will be evaluated without virtual simulation, and then, the anticipated outcomes will be predicted while considering the implementation of this approach to learning. Compare the current state with the ideal state and describe the gap and quantify the difference. By comparing the current state with the target state, we determine what the needs assessment are for a curricular technology in a virtual simulation. Stakeholders and the methods of collaboration with interprofessional teams will also be considered.

Stakeholders

The main stakeholders are as follows: students, preceptors who are the academic nurse educators, and the IT personnel of the educational organization. Students are the target audience to evaluate the advantages of virtual simulation in the ongoing educational process. Their experience will be evaluated based on the perceptions of the benefits that a renewed curriculum can bear and the importance of implementing more advanced learning techniques. Preceptors’ views on the upcoming changes should also be taken into account since they can give reasonable arguments regarding the differences between an outdated and innovative teaching process and identify the gaps that deserve intervention. The IT personnel as stakeholders can also provide relevant opinions on how the introduction of virtual simulation influences student learning outcomes by compiling statistical correlations and assessing the convenience of the new digital technology. Also, the IT personnel role provides a way to determine what is missing in the current state and then recommend and develop the application needed for the desired state.

Methods of Collaboration

The methods of collaboration with interprofessional teams may imply sharing experiences and organizing regular meetings and follow-up emails to discuss the current state of the change process. In order to maintain a sustainable system of interaction, all the stakeholders should provide feedback on how they assess the new technology, what amendments may be necessary, and what outcomes have been achieved. The comparison of current and desired curriculum technologies involves assessing potentially positive interventions aimed at improving the method of learning through appropriate innovations to address the existing gaps. In addition, discussing the changes with the stakeholders will help overcome intervention barriers and contribute to maintaining the technology in the educational process. In Table 2, the need-gap analysis is provided, and the main variables to address are presented.

Current Technologies

As two technologies for comparison, traditional laboratory training with standard learning tools and virtual simulation are offered. The former mechanism is a widespread practice that involves using simple tests to assess the academic performance of nursing students and the simplest forms of simulated practice based on ready-made data. As Staykova, Von Stewart, and Staykov (2017) note, this educational technology is a convenient way to disseminate knowledge since it offers familiar learning tools, such as digital presentations. However, the authors argue that with the development of digital education in the field of nursing education, such training methods are less effective than innovative approaches (Staykova et al., 2017). Applying these instruments can be filled with the student’s inattention and poor mastering of relevant skills.

As a more advanced practice, virtual simulation is the preferred learning technique. This practice allows students to immerse themselves in the care process and recreates working conditions that are close to reality. In addition, virtual simulation is a more modern mechanism for acquiring knowledge and a tool that enhances the student’s learning responsibility. At the same time, as Tiffany and Hoglund (2016) note, not all interested parties are ready to apply this new approach immediately, and time may be required to familiarize themselves with the differences. In addition, virtual simulation eliminates the variability of the interpretation of specific clinical cases, which may adversely affect student critical thinking. However, with the development of digital technologies, a more modern mechanism fits into the “The Role of the BSN Nurse in Promoting Community Health” course due to its ability to replace outdated modules or courses and give the student the ability to track their progress through simulation practices.

Technology Challenges

The current technology, which is traditional laboratory training, has several crucial challenges, and they are the reasons for a transition to more innovative instruments. Firstly, obsolete equipment may be a problem for honing nursing skills. For instance, if students are forced to use tools that are rarely used in modern practice, this does not bring any significant benefits, and valuable preparation time is wasted. Secondly, laboratory working methods complicate the disclosure of individual potential. Students can complete assignments together, which strengthens teamwork but, at the same time, inhibits personal professional development. Finally, the current state of technology in the nursing education program has an assessment system based on the achieved academic results, but this algorithm does not provide for evaluating individual learning outcomes from the standpoints of professionalism and readiness for non-standard working situations. If the curriculum tools are not updated, students will not be able to count on an objective assessment of their academic efforts.

Overcoming Challenges

To overcome these difficulties, special measures need to be taken. Preceptors should interact with the heads of the clinic and explain to them the importance of acquiring modern tools for preparing students, in particular, mechanisms for virtual simulation. In order to maintain high individual academic results, students are encouraged to participate in elective classes in which innovative educational instruments are utilized. Over time, new equipment can supplant obsolete training practices and become the primary tool for honing professional skills. Finally, a team of analysts can be organized at the general meeting in order to develop a potentially more advanced system for evaluating student academic outcomes, and as a possible improvement measure, the introduction of digital technology may be an alternative.

Summary of Findings

When summarizing the results of the curricular technology needs assessment, one can note that traditional laboratory training may be replaced with a more modern and efficient tool that implies utilizing a digital educational background. Today, stakeholders can benefit if the transition to the innovative training of nursing students is used. This approach is a valuable practice that can help not only solve a number of learning problems but also achieve other important goals associated with individual professional development. To implement these objectives, preceptors should interact with clinic leaders and explain the value of using modern digital tools. In addition, in order to encourage professionalism, virtual may be introduced into the educational process. The individual use of this technology by students will give them an opportunity to hone their skills and rely on an objective assessment of their academic results. Therefore, the proposed measures are significant to ensure a convenient transition to a new educational technology.

Collaboration with Stakeholders

Stakeholder engagement is mandatory so that all parties involved could have relevant information about upcoming changes. Preceptors should receive data about the specifics of virtual simulation, and at the general meeting, a basic description may be offered. Their feedback, in turn, is significant in the context of implementation since these stakeholders form one of the key groups, and in case of negative critique, the operating procedure is to be changed. If individual preceptors are not ready to implement virtual simulation, for instance, due to the lack of confidence in the value of innovative methods, career guidance should be carried out with relevant examples from academic practice to clearly demonstrate the merits of the virtual technology. This process can take up to two weeks, including gathering related materials, preparing presentations, and holding several meetings.

Nursing students should be aware of the advantages of updating the curriculum and the role of the new methodology in enhancing their academic potential. These stakeholders can offer alternative methods of work with virtual simulation, and collaboration with this group is mandatory to reach a consensus. An anonymous survey may be a convenient form to assess students’ willingness to utilize a digital form of training in order to obtain objective opinions regarding future nurses’ awareness of the convenience of virtual simulation.

The management of the healthcare institution needs to understand the rationale for purchasing the necessary equipment, and a full report is to be provided in order to avoid misunderstanding and bias. One of the potential obstacles is significant financial costs, and in order to convince the clinic leaders to allocate funds from the budget, joint meetings with preceptors can be organized to convey the benefits of virtual simulation. Finally, IT personnel should be ready to maintain the operation of the technology and service it timely. These specialists need to obtain the necessary data on the specifics of the new technology, its operational characteristics, and other technical aspects of maintenance. The measures considered are mandatory in order to ensure the successful implementation of virtual simulation in the educational process.

Force Field Analysis Assessment

Refer to Table 3-Organizational Readiness for Curriculum Proposal

In order to assess the readiness of the educational institution to introduce a new technology of virtual simulation in a continuous educational process, a Force Field Analysis may be conducted. This tool helps identify the key positions for and against a particular intervention, and based on this comparison, significant factors may be identified that can impact the adoption of the proposal. In Table 3, this readiness assessment is provided in accordance with specific criteria.

Based on the assessment of the organization’s readiness for changes, the forces for introducing virtual simulation are consistent with the goals of improving the quality of nursing education. In particular, increasing student academic performance by gaining new clinical experience and engaging innovative algorithms is a significant objective. Despite the forces against implementation, for instance, a long time to adapt for all interested parties and the costs of purchase and maintenance, the prospects for using virtual simulation correspond with the task of enhancing students’ knowledge and experience. All the measures are feasible and require communication among stakeholders.

Organizational Factors

In addition, specific factors should be considered, which may affect the implementation of the proposal. As internal organizational features, preceptors’ preparedness for innovations and the managers’ desire to improve the quality of training are positive drivers that accelerate the implementation process. If these stakeholders show sufficient interest in the new technology, the implementation process will not take much time, and less efforts will be required to introduce the change program. However, there are external factors that can slow down the innovation practice, for instance, the importance of following a national educational program and the need to involve third-party specialists to service new equipment. In the context of a unified teaching system, an innovative approach is not a generally accepted system, and, despite the potential benefits, appropriate justification for higher educational institutions should be presented to convince them of the value of changing the curriculum. The need to engage third-party specialists requires additional costs, but this practice may allow speeding up the implementation process and help maintain the stable operation of the virtual technology.

Forces for Integration

There are three forces that can enable to facilitate the integration of virtual simulation in “The Role of the BSN Nurse in Promoting Community Health” course. One can note several positive drivers that facilitate the implementation process. These are an active leadership position (encouraging implementation), the allocation of funds for the purchase (a full spectrum of options), and the development of an assessment system (the compliance of performance outcomes with academic goals).

Challenges to Integration

There are factors that can also slow down the integration of the technology into the learning course of the role of the BSN nurse in Promoting Community Health. These barriers are associated with gaps and omissions in the work process. These challenges include a weak level of staff training (unpreparedness for innovations), frequent failures with the technology (insufficient quality software), and multitasking (the complexity of virtual simulation projects).

Change Theory

Justification of Change Theory

As a change theory that is suitable for the convenient implementation and adoption of the virtual simulation technology in nursing education, Lewin’s change model may be applied. This concept is a common mechanism that is utilized in projects aimed to optimize the working or educational environment and provide for the transition to new activities. As Wojciechowski, Pearsall, Murphy, and French (2016) note, Lewin’s model includes three basic stages of intervention, which the entire change process includes. They are unfreezing (preparation for introducing the necessary changes and working with stakeholders), changing (the direct process of intervention), and refreezing (assessing the sustainability of changes and measures aimed to maintain a new regime). The choice of this change theory is due to the need to introduce a new training mode that is non-standard and has not been previously used in the educational environment under consideration.

Potential Resistance to Technology

Resistance to successful intervention may be caused by interested parties’ insufficient qualifications in the use or maintenance of virtual instruments. This barrier is a consequence of a poor innovative base in the educational process, and in the case of the lack of interested parties’ initiative, low academic productivity is a potential outcome. The principles of the change theory need to be communicated to all stakeholders, including preceptors, IT personnel, and students, and for the implementation of each stage, a certain period will be set to follow up with all the changes thoroughly. This will help avoid errors and the incorrect interpretation of the intermediate results of the assessment. As a barrier to the technology change, such forces and organizational conventions may be mentioned as stakeholders’ reluctance to participate in the innovation program and the inability to develop an adequate assessment system. Both preceptors and the clinic heads may be indifferent to innovation, which will be an obstacle to a successful changer process. Finally, the inadequate material background is a barrier to the acquisition of the necessary equipment. If these obstacles are not addressed, the implementation of the innovation program will be impossible.

Plans to Implement the Change Theory

The importance of both implementing and maintaining the stable operation of virtual simulation explains the relevance of following Lewin’s concept. Each of the three stages will be introduced in turn, which corresponds with the concept’s basic structure. Firstly, it is essential to “unfreeze” the environment for intervention and prepare the necessary resources. For these purposes, career guidance will be carried out both with the key stakeholders and the clinic management. The budget should be planned, and all the parties involved are to be aware of their role in the work process. The next stage that involves specific changes includes familiarization with the new methodology and the analysis of the first results of its introduction. Feedback from preceptors and students should be obtained regarding the convenience of virtual simulation, and short-term goals should be achieved, in particular, studying the topics of the curriculum with the help of the updated equipment. Finally, the third stage called “refreezing” implies conducting follow-up assessments. The results of using virtual simulation should be compared with those of traditional laboratory activities, and any challenges or shortcomings in the learning process need to be addressed and corrected timely.

Purpose of Proposal

The purpose of this proposal is to identify how beneficial virtual simulation mechanisms are to nursing education by analyzing the current gaps and justifying the needs to maintain the technology due to Lewin’s change theory. Outdated training tools for future nurses require reviewing teaching practices and moving to innovative practices. The features of virtual simulation as a modern educational practice explain the relevance and convenience of this intervention method.

Explanation of Proposal Needs Gap

The proposal offers objective reasons for addressing the current curriculum gaps and justifying the need for the new technology. The key benefits and potentially negative forces are mentioned, and underlying organizational factors are identified. Also, work with stakeholders is mentioned in relation to achieving an effective educational process. The chosen change theory makes it possible to implement all the stages of the intervention productively and facilitates the adoption of virtual simulation into continuous educational activities.

Significance of the Proposal

Implementing this proposal is essential in the context of transition to an innovative learning practicum and enhancing student performance outcomes. From the standpoint of influence on the broader area of nursing, it promotes the idea of introducing modern and high-tech tools to enhance the knowledge and experience of all medical staff. The significance of the proposal is also due to a solid academic background and theoretical framework, which justifies the importance of the change process.

References

Foronda, C. L., Fernandez-Burgos, M., Nadeau, C., Kelley, C. N., & Henry, M. N. (2020). Virtual simulation in nursing education: A systematic review spanning 1996 to 2018. Simulation in Healthcare, 15(1), 46-54. Web.

Huun, K. (2018). Virtual simulations in online nursing education: Align with quality matters. Clinical Simulation in Nursing, 22, 26-31. Web.

Padilha, J. M., Machado, P. P., Ribeiro, A. L., & Ramos, J. L. (2018). Clinical virtual simulation in nursing education. Clinical Simulation in Nursing, 15, 13-18. Web.

Staykova, M. P., Von Stewart, D., & Staykov, D. I. (2017). Back to the basics and beyond: Comparing traditional and innovative strategies for teaching in nursing skills laboratories. Teaching and Learning in Nursing, 12(2), 152-157. Web.

Tiffany, J. M., & Hoglund, B. A. (2016). Using virtual simulation to teach inclusivity: A case study. Clinical Simulation in Nursing, 12(4), 115-122. Web.

Verkuyl, M., Romaniuk, D., Atack, L., & Mastrilli, P. (2017). Virtual gaming simulation for nursing education: An experiment. Clinical Simulation in Nursing, 13(5), 238-244. Web.

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with Lean’s system approach for change. Online Journal of Issues in Nursing, 21(2). Web.

Table 1.
Literature Review Summary Table
Author (PubYear) Title Purpose Context Findings Relevance Strength of Evidence
Foronda, C. L., Fernandez-Burgos, M., Nadeau, C., Kelley, C. N., & Henry, M. N. (2020).

Huun, K. (2018).

Padilha, J. M., Machado, P. P., Ribeiro, A. L., & Ramos, J. L. (2018).

Tiffany, J. M., & Hoglund, B. A. (2016).

Verkuyl, M., Romaniuk, D., Atack, L., & Mastrilli, P. (2017).

“Virtual simulation in nursing education: A systematic review spanning 1996 to 2018”

“Virtual simulations in online nursing education: Align with quality matters”

“Clinical virtual simulation in nursing education”

“Using virtual simulation to teach inclusivity: A case study”

“Virtual gaming simulation for nursing education: An experiment”

The purpose is to determine the impact of virtual simulation on nursing education by reviewing studies on this topic.

To analyze the implications of applying virtual simulation methods in the framework of Quality Matters standards.

A few objections are set: to analyze the usefulness of virtual simulation techniques for nursing students, the ease of these tools, and specific stimulating drivers.

The focus of the study is on determining the impact of virtual simulation tools on learning nursing students’ inclusivity.

The goal is to compare virtual and laboratory simulations and analyze the data obtained in the framework of such three indicators as satisfaction, pediatric knowledge, as well as the level of self-efficacy.

The review of available articles on the use of virtual simulation in nursing education and the analysis of findings.

Different virtual simulation modalities are assessed to determine their impacts on the peculiarities of the nursing educational process.

The stated objectives were achieved by applying a cross-sectional study with a quantitative research method to analyze the feedback from stakeholders.

A randomly selected sample is utilized, and the data is obtained from the target audience through a qualitative research method.

The experimental study involves testing two groups of participants in the context of the influence of one each type of simulation on specific learning outcomes. Kolb’s model is utilized as a basic theoretical framework.

Utilizing virtual simulation in nursing education influences learning outcomes positively, in particular, skill performance, learner satisfaction, critical thinking, and self-confidence.

The modalities of virtual simulation utilized in nursing education are numerous, and each tool has its individual characteristics and implications on performance outcomes.

The findings prove all the three dimensions of analysis (usefulness, ease, and intentions) are high due to the usability and convenience of virtual simulation tools.

The participants involved confirm the importance of using virtual simulation as a technology that makes it possible to realize the problems other people, as well as appreciate the work of their colleagues.

No significant differences have been found in the results of the two groups. Participants in each type of simulation have showed average knowledge gains, although group members with virtual instruments have demonstrated higher self-efficacy indicators. As a result, the combination of the two types is the most effective form of honing educational skills among nursing students.

The study is relevant to the topic of this proposal and offers valuable findings that answer the question about the importance of virtual simulation in a nursing educational environment.

The article presents valuable data on the types of virtual simulation tools and describes how specific methods correlate with Quality Matters standards.

The study allows evaluating the data obtained from direct stakeholders, which is a valuable contribution to reviewing the merits and gaps in the topic of virtual simulation in nursing education.

Assessing the merits of virtual simulation is relevant in the context of the topic under consideration and provides an opportunity to determine its implications on the inclusivity indicator during nursing education.

The findings are relevant in relation to the topic under discussion and offer valuable results of the intervention to assess the usability of special virtual techniques to improve specific knowledge and the quality of the educational process.

Level 1

The article offers a detailed overview of all sources used and utilizes relevant sources for analysis. At the same time, the study does not involve the administration methods of virtual simulation, which is an omission.

Level 3

The study reviews the most common forms of virtual simulation techniques and assesses their relationships with specific learning outcomes. As a gap, Quality Matters standards are limited, and more learning dimensions could be added and analyzed to present a more comprehensive picture of impacts.

Level 1

All the information gathered is useful in the context of studying the topic in question and provides accurate feedback data. As a weakness, an underdeveloped grading scale is an omission, and more advanced data collection tools might be involved.

Level 3

The study presents the primary data collected directly from interested parties. Such an important criterion such as inclusivity is evaluated through virtual simulation. At the same time, too a small a sample (15 participants) is a limitation that can make the value of the findings not sufficiently high.

Level 1

The evidence is sufficiently string since all the results of testing are in digital correlations. In addition, the study contributes to finding specific effects of virtual simulation instruments on gaining specific knowledge. As omissions, one can note a small number of participants, as well as self-report evaluation, which may be a biased technique.

Table 2.

Curriculum Technology Need-Gap Analysis

Current Curriculum Technology Desired Curriculum Technology Need-Gap Action Steps to Meet the Need-Gap
Laboratory training with primitive learning tools Advanced virtual simulation technology with an educational function Addressing educational goals in a faster time frame;

Transition from obsolete to innovative learning mechanisms;

Obtaining detailed and accurate feedback after completion of tasks

Improving the material base for the introduction of more advanced training equipment;

Working with preceptors and other stakeholders to review the basics of digital learning;

Updating the foundation of resources and introducing modern algorithms of digital testing and knowledge assessment

Table 3.

Organizational Readiness for Curriculum Proposal
Organizational Readiness for Curriculum Proposal