The aim of this integrative review was to analyse the usage of different virtual reality (VR) technologies in learning and user experiences (UXs) of these technologies in healthcare practice and ...education. The integrative review was conducted in spring 2019 by searching eight international databases. The searches retrieved n = 26 original articles that were quality checked and included for the review. Three different VR technologies used in the field of healthcare education and practice were identified: haptic device simulators, computer-based simulations and head-mounted displays (HMDs). The haptic simulators were the most often used, whereas the HMD devices were the least-used technology in the field of healthcare. In immersive virtual environments, UX includes ten components. Most of the components were observed in the context of haptic devices and HMD devices, with all ten components being observed with the HMD devices. Almost all of the components were rated as positive. In conclusion, the development of VR technology has enabled the creation of the most comprehensive UXs, thus enhancing skill development, enabling remote access to training and, ultimately, improving patient safety. This review is important as it highlights the need for far more UX research within immersive virtual environments.
Aim
To describe nursing students' user experiences' (UX) regarding highly immersive virtual reality (VR) simulation with head mounted display used for learning.
Design
Qualitative descriptive study.
...Methods
Graduating nursing students (n = 41). Individual interviews were held right after VR simulation. The usability was assessed using System Usability Scale (SUS).
Results
User experiences emphasized three themes about the highly immersive VR simulation: nursing care in the immersive VR simulation, technology in the immersive VR simulation, and learning nursing in the immersive VR simulation. Usability was evaluated as fair (SUS score 62.3 out of 100). Scores revealed that the VR simulation was easy to use. The support of a technical person was highlighted.
Conclusions
This study supports strongly the use of highly immersive VR simulation for nursing education. VR simulations should replicate the most authentic nursing care. Technical assistance is crucial when adopting new technologies in education. The results highlighted the importance of UX in an education context.
Aim
To explore nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care.
Design
A descriptive qualitative design.
Methods
Seven focus groups were ...conducted with nurses (n = 27) from five specialized palliative care wards in four hospitals in south and southwest Finland. The focus groups were conducted between June and November 2019, and the transcripts were analysed using inductive analysis.
Results
The findings revealed three categories: recognizing dyspnoea is a multi‐faceted problem, dealing with the complexity of assessment of dyspnoea and strategies for relieving dyspnoea. Nurses perceived the complexity of dyspnoea as a symptom and emphasized the importance of utilizing patients' subjective experiences and consistent assessment scales to determine its severity. Furthermore, nonpharmacological interventions are as pertinent as pharmacological and medical interventions. The findings can assist nurses in selecting appropriate interventions for dyspnoea care, ultimately enhancing the quality of patient care and patient safety.
Clinical reasoning is viewed as a problem-solving activity; in games, players solve problems. To provide excellent patient care, nursing students must gain competence in clinical reasoning. Utilising ...gaming elements and virtual simulations may enhance learning of clinical reasoning.
To investigate nursing students' experiences of learning clinical reasoning process by playing a 3D simulation game.
Cross-sectional descriptive study.
Thirteen gaming sessions at two universities of applied sciences in Finland. The prototype of the simulation game used in this study was single-player in format. The game mechanics were built around the clinical reasoning process.
Nursing students from the surgical nursing course of autumn 2014 (N=166).
Data were collected by means of an online questionnaire.
In terms of the clinical reasoning process, students learned how to take action and collect information but were less successful in learning to establish goals for patient care or to evaluate the effectiveness of interventions. Learning of the different phases of clinical reasoning process was strongly positively correlated. The students described that they learned mainly to apply theoretical knowledge while playing. The results show that those who played digital games daily or occasionally felt that they learned clinical reasoning by playing the game more than those who did not play at all.
Nursing students' experiences of learning the clinical reasoning process by playing a 3D simulation game showed that such games can be used successfully for learning. To ensure that students follow a systematic approach, the game mechanics need to be built around the clinical reasoning process.
•Simulation game provides opportunities for learning clinical reasoning by acting and thinking while gaming.•Building the game mechanics around the clinical reasoning process supports learning of the clinical reasoning by playing.•Digital game players learned clinical reasoning by playing the game more than those who did not play at all.•Simulation games can enhance the development of clinical reasoning and offer meaningful learning experiences.
Simulation games are effective for acquiring surgical nursing knowledge during education by offering possibilities to learn theoretical knowledge through practical patient scenarios, thus preparing ...students for demanding surgical nursing care. Game metrics stored in the game system enable assessment of students' behaviour while gameplaying. Combining game metrics with the assessment of a student's surgical nursing knowledge allows versatile information to be obtained about the student's learning outcomes. However, studies on game metrics stored in systems and their relationship with learning outcomes are scarce.
The aim here was to evaluate the association between game metrics in a simulation game and nursing students' surgical nursing knowledge. Nursing students from three universities of applied sciences in Finland participated in a one-week simulation gameplaying intervention that included five surgical nursing scenarios. Students' surgical nursing knowledge was investigated with a quasi-experimental, one-group, pre- and post-test design using a surgical nursing knowledge test. In total, 280 students filled in the knowledge tests. In addition, cross-sectional game data were collected at a single time point between pre- and post-tests. The data were analysed with descriptive statistics and multivariate analysis methods.
Students' surgical nursing knowledge improved with the intervention. The total number of playthroughs was 3562. The mean maximum score was 126.2 (maximum score range 76-195). The mean playing time of all playthroughs by all players was 4.3 minutes (SD = 81.61). A statistically significant association was found between mean score and knowledge test total score (p < 0.0072), but no significant association emerged between mean playing time and knowledge test total score.
The results indicated that the higher the mean score the better the students' surgical nursing knowledge in the knowledge test. This study did not show that the time spent playing had an impact on students' post-playing knowledge. Our findings support the idea that game metrics can be used in performance evaluation and the results can be used to improve nursing students' readiness for challenging preoperative and postoperative clinical situations.
Collaborative clinical reasoning (CCR) occurs when two or more healthcare professionals reflect and negotiate an issue regarding patient's situation or care. This represents a crucial learning goal ...that needs to be achieved during healthcare education.
To describe the characteristics of and the pre-conditions for learning collaborative clinical reasoning in healthcare education.
An integrative review was conducted. A systematic search was carried out in May 2020 (updated in August 2022) in four databases (CINAHL, Pubmed/Medline, Scopus and Eric/EBSCO). Thirty-three peer-reviewed research articles met the inclusion criteria and were included into a data quality appraisal and analysis. The data was analysed with inductive content analysis.
The characteristics of learning collaborative clinical reasoning were described using the following categories: 1) the collaborative clinical reasoning learning method 2) the collaborative clinical reasoning learning environment and 3) the collaborative clinical reasoning learners. The pre-conditions for learning collaborative clinical reasoning were described using the following categories: 1) the learning situation when learning collaborative clinical reasoning, 2) interaction when learning collaborative clinical reasoning and 3) clinical context when learning collaborative clinical reasoning. The learning situation includes the pedagogical preparation before the learning of collaborative clinical reasoning. The interaction consists of facilitation, feedback and peer communication during the learning of collaborative clinical reasoning. The clinical context utilized in the learning of collaborative clinical reasoning needs to be realistic and familiar for the students.
The results indicate that interventions enhancing collaboration and clinical reasoning apply a variety of learning methods, however there are certain characteristics of and pre-conditions for learning collaborative clinical reasoning to be considered.
•Clinical reasoning (CCR) often occurs in collaboration with several healthcare professionals in complex situations•CCR is crucial in ensuring patient safety and therefore needs to be addressed in healthcare education•Further research on learning interventions enhancing CCR is needed
This article analyses multi-professional knowledge creation in relation to the future of health and social services in Finland. The empirical data were collected from a workshop and it was carried ...out in cooperation between the representatives of higher education and working life. Workshop gave to its participants the possibility for multi-professional knowledge creation exercise to expand on future integrated health and social services. Participants saw digitalisation as enabling clients to use services and as offering more holistic help in incorporating clients' service histories and needs. The analytical framework is based on the cultural-historical activity theory (CHAT) and the knowledge creation approach, which directs attention to creation of the future object of client-centred services and knowledge artefacts by means of which future visions are collectively imagined and concretised. The activity-theoretical analysis of the elements of the envisioned service activity brought into daylight contradictions between the present and the future in terms of overcoming the siloed services and acknowledging the diversity of the clients' situations. These challenges may be difficult to grasp by means of a knowledge creation exercise alone. However, the realization of future activity requires solving the contradictions of the present service and care.
Dyspnoea, a commonly reported symptom among patients with cancer, necessitates the need for appropriate non-pharmacological interventions for its management and suitable assessment scales.
To explore ...the nursing interventions and assessment scales for managing dyspnoea in patients with cancer receiving palliative care.
Systematic review. Five databases (CINAHL Complete, PubMed, Web of Science, Scopus and the Cochrane Central Register of Controlled Trials) were searched, and seven studies were identified. Only studies that comprised randomised controlled trials (RCTs), non-randomised controlled trials or quasi-experimental settings were included.
Nursing interventions, that support a patient's physical breathing and mental functioning, are effective in managing dyspnoea. It is crucial to use both subjective and physical assessment methods to accurately measure the outcomes of these interventions.
These interventions have been proven to be effective, with outcomes centred on changes in physiological measurements and patients' subjective expressions.
The review explored how serious games are utilized for preventing adolescents’ social exclusion. Four original articles were retrieved using six databases. The use of serious games to prevent ...adolescents’ social exclusion was rare, but there are potential areas where serious games could be utilized. Serious games may be a promising new intervention to use in adolescents’ social rehabilitation and social work, preventing social exclusion, reducing the risk of unemployment, lack of education and training. These early findings suggest using serious games as a part of adolescents’ social work and social rehabilitation to prevent social exclusion among adolescents, along with other methods.
ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and ...patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.
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