Despite fast-growing demand for new nurses, more than 80,000 qualified students are turned away from nursing schools every year due to insufficient faculty, clinical sites, classroom space, clinical preceptors, and budget. This has contributed to an unprecedented shortage in nursing staff nationwide, increasing workloads for current nurses and worsening patient outcomes.

In response to this challenge, the University of Kansas School of Nursing is launching a virtual, immersive nursing school program to broaden access for prospective students, expand its enrollment capacity, and build a more engaging and effective competency-based virtual curriculum.

The School of Nursing’s exploration of virtual alternatives to their current education model began during COVID-19, when the school was forced to suddenly close all of its classrooms and cancel clinical rotations for nursing students. Working quickly, the school developed a series of virtual simulations and learning activities that allowed 250 students to receive over 30,000 hours of virtual learning in the midst of pandemic disruptions. Despite the challenges involved, KU nursing students and educators found that the virtual experiences ended up being highly effective, leading to interest in building on this work even after in-person classes resumed.

In the Spring of 2021, during the height of the pandemic, KU School of Nursing began to work with Kansas City Digital Drive as part of an AR/VR Hackathon. The project – Animating Manikins – was focused on using augmented reality to create a more interactive and immersive experience for nursing students who were practicing medical procedures on manikins. Undertaken as a partnership between Kesa Herlihy of the KU School of Nursing, Brad Chesham of Bundle of Rays, and Doug Hohulin, this project tied for first place in the Augmented Reality/Virtual Reality (AR/VR) Heartland Developer Challenge.

Soon afterwards, the KU School of Nursing shifted its XR ambitions away from augmenting in-person learning, and towards creating a fully immersive VR environment for instruction. In December 2021, the school formed a partnership with Victory XR to create a digital twin of the KU School of Nursing campus. By putting on a VR headset, this digital twin would allow nursing students from anywhere across the country to ‘walk’ onto KU’s virtual campus to attend classes and complete their clinical work.

Demos of the system conducted with undergraduate students found that 95% wanted to use the system frequently as part of their education, and nearly three quarters reported feeling very confident in being able to use the technology. However, the school also noticed several challenges that would have to be overcome before they could adopt virtual programming more widely.

For one, a small number of students experienced nausea or migraines while using the headsets. Without improved hardware that allows every student to comfortably use the system, it will be difficult to shift towards making virtual exercises a more central part of the school’s curriculum. In addition, the financial cost of the system is substantial. In addition to the cost of maintaining an updated library of VR devices, the costs of developing medical training content for a VR environment is extremely high. Educational materials for one setting and one event could cost between $10,000 and $100,000 depending on the complexity of the material.

With the content developed so far, the school is rolling out a pilot test of the technology this fall with 37 students in two classes. Nursing educators are hoping to feature the new system as part of a study into how VR clinical experiences support the development of clinical judgment and competencies for nursing students. The school is also continuing to apply for additional competitions and grants to fund further expansions of XR programming across their programs. Eventually, the school hopes that greater adoption of XR technologies will lead to reduced demand for nursing faculty supporting clinical rotations, more students entering the program, better engagement and knowledge retention throughout the curriculum, and expanded opportunities for ongoing professional development and skills training.

Kesa Herlihy, Director, Simulation Education Program, and Clinical Assistant Professor at the University of Kansas School of Nursing, presented to the KC Digital Drive Health Innovation Team on August 31, 2022.

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