Exploring undergraduate nursing student interactions with virtual patients to develop ‘non-technical skills’ through case study methodology

Abstract

BackgroundVirtual patients are a recent addition to the educational arsenal to develop non-technical skills in undergraduate health professionals. The Virtual Simulated Patient Resource (www.vspr.net.au) is a web-based resource that uses branching, narrative virtual patients to develop knowledge, attitude and practice of all categories of non-technical skills in undergraduate health professionals. However, there is limited literature exploring how the interaction with a virtual patient influences the development of knowledge, attitude and practice of non-technical skills in undergraduate nursing students.MethodsAn intrinsic case study method, using focus groups and individual interviews, enabled exploration of the experience of undergraduate nursing students when interacting with a virtual patient to develop non-technical skills. Purposive sampling identified participants to address the research question. Framework analysis supported by a codebook enabled deductive and inductive data analysis.ResultsForty-five first-year and 31 third-year students consented to participate. Findings indicated that the different years interacted differently with the virtual patients. Four themes were recognised in the data: how the virtual patients enabled learning non-technical skills, learning surrounding the virtual patient encounter, changing the way students perceive practice and potential limitations to learning.ConclusionsInteractions with virtual patients influence learning knowledge, attitudes and practice of non-technical skills in undergraduate nursing students via authenticity in the virtual patient interaction, socialisation to the professional role, vicarious learning and learning by making mistakes. Potential limitations to learning from virtual patient interactions include fear, overconfidence, groupthink and confusion. To manage limitations to learning, facilitation approaches, opportunities for reflection, constructive feedback and debriefing may be key. This study demonstrates learning non-technical skills via interactions with virtual patients can change the way students perceive practice, with learning transferable to the clinical setting to support safe and competent patient care.Electronic supplementary materialThe online version of this article (10.1186/s41077-019-0088-7) contains supplementary material, which is available to authorized users.

A virtual patient model for students’ interprofessional learning in primary healthcare

“…Watching a video clip might facilitate a better understanding of complex situations and procedures and illustrate the tools used by different professions. These findings are in accordance with a study by Peddle et al [17]. Woodham et al [26] found in their study that the students appreciated the video clips because they perceived that they made the scenario feel more real and the case more engaging, and we made similar observations in our study.…”

“…Peddle et al [17] found "groupthink" to be a limitation to learning when only nursing students worked with a VP. Students in their study group influenced each other to express their thoughts more as a group than as individuals.…”

“…VPs can facilitate learning in a safe and realistic environment and can provide opportunities for students to practice repeatedly without any risk of harm to the patient [12]. VPs are in most cases designed for only one specific health profession with the aim of teaching clinical reasoning skills and supporting professional development [10,14,15], and the use of VP activities in the fields of nursing and medicine have been extensively studied [16,17]. We have found only one study that assessed a VP, that was aimed to be used by three different health professions [18], and we have not found any studies aimed at assessing the impact on students' learning of a VP created for IPE for students in a primary healthcare context.…”

Integrative review of soft skills the desirable traits and skills in nursing practise

“…Out of the 44 that were selected for the full articles screening, only 17 were included in this study. Twenty-seven (27) were excluded from the study because those studies did not address soft skills in nursing. Figure 1 shows the PRISMA flowchart showing the literature search and selection of studies.…”

“…As one of the students noted, 'I feel more confident in how to handle situations now. I feel a lot more prepared in handling a patient 27 .…”