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C922 Proposal for Virtual Simulation in Nursing Education

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Western Governors University

C922 Emerging Trends and Challenges in 21st Century Nursing Education

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Executive Summary

Nursing education relies on multiple instructional strategies to support the development of clinical competence, critical thinking, and professional confidence. No single teaching method is sufficient in isolation; instead, effective learning occurs when diverse approaches complement one another. One increasingly significant instructional strategy is the use of online simulation laboratories. These platforms allow nursing students to practice clinical skills, decision-making, and patient interactions in realistic scenarios without the risk of harm to actual patients. Errors become learning opportunities rather than safety threats.

Despite the value of traditional in-person simulation and clinical experiences, many nursing students encounter barriers that limit their participation. Common challenges include employment obligations, childcare responsibilities, illness, geographic limitations, and restricted access to clinical training resources. To address these barriers, remote online simulation laboratories have emerged as a viable and flexible educational technology. These platforms can be customized to align with institution-specific curricula and provide consistent learning experiences regardless of students’ physical location.

This paper examines the integration of remote online simulation labs within the nursing curriculum, specifically in the course “The Role of the BSN Nurse in Promoting Community Health.” Scholarly evidence from five peer-reviewed sources is used to evaluate the impact of this technology on student learning outcomes, engagement, satisfaction, and assessment performance. Three tables are incorporated to support the analysis: a literature review summary, a curriculum technology need-gap analysis, and a force field analysis. The proposal’s implementation is examined using Lewin’s Change Theory, and the anticipated impact on nursing education and student outcomes is discussed. Key stakeholders—including nursing students, faculty, and program leadership—are identified as central contributors to successful adoption and sustainability.

Remote Simulation Labs Literature Review

The proposal to implement remote online simulation laboratories is well-supported in existing scholarly literature. Table 1 summarizes five peer-reviewed studies that collectively demonstrate the effectiveness of virtual simulation in nursing and higher education. These studies examine outcomes related to cognitive development, psychomotor skills, affective learning, student engagement, and satisfaction.

The selected literature consistently supports the integration of virtual simulation as a supplement to traditional clinical education. The articles reviewed provide evidence that online simulation enhances skill acquisition, promotes deeper learning, and supports flexible access to educational resources. Each study contributes insight into the relevance, level of evidence, strengths, and limitations associated with virtual simulation technologies in academic settings.

Research Findings and Support of the Proposal

Tolarba (2021) synthesized findings from 23 studies involving 1,929 participants, the majority of whom were nursing students. The results demonstrated strong positive effects of virtual simulation on cognitive, psychomotor, and affective learning outcomes. Students showed improved clinical reasoning, increased confidence, and enhanced emotional engagement. These findings directly support the proposal to integrate remote simulation labs, as they indicate measurable improvements in student performance across multiple learning domains.

Reginald (2023) examined the role of virtual laboratories in fostering self-regulated learning through internet-based platforms. The study highlighted that virtual labs enable students to access learning tools anytime and from any location, using devices such as laptops, tablets, or smartphones. This accessibility promotes learner autonomy, deeper engagement, and improved knowledge retention, reinforcing the relevance of remote simulation for nursing students with diverse learning needs.

Medel et al. (2024) found that nursing students who participated in virtual clinical simulations demonstrated superior theoretical understanding and practical skill development compared to peers receiving traditional instruction alone. Students also reported reduced anxiety about entering professional practice and higher satisfaction with their educational experience. Notably, the benefits were observed regardless of prior healthcare experience, suggesting broad applicability across learner populations.

May et al. (2023) identified usability challenges associated with online laboratories, including technological, pedagogical, and social factors. While the study supported virtual simulation, it emphasized the importance of thoughtful design and faculty preparation to ensure effective implementation. These findings inform the proposal by identifying areas that require proactive planning.

Garrison et al. (2023) reported that some students experienced feelings of isolation and missed hands-on interaction following a transition to online nursing education. Although this finding highlights a potential limitation, the proposed technology is intended to supplement—not replace—in-person experiences. As such, remote simulation labs are positioned as an enhancement that accommodates varied learning styles rather than a substitute for clinical engagement.

Need for Further Research or Development

The literature review revealed several areas requiring further investigation prior to full-scale implementation. Comparative studies examining outcomes between students using only virtual simulation versus those participating exclusively in in-person clinical experiences are needed to strengthen causal conclusions. Additional research focusing specifically on nursing students, rather than broad STEM populations, would increase relevance and validity.

Further exploration of simulation modalities—such as desktop-based programs versus immersive virtual reality—would support cost-effective decision-making. Additionally, student resistance to online learning, digital fatigue, and concerns regarding reduced human interaction must be addressed through faculty support, hybrid learning models, and intentional instructional design.

Needs Assessment

A comprehensive needs assessment indicates that remote online simulation labs address several persistent challenges in nursing education. Limited access to clinical placements, scheduling conflicts, and inconsistent learning opportunities hinder students’ ability to practice safely and effectively. Remote simulation labs provide continuous access to standardized learning scenarios, enabling students to practice skills repeatedly in a controlled environment.

These platforms support experiential learning by allowing students to make and correct errors, receive immediate feedback, and develop confidence without jeopardizing patient safety. The flexibility of remote access ensures that students can engage with course material regardless of personal or logistical constraints.

Need-Gap Analysis

Table 2 outlines the disparity between current curricular technology and desired instructional outcomes. Traditional reliance on in-person simulation limits access and consistency. Remote simulation labs close this gap by providing equitable, flexible, and scalable learning experiences.

Table 2

Curriculum Technology Need-Gap Analysis

Current Curriculum TechnologyDesired Curriculum TechnologyIdentified Need-GapAction Steps
In-person clinical and simulation labs onlyRemote online simulation laboratoriesLimited access due to time, location, and personal obligationsDevelop and pilot remote simulation labs; train faculty; integrate into curriculum

Collaboration with Stakeholders

Successful implementation depends on collaboration among nursing students, faculty, and program leadership. Students provide essential feedback regarding usability and learning effectiveness. Faculty are responsible for curriculum alignment, instructional integration, and assessment design. Program directors authorize funding, oversee implementation, and evaluate outcomes.

Collaboration methods include email communication, in-person meetings, and virtual platforms such as Zoom. These approaches ensure transparency, shared decision-making, and continuous evaluation throughout the implementation process.

Current Technology Challenges

Existing technologies—including high-fidelity mannequins and recorded lectures—offer valuable learning opportunities but present limitations. Mannequins provide realistic physiological assessment but are costly, space-intensive, and limited in availability. Recorded lectures support flexible learning but lack real-time interaction and immediate clarification.

Overcoming Challenges Through Remote Simulation

Remote online simulation labs address these limitations by eliminating scheduling constraints, expanding scenario diversity, and enabling repeated practice. Students can engage with a wide range of patient populations, including pediatric and community-based scenarios that emphasize social determinants of health. This approach enhances cultural competence and holistic assessment skills.

Summary of Curricular Technology Needs Assessment

The proposed technology ensures equitable access to learning experiences, promotes student confidence, and supports diverse learner needs. By offering immediate feedback and unlimited practice opportunities, remote simulation labs enhance skill mastery and patient safety preparedness.

Stakeholder Consensus

Stakeholder engagement through structured meetings facilitates consensus-building and shared ownership. Program leadership, faculty, and students collectively determined that the benefits of remote simulation outweigh potential challenges, particularly when implemented as a supplement to existing instructional methods.

Factors and Forces to Consider

Table 3 presents a force field analysis identifying factors that support or hinder implementation.

Table 3

Force Field Analysis

Forces Supporting IntegrationForces Resisting Integration
Flexible, student-centered learningLimited student access to technology
Enhanced cultural competenceFinancial constraints
Increased practice opportunitiesReduced physical skill practice

Change Theory

Lewin’s Change Theory provides a structured framework for implementation through unfreezing, changing, and refreezing phases. This model emphasizes stakeholder readiness, systematic transition, and long-term stabilization of curricular changes.

Justification of Change Theory

Lewin’s Change Theory is widely used in healthcare education due to its emphasis on human factors, communication, and sustainability. The theory supports thoughtful planning, faculty engagement, and continuous evaluation.

Potential Resistance to the Technology

Resistance may arise from financial concerns, faculty workload, or discomfort with change. These barriers can be mitigated through transparent communication, phased implementation, and institutional support.

Plans to Implement Change Theory

The unfreezing phase will involve needs assessment and stakeholder engagement. The changing phase will focus on pilot implementation and faculty training. The refreezing phase will integrate the technology into standard practice, supported by evaluation and feedback mechanisms.

Conclusion

Integrating remote online simulation labs into the course “The Role of the BSN Nurse in Promoting Community Health” offers a transformative opportunity to enhance nursing education. This technology supports flexible, inclusive, and experiential learning while strengthening clinical judgment, cultural sensitivity, and confidence. By addressing existing curricular gaps and accommodating diverse student needs, remote simulation labs contribute to safer patient care and a more prepared nursing workforce. The broader impact extends beyond individual programs, advancing the quality and consistency of nursing education across healthcare systems.

References

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Change management. StatPearls.

El-Shafy, I. A., Zapke, J., Sargeant, D., Prince, J. M., & Christopherson, N. A. M. (2019). Decreased pediatric trauma length of stay with implementation of Lewin’s change model. Journal of Trauma Nursing, 26(2), 84–88.

Garrison, C. M., Hockenberry, K., & Lacue, S. (2023). Adapting simulation education during a pandemic. Nursing Clinics of North America, 58(1), 1–10.

May, D., Jahnke, I., & Moore, S. (2023). Online laboratories and virtual experimentation in higher education. Journal of Computing in Higher Education, 35(2), 203–222.

C922 Proposal for Virtual Simulation in Nursing Education

Medel, D., et al. (2024). Analysis of knowledge and satisfaction in virtual clinical simulation among nursing students. Nursing Reports, 14(2), 1067–1078.

Reginald, G. (2023). Teaching and learning using virtual labs. Cogent Education, 10(1), 1–14.

Tolarba, J. E. L. (2021). Virtual simulation in nursing education: A systematic review. International Journal of Nursing Education, 13(3), 48–54.

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