Available online 5 December 2022

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The use of virtual simulations exponentially increased as nursing schools experienced an urgent need to integrate online educational technologies during the COVID-19 pandemic. This qualitative descriptive study was conducted to explore associate degree nursing students’ perceptions about the comprehensive Synchronous Group Virtual Simulation educational strategy. This strategy was developed based on the National League for Nursing Jeffries Simulation Theory (JST) and the Healthcare Simulation Standards of Best PracticeTM, including structured synchronous prebriefing and debriefing stages. Content analysis revealed 12 recurrent themes, from which 10 positive themes strongly correlated with concepts of the JST. Our findings support the effectiveness of a high-quality synchronous virtual simulation—guided by an empirically supported simulation theoretical framework and evidence-based simulation best practice standards—can be realistic, experiential, interactive, collaborative, learner-centered, and promote simulation participant outcomes.

Section snippetsBackground

The use of virtual simulations exponentially increased in 2020 with the COVID-19 global public health crisis as nursing schools experienced an urgent need to implement online educational technologies. However, despite the rapid growth in the virtual simulations literature supporting positive student (participant) outcomes, there was limited evidence to guide virtual simulation best practices and curriculum integration. A systematic review conducted by Foronda et al. (2020) demonstrated that

Methods

This qualitative descriptive single site study was conducted in the United States at a Northeastern urban public community college. This research design allowed for discovering and understanding associate degree nursing (ADN) students’ perceptions after participating in the Synchronous Group Virtual Simulation (SG-VS) educational strategy, which included structured prebriefing and debriefing strategies. The overarching question was: What are the perceptions of ADN students about their

Results

Of 125 students who participated in the SG-VS educational strategy, 86 completed the Virtual Simulation Experience Questionnaire (69% response rate). The students were predominantly female (84%). Students from the following racial/ethnic groups were represented: White (34%), Black (28%), Asian (20%), Hispanic (16%), and Multiracial (2%). Most students were between 25 and 44 years of age (79%); other students were under 25 years of age (12%) and between 45 and 54 years of age (9%).

Content

Realistic

Students expressed that the SG-VS experience was “realistic” and “felt as if [they] were in an actual clinical setting.” Additional key quotes included: “It put me back into the clinical setting, it got my heart pumping and adrenaline going,” and “Just like with a real patient in the hospital, we were able to begin with a physical assessment and walk through what we would do as soon as we set foot in a patient's room.”

Experiential

Students expressed that the SG-VS experience was “hands-on” and allowed them

Facilitator

Students acknowledged the importance of having a virtual simulations facilitator. Key quotes include: “I think doing it alone is not helpful, the guidance from [the facilitator] is vital”; “[The facilitator] truly helped keep us focused and productive”; and “I enjoyed [the facilitator] the most, the simulation experience was great because she made me feel comfortable participating and kept us all on track and focused.”

Prebriefing

Students expressed their satisfaction with the prebriefing and acknowledged

Reaction (Satisfaction and Confidence)

Students expressed satisfaction with the SG-VS experience and acknowledged that it positively affected their confidence. Key quotes include: “Great experience,” “Excellent experience,” “Really enjoyed it,” “Great! I learned a lot, and it increased my confidence in preparing for actual hospital practice.”

Learning (Changes in Knowledge, Skills, and Attitudes)

Students expressed that the SG-VS promoted learning and understanding of the nursing process, critical thinking, and clinical judgment. Key quotes include: “It helped me understand,” “This

Discussion

Our findings are consistent with concepts of the NLN Jeffries Simulation Theory and support that a well-structured synchronous virtual simulation that integrates the Healthcare Simulation Standards of Best PracticeTM can be realistic, experiential, interactive, collaborative, and learner-centered. Participants' interactions occurring during a SG-VS may improve realism, psychological fidelity, students' connectedness, and virtual simulations performance. In addition, preparatory activities and

Conclusion

Among the various types of programs that educate prelicensure nursing students, ADN programs prepare the largest number of undergraduate students within a short curriculum timeframe. Therefore, ADN programs may benefit from the use of high-quality virtual simulations to promote students’ readiness for clinical or HPS experiences, the NGN licensure examination, and future clinical practice. As nurse educators continue to integrate virtual simulations in the ADN curriculum, it is imperative to

Declaration of Competing Interest

The authors declare no conflict of interest.

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© 2022 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.