Fostering Clinical Judgement Decision Making Using Extended Reality Simulation

Abstract : According to AACN (2022), 40% of baccalaureate programs reported insufficient availability of clinical sites. This is particularly problematic in specialty areas such as behavioral health and pediatrics, where critical judgment decisions, affective therapeutic communication, and empathy are traditionally learned through patient interaction. While simulation-based experiences (SBE) can replace this domain of learning, the lack of consistency and costs of traditional simulations including the use of standardized patients (Haerling, 2018) can deter student learning. According to Logeswaran et al., (2021) XR can enhance the quality and execution of healthcare education, and Ryan et al., (2022) suggest XR self-efficacy increases in learners. A quality improvement education pilot was conducted using XR simulations, following the Healthcare Simulation Standards of Best PracticeTM, to standardize the immersive “client” experience, and provide an opportunity to develop therapeutic and empathetic communication and critical judgment decisions that affect patient outcomes.
116 accelerated BSN students completed a post-simulation survey after the completion of either pediatric or behavioral health XR simulation. The SET-M is a 3-point Likert scale of 19 items with four subscales. The results of the survey showed that 98% of students agreed to XR simulation enhancing their ability to actively engage in the clinical judgment decision-making process in both the behavioral health and pediatric milieu. 98.5% of respondents reported XR improving confidence in providing therapeutic patient experiences.
This quality improvement project validates the capacity of XR simulation encounters to mirror reality-based clinical experiences in an accelerated BSN program.