The accrediting and nursing organizations are promoting patient safety and well-being by emphasizing clinical language proficiency. This presents a challenge for English as second language (ESL) nursing students in learning language skills for the clinical environment. This study explicates the experiences and reflections from nursing students, who are not native English speakers that used a virtual simulation program called vSim in relation to clinical language skills. Five students participated in this study. A qualitative study utilizing hermeneutic phenomenological methodology was used to collect experiential data and then was interpreted according to Van Manen’s (1990) data analysis method. Themes of confidence, patient safety, knowledge transfer from classroom to clinical, communication within the clinical environment, and acquisition of language skills emerged from the interviews and reflective journals. This research study shows that the use of a non -immersive virtual simulation provides a positive contribution to ESL nursing students’ experiences with clinical language skills and can provide nursing educators another teaching strategy to assist ESL nursing students achieve clinical language competency. / Graduate / 0569 / sh_samwel@rogers.com

Racism and microaggressions have proved to damage individuals’ physical and mental health and continue to exist worldwide today. Within the nursing context, minority nursing students are likely to experience racism and microaggressions and lack the privilege of learning in a healthy environment. There were no current interventions to support students; however, virtual simulation was found to have enhanced learning outcomes. This research explored the perceived effectiveness of a virtual simulation and debriefing to navigate racism and microaggressions for undergraduate nursing students at an Ontario University. The virtual simulation adhered to the International Nursing Association for Clinical Simulation and learning (INACSL) standards. Kolb’s Experiential Learning Theory (ELT) was the conceptual framework guiding the study’s structure. Multiple methods research incorporating the Simulation Effectiveness Tool-Modified survey for quantitative data collection and semi-structured interviews on perceptions of the CAN-Sim Cultural Humility and Intersectionality for Psychological Safety debriefing framework for qualitative data collection was completed. Data collection took place over three months (October – December 2021) and after participants completed the survey (n = 39) and semi-structured interviews (n = 2), statistical and thematic analyses were completed. Findings from the survey indicated the virtual simulation as having a positive impact on learning ranging from prebriefing, scenario, and debriefing content. Findings from the semi-structured interviews included common themes of emotional competence, cognitive change, and comprehensiveness related to the debriefing framework. Future research on evaluation tools focusing on racism and microaggression or other sensitive topics was suggested and suggestions on the future use of the debriefing framework was provided.

Introduction: The nursing shortage continues to be a major topic of concern for the American Association of Colleges of Nursing (AACN). Creative ways to educate more nurses are essential to bridge the nursing shortage gap. Background: Virtual Simulation (VS) has shown positive outcomes when used in unfolding simulations. Using VS technology, initial research supports using VS for hands-on skill building. Hands-on skills are primarily nursing skills that are performed at the bedside. Methods: This dissertation is a mixed-methods, exploratory design. The Technology Acceptance Model (TAM) (Davis, 1989) was used to determine the usability and ease of use of a specific VS program. Two versions of the same skill were created, and the sample was randomly placed into either version A or version B. Version A used all 29 specific steps that were on the skill competency checklist as options and Version B condensed some of the steps into logical groupings for a total of 11 options. A comparison was made using the TAM (Davis, 1989) questionnaire for Version A and Version B. Three open-ended questions were asked to gather more feedback from the students. Results: Results indicate no differences in usability and ease of use using either version of the software. The final part of the dissertation used the information from the literature review and study to create a “how to use” virtual simulation for skill-building while keeping alignment with current standards. This information will add to the limited knowledge of using virtual simulation for hands-on skill building in undergraduate nursing education. Further studies with a larger sample size will add to the body of science which can potentially increase opportunities for access to online nursing education.

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As the number of English Learners (ELs) in US schools continues to rise, the need for effective instructional strategies to bridge the achievement gap between these learners and their English-proficient peers become more crucial to reduce the inequality among language minority groups. This study investigates the impact of virtual simulation experiences in developing communication strategies among teacher candidates for teaching ELs. Focused on the real and simulated teaching encounters of teacher candidates via the TeachLivE platform, this case study seeks to understand how these virtual experiences contribute to the practical application and transformation of teaching skills for effective EL communication. The research was conducted with teacher candidates pursuing Elementary and/or Secondary Education degrees at a large southeastern university in the United States, selected through purposive sampling. Data collection involved semi-structured interviews and was analyzed using Braun and Clarke's (2006) thematic analysis methodology. The findings indicate that virtual simulations are instrumental in enabling teacher candidates to apply theoretical knowledge in real-life settings, thereby enhancing their communication strategies with ELs. This adaptation to teaching methods underscores the necessity for flexibility in multicultural and multilingual classrooms. The study addresses a significant need to close the gap in traditional teacher education practicums, which often inadequately prepare candidates for the complexities of teaching ELs. It contributes to the literature on the use of virtual simulations in teacher education by highlighting their potential to bolster teacher effectiveness and student outcomes in diverse settings. The paper suggests that future research should broaden the scope regarding participants, and longitudinal research could be conducted to get insights into the long-term impact of virtual simulation training on teacher practices and student outcomes.

The construction of phantoms for testing imaging parameters has been well documented in the literature. As computers have been introduced into the different areas of medicine, they have become more and more relied upon to replace conventional technologies. One specific example is that of plane film X-rays. Digitally Reconstructed Radiographs (DRR's) are computer generated images that are generated from a 3 D volume of data, such as CT or MRI axial scans, and can be used in place of conventional X rays. The computer can generate a DRR image for any position, orientation and magnification, and geometries not physically possible in the real world. In this work a technique is developed to generate phantoms that can be used for testing the accuracy of DRR's. A computer generated phantom can produce multiple test cases that can be used to test specific variables of the DRR's. A series of 12 different standard phantoms were used to test the ability of three different commercially available treatment planning or virtual simulation systems to generate DRR's. A virtual simulation system under development by the author and collaborators and seeking approval from the Food and Drug Administration (FDA), was used as a development platform for this work. Initial evaluation of the usefulness of the digital phantoms for testing showed immediate results. The first virtual simulation system tested with the phantoms revealed a major error in its ability to generate accurate DRR's. Subsequently tests of the three commercially available systems further demonstrated the usefulness of the work. The tests revealed errors in two of the three systems evaluated but it was determined that they were not clinically significant. In conclusion, the digital phantoms developed in this work are a fast, accurate method for testing digitally reconstructed radiographs. It is an extremely versatile testing method, as the phantoms can be generated with ease for any geometry without needing access to a CT scanner. This method of testing can be used to test a number of different DRR image parameters. Should an error be found, it can be used to isolate errors that might exist in the imaging device. It is an extremely versatile testing method, as the phantoms can be generated with ease for any geometry without needing access to a CT scanner. This method of testing can be used to test a number of different DRR image parameters. Should an error be found, it can be used to isolate errors that might exist in the imaging device.

Virtual simulations and serious games (video game-based technologies applied to teaching and learning) have been incorporated in the teaching and training curricula of a large number of professions including medicine/surgery. Despite their benefits, there are open, fundamental issues regarding simulation quality, multi-modal cue interaction, and the resulting effect on visual quality perception and ultimately on knowledge transfer and retention. Here the results of a series of seven studies that examined the effect of background sound (contextually related and non-related with respect to the visual scene) on the perception of visual quality (defined with respect to texture resolution, polygon count) presented in stereoscopic and non-stereoscopic 3D. Results indicate that the perception of visual quality is dependent on ambient (background) sound. The results of these studies have implications for designers and developers of serious games who typically strive for high quality virtual worlds despite the computational burden associated with doing so. The results of these studies also bring us closer to understanding the role of quality, multi-modal interactions, and their effect on visual quality perception. This thesis is part of a larger effort in developing an understanding of virtual environment rendering quality, multi-modal interactions, user-specific factors and their effect on knowledge transfer and retention. / UOIT

This report describes a method of incorporating decision analysis principles to enhance a simulation being created by The University of Texas at Austin’s Institute for Advanced Technology (IAT). The simulation is called Virtual Simulation Learning Platform (VSLP) and the scenario created to test the platform is called Virtual Platoon Leader (VPL). Recommendations include a method of implementing value-focused decision making, the implementation of decision tools to build a scenario within the simulation, a dialogue process between the developer and the subject matter expert, a design for the implementation of graphical user interfaces for the decision tools used to build a scenario and a user scoring methodology. / text

A training unit has been developed that allows NVESD researchers to develop training simulations within virtual environments to enhance infantry skill and awareness. A ground station was developed to house a computer, power system, and video transmission system. This station will allow for a remote operator to wirelessly send a video/audio stream to the handset. The ground station also allows the use of external video and audio inputs to be sent using onboard converters. Different wireless frequencies were evaluated to determine the best for long-range transmission of content. A handset was developed from a carbon fiber prototype shell. The handset features a video receiver, display, power system, OSD system, and external video inputs. The user can view transmitted video and audio while obtaining real-time GPS feedback from the OSD. The alternate video input allows the handset to be used within the virtual environments developed at the University of Kentucky’s Center for Visualization for virtual environments. This thesis will present the research conducted in order to develop Mark VIIE training unit including the requirements for the project, the desired functionality, the NVESD provided equipment, the analysis of the prospective components, the design of custom fabricated parts, and the assembly and integration of the components into a complete system.

Bakgrund: Trauma är en vanlig orsak till död och invaliditet världen över. Det innebär även ett lidande för patienten, både i den akuta fasen och på sikt. Ett välfungerande traumateam är här av största vikt. Adekvat utbildning och träning av personalen är en nyckel. Tidigare forskning har visat positiva resultat av att lära sig genom simulering, men det finns ett behov av tids- och kostnadseffektiva alternativ. Ett forskningsprojekt inom Linnéuniversitetet och Region Kronoberg har därför utvecklat en virtuell traumasimulering, som ett led i att utveckla och förbättra utbildningen inom trauma. Syfte: Syftet med studien var att beskriva specialistsjuksköterskestudenters uppfattningar av lärande vid en virtuell traumasimulering.  Metod: Intervjuer genomfördes med 15 specialistsjuksköterskestudenter som hade testat simuleringen i grupp. En fenomenografisk analys genomfördes vilket genererade i tre beskrivningskategorier med tillhörande grupper av uppfattningar. Resultat: Den första beskrivningskategorin var ”Att få goda förutsättningar för lärande” genom ett nytt och roligt sätt att lära, tillgång till regelbunden övning, att få lära sig i sin egen takt och ett tryggt sätt att lära sig. I den andra beskrivningskategorin ”Att lära sig på olika sätt” uppfattade studenterna att de lärde sig genom att använda sina sinnen, gruppinteraktion samt genom reflektion och kritiskt tänkande. Den tredje beskrivningskategorin ”Att ha nytta av lärandet” handlade om att studenterna uppfattade att övningen ledde till att behovet av att förberedas för akuta situationer kunde tillgodoses samt att övningen utgjorde ett komplement till fysiska övningar - men inte en ersättning. Slutsatser: Studenter har positiva uppfattningar av lärandet vid en virtuell traumasimulering och kan utgöra ett viktigt komplement till fysiska simuleringar. Fler studier behöver göras för att se om det leder till ett förbättrat traumaomhändertagande. / Background: Trauma is a common global cause of death and invalidity. It causes the patient suffering, in the acute phase as well as in a long-time perspective. A well-functioning trauma team is of greatest importance. Sufficient education and training is the key. Previous research has shown positive results in learning by simulation, but there is a need for time- and cost-effective alternatives. To achieve this, a research project within Linnaeus University and Kronoberg County has developed a virtual trauma simulation where the user interacts in a trauma situation at the emergency room. Aim: The aim of the study was to describe Nurse Specialist student´s perceptions of learning by a virtual trauma simulation. Method: Interviews were carried out with 15 Nurse Specialist students who had performed the simulation in groups. A phenomenographic analysis was conducted which resulted in three categories of description with appurtenant groups of perceptions. Results: The first category of description was ”Getting good conditions for learning” through a new and funny way to learn, access to regular practice, learning at one´s own pace and a safe way to learn. In the second category of description ”Learning in different ways” the students perceived how they learned by using their senses, group interaction and through reflection and critical thinking. The third category of description ”To draw advantage from learning” consisted of the student´s perceptions that the virtual simulation satisfied their needs to be prepared for emergency situations, and also that the simulation acted as a complement to face-to-face simulations - but not a replacement. Conclusions: Students have positive perceptions of learning by a virtual trauma simulation. It could be an important complement to face-to-face simulations. Further studies are necessary to determine if virtual trauma simulation can improve trauma care for the patient. / Virtuell tabletop