NYU Langone Uses UbiSim VR to Prepare Nurse Residents for Clinical Practice & Onboard New Staff

Professional Development for Nurse Residency Programs 

NYU Langone Health’s nurse residency programs support recent nurse graduates as they transition into their first professional roles, helping to bridge the gap between academic training and real-world practice. Classes of 30-50 nurses meet approximately every month and, since 2023, have included simulation in immersive virtual reality (VR) with UbiSim. 

Arjuna Jacob, MS, RN, NPD-BC, Nursing Professional Development Specialist at NYU Langone Hospital - Tisch/Kimmel, uses the faculty-led casting method to show UbiSim on the main screen and take the nurse residents through the complete simulation process. 

“I wear the headset and cast it to the screen while the nurses coach me through the scenario,” explained Jacob. “They will coach me through the steps, and whatever they tell me to do, I’ll do. During the debrief sessions, nurses engage in visualization and critical thinking exercises, which contributes to their learning process.”

“I start off by introducing the scenario and the objectives without really giving away too much about it. I do go over who the patient is, and I tell them if they need more information, it's going to be in the EMR,” said Jacob.

“We reiterate, ‘This is a real patient, and you're walking into the patient's room. What do you think you'll do next?’” added Manjula Stanislaus, DNP, MHA, RN, NPD-BC, CV-BC, CCRN, CMC, Nurse Residency Program Coordinator at NYU Langone Hospital - Long Island. “At the end, we debrief.” 

Debriefing Sparks Critical Thinking

During debriefing sessions following virtual simulations, nurses raise additional questions about procedures like blood transfusion protocols. The simulation scenarios facilitate discussion and critical analysis of clinical procedures,” said Jacob. "The visual component of the training sessions provides opportunities for nurses to work through clinical scenarios and engage in analytical thinking.”

Stanislaus agreed about the importance of the debrief. “If they did something wrong in the simulation, we used the guided reflection questions to talk about it so they could learn from their mistakes. That’s where they’re able to realize, ‘Wow, yes, I should have done that. I should have verified the patient. I should have used the alcohol swab, but I couldn't find it,’” she said.

Nurses have expressed interest in additional simulation training opportunities. 

A Skills Refresher for Staff Onboarding

UbiSim is also used in onboarding new nursing staff at the Long Island campus. 

“For some of the new staff, it might have been a while since they had left clinicals and taken their NCLEX. So there may have been a period of time when they hadn't been in a clinical setting,” said Lauren Moran, MSN, RN-BC, SCRN, CNRN, Nursing Professional Development Specialist at NYU Langone Hospital - Long Island. The virtual simulation sessions allowed nurses to practice fundamental skills like patient room protocols and identification procedures, particularly beneficial for those who had a gap between graduation and starting clinical practice. 

‍Key takeaways:

• New graduate nurses transitioning to practice used UbiSim during their orientation and Residency Seminar. 
• Experienced nurses returning to practice used UbiSim to refresh fundamental skills like patient room protocols and identification procedures. 
• Facing nerve-wracking emergency situations in UbiSim helped nurses reduce their anxiety.

Practice in VR Mirrors Real Practice

“First-time new graduate nurses practiced in VR during their first week of orientation on the Skills Day,” said Stanislaus. “They were given a second opportunity to use UbiSim during their Residency Seminar II. Through repeated practice sessions, nurses demonstrated improved critical thinking skills in scenario completion and increased familiarity with the simulation technology. 

Jacob added, “Sometimes we couple our nurse residencies with different types of learning. For example, we have a mock code that we go through pictures with mock code carts, and then we have a PowerPoint, and then we do gaming, and then we have VR. So it touches upon a lot of different types of different methods of learning. Coupling UbiSim with other modalities helps cement the learning.”

Practice Helps Nurses Overcome Anxiety 

“What they really are nervous about coming off orientation are emergency situations,” said Jacob. “Some of the scenarios that we have in UbiSim help them prepare for clinical patient deterioration and figure out ‘what do I do?’. That's helpful for them to work through the emergency situations they’re nervous about and really decreases their anxiety.”

VR is for Everybody

“The technology could be scary for some of the generations,” said Stanislaus. “Some people just think ‘that's not for me’. But this is for everybody. We have to make that really clear. Anybody can use UbiSim by adjusting the boundaries. For example, a person who is elderly and not able to walk well can sit in a chair and use UbiSim.”

“And of course, when we introduce it to the nurse residents, we invite volunteers who want to try on the headset - no one has to use it unless they’re interested,” she added.  

Using VR to Teach the Social Determinants of Care

Jacob described that UbiSim scenarios help orient staff to provide holistic patient care. “We use the scenario with “Geraldine Larson” who has heart failure exacerbation and didn’t take her medication because she couldn't get to a pharmacy to pick them up. I did it with a group of nurses who were maybe two or three weeks into the institution. I think the reason they really enjoyed it is that it gave them a different way of thinking and approaching their patients.” 

“They told me these kinds of patient challenges are things that they're not really thinking about - they're more focused on giving the meds and doing the assessment than thinking about what might prevent a patient from taking their meds and barriers to discharge. I had one nurse who was so thankful for that scenario. He came over to say, ‘Thank you for giving me a different way of looking at the big picture.’”

Related Research on Virtual Reality in Nursing Professional Development

Highlighted findings from a survey of 63 participants regarding their VR experience include:

• The use of VR met the educational learning objectives outlined during the prebriefing: 77.7%
• VR enhanced participants’ clinical knowledge retention: 98.3%
• The VR learning environment was enjoyable for participants: 69.8% 
• VR was an effective method for participants to learn nursing clinical skills: 66.7%
• VR is preferable compared to traditional teaching methodologies: 38.1%

Citation: 

Coughlin, V., Bolanos, G., Jacob, A., & Maydick-Youngberg, D. (2024). Welcome to the Metaverse: virtual reality in nursing professional development. Journal for Nurses in Professional Development. 40(5), 236–241. Retrieved from https://journals.lww.com/jnsdonline/abstract/2024/09000/welcome_to_the_metaverse__virtual_reality_in.3.aspx 

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