VR Simulation As Part of Competency-Based Education in Nursing 

A nursing student carefully draws medication into a syringe in a virtual reality simulation, double-checking the dosage against the prescription. She reviews the patient’s details one final time before administering the injection. At the end of the simulation, she receives critical feedback: she forgot to scrub the hub before giving the medication. This small but essential oversight becomes a learning moment—one she is unlikely to repeat in a real clinical setting.

This iterative approach to preparation lies at the heart of competency-based education (CBE), where students develop practical skills and clinical judgment in a safe, controlled environment. CBE embodies the National League for Nursing’s (NLN) vision of closing the gap between theoretical knowledge and hands-on practice, with a strong emphasis on cultivating clinical judgment and decision-making.

This urgency of the gap is driven by the nurse readiness crisis. While 93% of nursing students pass the NCLEX exam, only 9% feel adequately prepared for clinical practice. CBE addresses this challenge by fostering deliberate, immersive learning experiences that prepare students for the complexities of modern healthcare.

One VR simulation at a time, nursing programs are transforming NLN’s vision into reality, equipping students with the clinical judgment and skills necessary to provide excellent patient care… because patient outcomes depend on nurse readiness. 

What is Competency-Based Education (CBE) in Nursing?

Florence Nightingale famously believed that nursing required the integration of the brain, heart, and hands to create a healing environment for patients. This philosophy emphasized the holistic and humanistic aspects of care, ensuring that nursing practice transcends technical skills. 

CBE builds on this legacy, aligning with the NLN’s vision for nursing education. Let’s examine the key characteristics that define CBE in nursing:

Emphasis on outcomes vs. inputs

Traditional nursing education often centered on standardized curricula and fixed hours of instruction. CBE shifts the focus from what is taught to what students are able to do. It prioritizes measurable outcomes, ensuring that students acquire the skills and knowledge they need to excel in patient care. 

Focus on mastery vs. time-based learning

In traditional models, students are often assessed based on the completion of predetermined timelines, such as finishing a semester or clocking a certain number of clinical hours. CBE, however, emphasizes mastery of skills and concepts over adhering to rigid schedules. 

Individualized pacing vs. standardized timelines

CBE recognizes that every student learns at their own pace. Instead of requiring all students to progress through the program at the same rate, it allows learners to advance as they achieve competence. This personalized approach supports students in developing clinical judgment and critical thinking skills on their own timelines. 

Practical application vs. theoretical knowledge

Historically, nursing education relied heavily on textbooks and lectures. CBE emphasizes experiential learning, where students engage in hands-on activities that mimic real-world clinical scenarios. Simulation plays a critical role, providing students with opportunities to refine their skills in safe, controlled environments. 

The Future of VR in Competency-Based Nursing Education

As nursing education evolves to meet the demands of modern healthcare, VR will play a pivotal role in CBE. According to the American Association of Colleges of Nursing (AACN), a core principle of CBE is that competency must be "visibly demonstrated and assessed over time by multiple methods and multiple assessors." VR offers a powerful method for this, complementing traditional modalities like manikins, task trainers, and standardized actors to create a comprehensive, multidimensional learning experience.

UbiSim is a nursing education virtual reality platform created by nurses for nurses. Recognized as one of TIME’s Best Inventions of 2024, UbiSim is here to make the transition to competency-based education possible.

Here are the ways VR can help the goals of CBE: 

Enhancing clinical judgment

While VR simulations do focus on specific skills, such as scrubbing the hub before administering medication, the true power lies in helping learners develop clinical judgment. As Melissa Bruce from Bow Valley College explains, “We’re focusing on building clinical judgment, not just skills. I tell students, ‘I’m not concerned about whether you can insert an IV line in VR; I want to know if you understand why this patient needs an IV.’” 

VR helps students move beyond skill acquisition by immersing them in scenarios where critical thinking and decision-making are essential. For example, UbiSim released distractors that force learners to make difficult decisions, such as taking a call from a provider in the moment. 

Developing empathy by stepping into a nurse’s shoes

One of the biggest benefits of VR is how realistic it is. With manikins, students struggle to suspend disbelief and act like it’s a real situation. With VR, there are no cell phones to distract learners, and they are entirely immersed in the virtual hospital room. A baby is crying at them, requiring their attention as the sole nurse in the room, or a patient is deteriorating in real-time, encouraging learners to pay close attention. In all of UbiSim’s scenarios, students and new nurses develop empathy by stepping into the shoes of a real nurse.

Bridging gaps in clinical training

It’s so hard to get students into robust clinical experiences, especially after COVID-19. Even if educators can get them into clinicals, there’s no guarantee they’ll experience a wide variety of scenarios to adequately prepare them, contributing further to the nurse readiness crisis. Dr. Tina Barbour-Taylor from the University of West Florida shared, “It builds their confidence when they go into the clinical realm to be able to say, ‘OK, so this is what I learned in the classroom, this is what I learned in simulation, now I can see how I would use that in clinical. For me, it's huge to see the light bulb go off for students.” 

Enabling data-driven assessments

In UbiSim, learners receive instant feedback on critical actions, complete with evidence-based rationales. Simulations are recorded, allowing students to review their performance and refine their skills, ensuring they progress toward skill and clinical judgment development.

Final Thoughts

Ready to bring the power of VR to your nurse learners? VR is transforming how we prepare the next generation of nurses. UbiSim equips nursing students with the skills and confidence they need to deliver excellent patient care. Learn more about how UbiSim can help transform your nursing program and bridge the gap in nurse readiness.

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