Team Name
NurSim
Timeline
Spring 2022 – Summer 2022
Students
- Emelyne Hoang
- Jackson Park
- Rafel Tsige
- Jorge Rodriguez
Sponsor
Jennifer Roye, Assistant Dean of Simulation and Technology
UTA Computer Science Department
UTA Nursing Department
Abstract
Nursing students at the University of Texas at Arlington require a tool that will give them greater exposure to hospice and palliative care experiences. To create this tool, several computer science and engineering students have worked to design various VR simulations in which students care for a patient at different stages of palliative care. Debugging each scenario and ensuring the fluidity between scenarios before conducting player testing will ensure that nursing students are able to receive proper exposure to hospice and palliative care upon release.
Background
The sponsor and customer for this project is the Department of Nursing at the University of Texas at Arlington. The point of contact for the department is Jennifer Roye along with Dr. Shawn Gieser, who is acting as a foreman for the project. One area that the Department of Nursing is lacking in is hands-on experience for nursing students working with hospice patients. This is an area of nursing that is challenging to work in, and by having experience prior to graduating, nursing students will be much more prepared for their careers. Gaining experience will not only help nursing students manage hospice care in a more positive manner, but will also make them more effective at easing the patient to their end. It can be difficult to witness an individual on their last legs, and so by training in a realistic environment, future nurses will be better prepared for managing the emotions and outcomes involved. Overall, a VR simulation will allow nursing students to gain valuable experience working with hospice patients. The simulation will expose students to elderly individuals and show them how to manage their environment. It will also enable students to witness issues that could potentially come up in a real situation in an immersive training session. Since the simulation will be three dimensional, it will provide a more realistic training experience for students compared to any current two dimensional implementation.
Project Requirements
The highest priority requirements are split among two categories: Simulation Content Requirements and Scenario Content Requirements. Simulation Content Requirements take priority over Scenario Content Requirements since Scenario Content Requirements must exist within each scenario described in the Simulation Content Requirements.
Simulation Content Requirements
- Scenario 1 – The nurse encounters Mr. Russell in the hospital. The nurse will be required to ensure patient safety, perform an assessment and obtain a nursing diagnosis, and administer medication to the patient.
- Scenario 2 – The nurse first enters Mr. Russell’s house for hospice care following his terminal cancer diagnosis. The nurse will assess the safety of the environment and perform an assessment of the patient. Finally, the nurse will communicate Mr. Russell’s condition to his wife.
- Scenario 3 – Mr. Russell is exhibiting symptoms of impending death. The nurse will identify the change in status, perform a GCS, assess pain, perform suction, and communicate the patient’s status to his wife.
- Scenario 4 – Mr. Russell has passed on. The nurse will perform comfort measures for the patient and his family, and conduct postmortem care.
Scenario Content Requirements
- Glasgow Coma Scale Reporting (GCS) – Must be able to check patient eye movements, verbal responses, and motor responses.
- Administering Medication – Must be able to choose between dosage options, verify the compatibility of the medication to current infusions, and be able to choose the administration rate.
- Hygiene Mechanics – Functional sink, soap dispenser, and towel dispenser.
- Vitals – Must be able to observe vitals on a monitor and allow the nurse to announce that they will take vitals before recording data.
- Focused Patient Assessment – Allow nurse to observe lung and heart sounds, patient pulse, skin color, history of CVAs, prior pain medication administration, etc.
- IV Site Assessment – Allow nurse to inspect IV site for signs of infiltration or extravasation, do a light palpation, and review a list of abnormalities that display upon interacting with the patient.
System Overview
The system overview of our project consists of two high-level layers: the User Interface Layer and the VR Simulation Software Layer. The User Interface Layer is made up of the systems that enable the user to input data to affect the virtual reality environment and receive feedback on what those effects are. The VR Simulation Software Layer is where the program that dictates what occurs in the virtual reality environment–including how user input affects it and processes how it should be updated–is created and built. When running the program via Unity, the VR Simulation Software Layer sends the updated environment back to the user through the PC. When running the program via the headset, this layer builds and uploads the program to the headset via the PC.
Results
As this project has been in the works for many years already, the goal of this team was to do final requirement checks and debugging for each scenario. In particular, this team has done the following:
- Implemented required functions in Scenario 1 and 2
- Incorporated the focused patient assessment, medicine ordering, and EMR diagram display into Scenario 1
- Implemented overall scenario content requirements in Scenario 2
- Implemented results screen at the end of both scenarios
- Completed bug fixes for Scenario 3
- Fixed various interaction and dialogue issues
- Completed partial bug fixes for Scenario 4
- Switched testing hardware from the HTC Vive to the Oculus Quest 2
- Fixed various bugs that occurred due to switching
Demo of Scenario 1 and 2
Future Work
- Conduct preliminary usage testing with CSE students
- Conduct final play testing with Nursing students
- Final bug fixes for all scenarios
- Finalize all details of deployment
- Create tutorial for those new to VR
Project Files
Project Charter (link)
System Requirements Specification (link)
Architectural Design Specification (link)
Detailed Design Specification (link)
Poster (48inx36in PPT) (48inx36in PDF) (16:9 PPT) (16:9 PDF)
References
[1] F. Q. Chen, Y. F. Leng, J. F. Ge, D. W. Wang, C. Li, B. Chen, and Z. L. Sun, “Effectiveness of virtual reality in nursing education: Meta-analysis,” Journal of Medical Internet Research, vol. 22, no. 9, p. e18290, Sep 2020.
[2] C. L. Foronda, S. M. Swoboda, K. W. Hudson, E. Jones, N. Sullivan, J. Ockimey, and P. R. Jeffries “Evaluation of vsim for nursing: A trial of innovation,” Clinical Simulation in Nursing, vol. 12, no. 4, pp. 128-131, 2016, Special Issue: Gaming.
[3] R. McCloy and R. Stone, “Virtual reality in surgery,” Journal of Medical Internet Research, vol. 323, no. 7318, pp. 912-915, 2001.
[4] J. M. Padilha, P. Puga Machado, A. Ribeiro, J. Ramos, and P. Costa, “Clinical virtual simulation in nursing education: Randomized controlled trial,” Journal of Medical Internet Research, vol. 21, no. 3, 2019.
[5] P. C. Smith and B. K. Hamilton, “The effects of virtual reality simulation as a teaching strategy for skills preparation in nursing students,” Clinical Simulation in Nursing, vol. 11, no. 1, pp. 52-58, 2015, Special Issue: Works of Doctoral Students and Recent Graduates.
