Constructing a Mixed Simulation With 360° Virtual Reality and a High-Fidelity Simulator Usability and Feasibility Assessment

Virtual reality technology has been adopted to overcome barriers of conventional simulation. This study was conducted to determine the impact of mixed simulation (a 360 & DEG; virtual reality and a high-fidelity simulator) on learning how to provide nursing care for patients with arrhythmia. A total of 49 students were randomly assigned to intervention (n = 25) and control (n = 23) groups. They were given four arrhythmia cases with a 360 & DEG; virtual reality system first followed by a manikin-based simulation. The mixed simulation group showed greater improvement in knowledge, higher decision-making competency in "knowing and acting" (P = .025) and "seeking information from instructors" (P = .049), and lower anxiety in "using resources to gather information" (P = .031). Study participants achieved a good level of empathy (3.28 & PLUSMN; 0.72) and liked the program (4.56 & PLUSMN; 0.60). They were satisfied with the program (4.48 & PLUSMN; 0.65). These findings provide new insight into learning through blending of new technology. When the 360 & DEG; virtual reality was used with existing manikin-based simulation, they effectively reinforced one another. The 360 & DEG; virtual reality can be an effective strategy to ensure active participation to gain a comprehensive understanding of and empathy for patients.