Virtual Reality Simulations in Healthcare Education

Ryerson University partners to create non-immersive virtual gaming clinical simulation for nursing

Providing practical experience for nursing and healthcare students in clinical application can be costly. Laboratory space, specialized equipment, resources, and the personnel to manage it can be expensive. Together, Toronto-based Ryerson University, Centennial College, and George Brown College created realistic scenarios to replace the need for live clinical simulations.

They created three self-study modules to teach foundational therapeutic communication and mental health assessment skills using a simulation game for learners to apply principles learned. Called the non-immersive, virtual gaming clinical simulation (NIVGCS), a series of video scenarios have been created using actors on a script.

One simulation, for example, portrays a client and a nurse home visit.

“Would you like to sit down?”


The simulation depicts situations that require a series of decision points. For each response made, the coordinating response scenario plays out. Various scenarios give the students the opportunity to practice skills in handling domestic violence, suicide risk, and more.  This is a great model for providing online clinical application.

Ryerson University, George Brown College and Centennial College embarked upon a collaborative project to create a learning resource for healthcare and nursing students.
Learning modules and a virtual interactive game were designed to promote active learning and improve the student’s retention of knowledge, problem solving and critical
thinking skills.

Virtual simulation in nursing educationThree self-study modules augment the teaching of foundational therapeutic communication and mental health assessment skills. They include short videos from experts, development skills videos, and learning objects with quizzes and matching exercises. The complementary simulation game, coined non-immersive virtual gaming clinical simulation (NIVGCS), provides a virtual clinical situation that allows learners to apply the principles they learn in the three modules.

To portray a client and nurse home visit, the universities created a series of videos using actors that follow a script. Students comment often that the scenarios were realistic and immersive making the game a fun and engaging way to practice communication and assessment skills.

NIVGCS replaces the need for traditional live clinical simulations, which are quite expensive due to the need to have laboratory space, specialized equipment, and other resources. The universities felt that virtual simulations using live actors instead of avatars made the nursing experience more realistic.
The student participating assumes the role of a community health nurse assigned to complete a home visit. The various scenarios provide them the opportunity to practice skills in handling domestic violence, suicide risk, and depict situations that require a series of decision points. By replicating real-life situations learners can practice their problem-solving and decision-making skills in a safe environment.

Three modules include:
Module 1: Therapeutic Relationships and Communication Techniques
Module 2: Mental Status Assessment, Depression and Suicide Risk
Module 3: Interpersonal Violence

Interestingly, the project was designed to have students first take the modules first and then practice through the nursing simulation game. However, the standalone game can be played before and/or after taking the modules. The learning modules can also be used to prepare for the NCLEX or CPRNE exams. A proposed study in underway to compare student knowledge gains, self-efficacy and learner satisfaction between those who participate in NIVGCS (non-immersive virtual gaming clinical simulation) to the traditional laboratory simulation.