Examining the impact of virtual reality on clinical decision making – An integrative review

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Nurse Education Today


Background: Clinical decision making is an essential cognitive skill in nursing. It is a process undertaken daily by nurses as they make judgements about patient care and manage complex issues as they arise. Virtual reality is an emerging technology that is increasingly being used pedagogically to teach non-technical skills including CDM, communication, situational awareness, stress management, leadership, and teamwork. Objective: The objective of this integrative review are to synthesise the research findings regarding the impact of virtual reality on clinical decision making in undergraduate nurses. Design: An integrative review using Whittemore and Knafl's framework for integrated reviews. Data sources: An extensive search was conducted of healthcare databases including CINAHL, Medline and Web of Science between 2010 and 2021 using the terms virtual reality, clinical decision and undergraduate nursing. Review methods: The initial search located 98 articles. After screening and checking for eligibility, 70 articles were critically reviewed. Eighteen studies were included in the review and were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. Results: Research in the use of VR has demonstrated its potential to improve undergraduate nurses' critical thinking, clinical reasoning, clinical judgement and clinical decision-making skills. Students perceive these teaching modalities to be beneficial to the development of their clinical decision-making ability. There is lack of research related to the use of immersive virtual reality in developing and enhancing undergraduate nursing students' clinical decision-making skills. Conclusion: Current research on the impact of virtual reality on the development of nursing CDM has demonstrated positive results. VR is one pedagogical approach that could further assist, however, there are no identified studies that focus on its impact in developing CDM, therefore further studies are required to address this gap in the literature.

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