On September 4th, Kendal Bailey, Director of Nursing Innovation and Strategy at SimX, gave a webinar presentation hosted by HealthySimulation.com. Kendal is a dynamic nursing professional with a rich educational background and extensive experience in both clinical and academic settings. She is dedicated to promoting the utilization of advanced virtual tools to improve educational performance–particularly in Virtual Reality (VR) environments–and she spoke on this topic alongside Lance Baily from HealthySimulation.com. 

 

The webinar is titled “Transforming VR Clinical Education with the Cognitive Affective Model in Immersive Learning.” The Cognitive Affective Model of Immersive Learning (CAMIL) provides a theoretical framework for understanding and optimizing learning within immersive virtual reality (IVR) environments. This presentation aimed to give attendees an understanding of CAMIL, its components, and its implications for designing IVR-based learning experiences. The presentation explored leveraging the model’s insights to enhance educational outcomes, ensuring that IVR environments are engaging and educationally effective.

 

Watch the full webinar here and get access to all links and references!

 

Presence & Agency

 

CAMIL clarifies how learning occurs in IVR by highlighting the psychological affordances of presence and agency.

 

Presence is about both immersion in the program and the control factors. Educators, simulation operation specialists, and other facilitators should consider whether a VR environment is truly realistic and reflects what learners will experience in current clinical practice.

 

Educators must consider control factors when discussing the educational impact of immersive training. Control factors are the tools and engagement that learners have within a virtual environment, which create a more immersive and true-to-life simulation experience. The realism and smoothness of the virtual space, the accuracy of the virtual tools available, and the consistency of an object’s function all influence whether a learner can remain engaged with the scenario and focus on the learning objectives outlined within the simulation.  

 

The next psychological affordance discussed throughout the webinar is agency. Related to control factors, educators must consider how the learner can control certain factors within a simulation program. How learners interact with their virtual environment and whether those interactions are effective are huge for learning. 

 

“Your learners have to be able to go in and control the environment,” Kendal said, “So they can put on PPE, manipulate the IV pump, they can move the bed in the room, or access any tool that is needed for the learning in that case. In any of these actions, there actually needs to be a correspondence between motor function, movement, and visual feedback. If I move through a space, I’ve got to be able to grab and do things just like I would in real life.” 

 

Agency and presence are both essential to ensuring simulations support competency attainment in nursing education and both are also especially important to the buy-in of new technology.

 

Key Factors

 

CAMIL identifies six key affective and cognitive factors influencing IVR learning: interest, motivation, self-efficacy, embodiment, cognitive load, and self-regulation. By understanding these factors, educators can foster the acquisition of factual, conceptual, and procedural knowledge and improve knowledge transfer.

 

Each of these factors has a different effect on how we achieve learning. Kendal Bailey gave an example here: “When we look at immersive tools, how do we make sure that we increase interest and motivation, but ensure that we don’t have too much cognitive load? These [considerations] are how we achieve learning outcomes.” 

 

A Note on Cognitive Load

 

Cognitive load became a topic of interest and discussion throughout this webinar. Kendal noted that there’s a lot of literature out there that says if your cognitive load is too high in an immersive space, the learning is not going to be as effective. How can educators and simulation directors ensure that learners do not become overloaded and overwhelmed by a VR simulation experience? Choose a balanced platform that doesn’t necessarily include every tool or every environmental factor in every scenario. Instead, seek out representational fidelity where learners can experience true-to-life patient encounters with the objects they will actually need rather than an overload of tools and decisions. 

 

Q&A Highlights

 

There was great participation from the webinar’s live audience. Here are a few questions that were asked and answered during the presentation.

 

Question: Does repetitive practice in VR reduce the learner’s cognitive load? Can they become more comfortable over time?

 

Answer: Repetition is a fantastic tool to help regulate the initial high cognitive load because of the high immersion that learners experience. However, you will want to make sure students are oriented to the platform and that they understand how to navigate their virtual environment. We strongly believe that having a pre-briefing session and dedicating time to an orientation is essential to working through cognitive load. Dedicating time for learners to self-reflect and receive feedback after simulation sessions also increases self-efficacy and reduces cognitive load. 

 

Question: Educators often desire some level of cognitive load for experienced learners to simulate a more high-stress environment. How can you gradually increase that cognitive load and maintain a high level of agency as learners progress from first-time to more experienced VR users? 

 

Answer: Creating a dynamic simulation program/curriculum that can shift and change

over time is really dependent on how an institution scaffolds and builds its learning and if educators or facilitators have the flexibility to manage and adjust things over time. For example, it’s essential that you have a moderator who can help gauge learners’ progress and communicate with them throughout the course. The moderator knows the learner’s level and can accommodate varying needs for cognitive load and agency, as well as manage the immersive space as they go. For more experienced learners, the moderator may choose to give them fewer cues and less information during the simulation session because they have the knowledge, skills, and attitudes to work through it themselves. Read more about the importance of moderators here.

 

Question: How will AI contribute to creating immersive spaces and the ability to interact with them over time?

 

Answer: Both Kendal Bailey of SimX and Lance Baily of HealthySimulation.com commented on how AI will grow. On this topic, Kendal said, “I think there really is a lot of opportunity for affective domain development and having realistic conversations [with AI]. But I want to preface, that I think realism is the key there. If you’re in the middle of a simulation where something happens that isn’t realistic, it’s gonna pull you away from the learning. So if you’re talking to somebody and all of a sudden they have this extraneous, random conversation, it’s gonna pull you away from the learning completely. So I think AI will be essential for affective domain development in terms of the smoothness of the conversation and realism, and I think it’ll support moderators because they’ll have less that they will have to do to maintain dialogue. But I do want to make sure the technology is there to ensure the realism and that it doesn’t pull away from the learning.”

Watch the full webinar on transforming nursing education here at Healthysimulation.com.