Virtual reality nursing - in 3D - The University of Tulsa
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Virtual reality nursing — in 3D

A woman in a red top in the foreground and a woman in blue medical scrubs in the background
Clinical Assistant Professor of Nursing Cassandra Barrow and BSN junior Mary DeFrancisco

Does the thought of having an intravenous drip hooked up through the back of your boney hand give you the shivers? If so, spare a thought for the parallel anxiety many nursing students feel as they learn how to pierce your skin using razor-sharp metal without doing you any harm.

Enter Clinical Assistant Professor of Nursing Cassandra Barrow, who focused her recent Ph.D. research on the role 3D virtual reality simulation could play in alleviating such feelings while contributing to nursing students’ skills development, critical thinking and communication. Thanks in large part to Barrow’s work, such innovative technology is now a mainstay of undergraduate nursing education at The University of Tulsa School of Nursing.

Using virtual reality to quell real anxiety

TU’s Lawson Family Simulation Center and Nursing Skills Lab contains state-of-the-art high-fidelity equipment used to help train the country’s future nurses. Here, students in the undergraduate nursing program engage in hands-on activities – such as inserting a catheter or injecting medications – in a simulated clinical environment.

Prior to working with real patients, such experiences enable students to practice technical skills, gain muscle memory, make errors safely and receive feedback to improve their performance. According to Barrow, two of the main benefits of high-fidelity simulation – and the reason it is in such great demand – are that nursing students have the opportunity to improve their performance while decreasing their anxiety.

“At the same time, however, studies have shown that high-fidelity simulation itself often brings about anxiety for nursing students,” commented Barrow, who received her Ph.D. in nursing from Oklahoma City University in 2021. To address this, some nursing schools have introduced two-dimensional screen-based virtual simulations before turning students over to hands-on simulation work. This technology, Barrow notes, has been shown to help lower anxiety.

A 3D approach

Barrow’s interest in the potential role of virtual reality in nursing education was sparked by her husband, Thomas Barrow (BA ’06, BS ’19), a TU computer simulation and gaming graduate. “Having taught nursing since 2015, I would watch so many of my students shaking with anxiety during their first hands-on simulations with the high-fidelity mannequins we have at TU. I knew there had to be ways to lessen their stress. My husband’s work with virtual reality set me on the path of and inspired my passion for incorporating the approach into nursing education here at TU.”

Virtual reality nursing education


For her doctoral research, Barrow undertook a study of the effect of 3D virtual simulations and nursing students’ anxiety. “Basically, I wondered how much more could 3D virtual reality accomplish given that 2D had already been proven helpful.”

What she discovered was highly promising: There was a significant decrease (p=.005) in reported state anxiety of the nursing students after the intervention. “These results,” Barrow concluded, “suggest that virtual reality simulation really does influence state anxiety scores in pre-licensure nursing students regarding their first high-fidelity hands-on simulation.”

Based on her findings, Barrow recommended that 3D virtual reality simulation be added early during nursing students’ education. Further, she advised that such training include a debriefing session held either virtually or face to face.

Learning to deliver excellent care

“A person goes into nursing because they want to deliver excellent care,” said Barrow. “My research, as well as my experience as a nurse and nurse educator, have proven to me that decreasing student anxiety is itself a central concept of caring. And 3D virtual reality simulation is definitely a way to achieve that goal.”

A woman wearing blue medical scrubs and a virtual reality headset standing in front of a computer monitor
BSN junior Kyra Vanderweele

Today, 3D virtual reality simulation is being deployed in TU’s pre-licensure bachelor of nursing program. Using software from Oxford Medical Simulation, students now reap the benefits of experiencing five simulations over their first three semesters.

“Using 3D virtual reality simulation with headsets and hand controllers offers a bridge between 2D screen-based simulation and mannequin-based hands-on simulation,” noted Barrow. And with the technology, students can complete the same simulation in 2D as many times as they want after completing it in 3D.

“Not only do our students find their stress melt away,” noted Barrow, “but they also enjoy the process of learning more and find they are able to retain more information.”

Do you aspire to be a well-trained, caring health care professional with great job prospects? Then consider earning your bachelor of science in nursing degree at the TU School of Nursing!