Effectiveness of VirtualSim-COVID on Nursing Students' Learning Outcomes Toward COVID-19

Abstract

Introduction: The COVID-19 pandemic challenged the continuity of education worldwide, particularly in health and nursing education. Thus, web-based virtual simulation seems an appropriate pedagogical strategy to help nursing students continue learning safely during the pandemic and improve their learning outcomes. Aim: This study sought to improve nursing students' learning outcomes pertaining to COVID-19 among community-dwelling older adults using a web-based virtual simulation for COVID-19 (VirtualSim-COVID). Methods: Data were collected from September to November 2023 at a single college of nursing in Saudi Arabia. Participants were junior and senior nursing students recruited through convenience sampling. The study was approved by the Princess Nourah University (approval no.IRB log 22-0438, and all participants provided written informed consent. Data were analyzed using descriptive statistics, paired t-tests, and Wilcoxon signed-rank tests. Assumptions for paired t-tests were examined, including normality of difference scores (Shapiro–Wilk test), independence of observations, and absence of outliers. An alpha level of .05 was used for all inferential tests. The VirtualSim-COVID consisted of case scenarios, a general review of COVID-19, practice quizzes on performing hand hygiene, applying personal protective equipment (PPE), and administering the vaccine, and self-debriefing. Results: A total of 21 junior and senior nursing students were recruited; 23 consented and 2 withdrew after the pretest due to scheduling conflicts. The results showed that students demonstrated significant improvement in knowledge (t(19) = −3.33, p = .004, Cohen's d = 0.74), self-confidence (t(17) = −4.32, p < .001, Cohen's d = 1.02), and satisfaction (t(17) = −5.06, p < .001, Cohen's d = 1.19) after the intervention, as well as descriptive improvement in skill performance. No significant change was observed in the overall critical thinking score (t(20) = 0.45, p = .658), attitude subscale (Z = −1.00, p = .317), or practice subscale (Z = −0.26, p = .796). Conclusion: The findings revealed significant improvements in participants' knowledge, self-confidence, and satisfaction, as well as descriptive improvement in skill performance, following the VirtualSim-COVID intervention. However, the absence of a comparison group precludes definitive causal attribution of these improvements to the intervention alone. VirtualSim-COVID shows promise as an educational tool for improving nursing students' knowledge, skill performance, self-confidence, and satisfaction. Therefore, incorporating virtual simulation into nursing education programs' curricula is recommended. Further research using randomized controlled designs with larger samples is suggested.