Exploring the Role of Virtual Simulation Gaming in Reducing Physical Examination Anxiety for Undergraduate Nurses

Abstract

Simulated objective structured clinical examination (OSCE) assessments have traditionally evoked high levels of anxiety for students, both when learning the scenarios in face-to-face simulations and when undertaking the actual OSCE assessment. Virtual simulation gaming (VSG) is an identified method of preparation for simulation that may reduce performance anxiety for students undertaking OSCE assessment. This quantitative exploratory research utilised established satisfaction and anxiety/confidence scales to explore the impact of VSG on student perceptions of simulation experiences, anxiety and self-confidence in clinical decision-making. Summative OSCE assessments were conducted in two cohorts before an inpatient and ambulatory care clinical practicum. Cohort one undertook their summative OSCE assessment immediately following the initial teaching, with the second cohort completing a mental health and addictions clinical practicum before their summative OSCE. Descriptive and inferential statistics were used to examine the relationships between simulation satisfaction, students’ perceived anxiety, and confidence with clinical decision-making. Self-reported satisfaction with simulation levels were high and improved over subsequent simulations. Results showed that although the second cohort demonstrated higher levels of confidence in clinical decision-making, there was no significant difference in anxiety levels between the two cohorts. This suggests that OSCE-related anxiety is situational rather than directly related to self-confidence. Anxiety was reported by most students following summative OSCEs despite the introduction of VSGs in pre-OSCE clinical simulation preparation. Even though they had high satisfaction with the simulation experience and reported feeling confident, this did not allay student anxiety. Overall, the study did not identify any measurable factors that would indicate which students would score high in self-confidence and/or anxiety. While it was not possible to directly attribute high levels of self-confidence to the introduction of VSGs, student satisfaction with simulation and clinical learning that included VSGs was high, indicating the positive effect on learning.