Practice Learning Environment Research Articles

Developing new healthcare practice learning environments through a third-space reflective practice approach: a case study

PurposeThe creation of new practice learning environments for healthcare students promotes the development of professional judgement skills and decision-making. Through the modelling of established practices across other subject disciplines, Healthcare Technicians designed and created the Clinical Skills Lounge to support student learning outside of scheduled classes.Design/methodology/approachThe design and development of a new learning and simulation space for healthcare students was created following feedback from students. Using a model of learning support for students across the creative subject disciplines, the creation of the Clinical Skills Lounge provided an opportunity to create a space where practical techniques could be practiced and support provided by Technicians.FindingsStudent feedback highlights the importance and flexibility of the Clinical Skills Lounge design and opportunities to learn and practice key skills outside of timetabled sessions. Greater confidence and opportunities to further develop decision-making skills were reported by students who use this space.Originality/valueThis particular type of learning environment promotes greater reflection, provides the opportunity for students to learn alongside their peers and encourages inter-professional learning. The opportunities for greater decision-making, confidence building and preparation for clinical placements.

On the Use of an Online Polling Platform for Enhancing Student Engagement in an Engineering Module

Students’ engagement is a fundamental challenge in large classrooms in higher education. In recent years, innovative technologies such as electronic learning and online polling platforms have made learning more engaging, effective, and interactive. By using these platforms, educators can create more inclusive and enriching learning environments. This paper presents a novel approach in which an online technology is employed to enhance students’ learning experience. In this approach, features of an online polling platform, i.e., Slido, are employed to enhance students’ engagement in an engineering module, i.e., ‘Mechanics of Solids’, which is recognised as a fundamentally challenging module with difficult subjects. This study investigates how the interactive features of such technologies, such as real-time polls, question and answer (Q&A) sessions, and quizzes, can provide a more active and practical learning environment by improving student engagement in the classroom. In total, six online polls were designed: one for ice-breaking, two on the topics of shear forces and bending moment, two on stresses, and one on deflection. Each poll was presented to the students, and they participated in them by scanning a QR code or typing the poll’s code online. The rate of students’ participation in polls is extensively discussed to show the effectiveness of the proposed method. The findings of this study show a significant increase in student participation in classroom activities compared to traditional methods. Student feedback also indicates a positive learning experience with the use of the proposed approach. It is shown that the proposed approach has the potential to transform the way engineering students engage with challenging subjects, leading to enhanced learning outcomes and a more positive learning experience.

Approaches for sustainable professional skill development for vocational education students in Thailand.

This article presents a research study that aims to explore sustainable approaches for developing professional skills in vocational education students in Thailand. This is the second phase of the research, which utilizes a qualitative research methodology. The key informants in this study are administrators of vocational education institutions, teachers, and students currently enrolled in vocational education institutions in Thailand, totaling 36 participants. The research uses a purposive sampling method and snowball sampling method. Data collection methods include document analysis, in-depth structured interviews, and observation. The results of the interviews are analyzed, and the content analysis is summarized. The research process consists of 4 steps: 1) literature review, 2) data collection, 3) data analysis, and 4) verification and confirmation. The research findings highlight several key considerations, including: 1) factors influencing the development of professional skills among vocational education students, such as curriculum design, support and counseling, practical training in workplaces, interactive learning, problem-solving and analytical thinking skills development, practical learning, and supportive learning environments, 2) approaches for sustainable professional skill development involve employing the appropriate approaches for self-development. The steps include setting clear goals and plans, active learning and training, technology skill development, experiential learning, problem-solving skill development, participation in professional activities, self-reflection, and continuous self-improvement. These approaches aim to enhance the competencies of vocational education students, ensuring quality and efficiency as part of lifelong learning and sustainable development.

Supporting neurodivergent nursing students in their practice placements.

Neurodivergent conditions such as autism, attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dyscalculia and Tourette's syndrome are common, and it is highly likely that practice assessors and supervisors will be asked to support neurodivergent nursing students in their practice learning environments. This article details the strengths that neurodivergent students can bring to nursing, as well as some of the challenges they may experience in practice settings. It outlines how practice assessors and supervisors can develop neuro-inclusive learning environments where neurodivergent students can thrive, as well as how to support them if they are not meeting their required proficiencies. The authors also discuss how appropriate reasonable adjustments can be implemented by using a collaborative approach with students.

Evaluation of a new concept to improve and organize clinical practice in nursing education: a pilot-study

BackgroundNursing students may experience clinical practice as unsafe due to the interactions with patients, fear of making mistakes, lack of clinical experience and supervision, which results in anxiety and stress. Thus, interventions to improve and organize the learning environment in clinical practice for nursing students are warranted, and the aim of this pilot-study was to evaluate a new concept of clinical practice in order to get insight on the different initiatives and gain knowledge for further developing.MethodsThe new concept consisted of nursing students being affiliated to the same department during their clinical practices, reflective supervision, and participation in a self-compassion course. Data was collected using questionnaires and focus group interviews of 17 nursing students, 17 clinical supervisors, and 14 head nurses. A mixed-methods strategy was employed to give the study a pragmatic approach. Finding from the questionnaires and focus group interviews were analyzed separately and then weaved together into themes.ResultsThe results generated four themes: Information and involvement before and during the new concept, Learning outcomes, safety, and well-being, Impact of reflective supervision and self-compassion course, and Transition from study life to working life. In general, the participating nursing students, clinical supervisors, and head nurses had positives experiences regarding the new concept. They felt well-informed, and they experienced that it contributed to a safe learning environment, increased well-being, strengthened the relationship between nursing students and clinical supervisors and healthcare staff at the department, and prepared the nursing students to working life.ConclusionOur results complement the suggestion that improved quality of clinical practice for nursing students is an effective strategy to establish a safe and supportive learning environment that contribute with satisfaction, successful experiences, and attraction of future nurses. However, further intervention studies are needed to compare the effect of the new concept with traditional clinical practice.

THE FEASIBILITY AND EFFECTIVENESS OF LIFE SCIENCE IN STEM PRACTICAL LEARNING ENVIRONMENT

Building 21st-century life science skills requires educating participants according to STEM abilities. Therefore, this research aimed to examine the effectiveness and feasibility of the STEM ability assessment framework in the practical learning environment. The study uses STEM coffee preparation experiential activity with a Royal Belgian siphon pot to construct a learning environment in the classroom. The study also develops two assessment instruments, a knowledge concept questionnaire, and an entrepreneurial scientific thinking scale, to examine their effectiveness and feasibility in the STEM learning environment. The results of the content validity index reveal the value of good-grade literature for two questionnaires. Kendall's coefficient of concordance (ω) of the four reviewers' responses shows that the inter-rater reliability of the two questionnaires reaches a better level. The Chi-square test found that this STEM learning environment is feasible and effective and will help the participants assess their STEM abilities. The entrepreneurial scientific thinking for preparing beverages of life science is rich in viability and efficacy for instrument creation and assessment. Future research lengthened the extraction process while also improving consistency. Last but not least, more teaching practices and research designs are available. However, the goal is for learners' STEM aptitude to increase practice depth. Keywords: effectiveness and feasibility, entrepreneurial scientific thinking, life science, Royal Belgian siphon pot, STEM education

Simulation as a teaching method in the Systems Engineering career

This article aims to diagnose teachers of the System Engineering career on the knowledge of simulation as a teaching method. A non-experimental descriptive research was carried out to evaluate the knowledge of 12 Systems Engineering teachers about the use of simulation as a teaching method. The results showed that 50% of the teachers had not used simulation previously. 67% claimed to master the method, of which 33.3% considered that it accelerated the learning process and 25% that it facilitated the reproduction of specific situations. 75% of teachers had used it in their subjects, 92% in evaluation, 83% in teaching practice and 42% in content orientation. It is concluded that simulation is an effective teaching method in the Systems Engineering degree. This methodology allows students to experience and understand real-life situations virtually, providing a practical and realistic learning environment.

Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review

Background and objectivesVirtual reality dental simulators as an educational tool may create specific training conditions for dental students, allowing them to practice dental skills in a safe and controlled condition. This study aimed to investigate the effectiveness of virtual reality-based education in dental education compared to traditional education approaches.MethodsIn this systematic review, four databases (PubMed, Scopus, Web of Science, and Science Direct) were searched until 2023 following PRISMA guidelines. The Quality assessment and risk of bias were assessed by the Cochrane Collaboration Tool for RCTs and GRADE, respectively. Inclusion criteria were restricted to randomized or quasi-randomized trials about virtual reality efficacy in dental education. Two authors independently evaluated the data and reviewed the overall risk of bias for all selected studies. Study design, sample size, hardware, onset time of intervention, duration, and number of procedures performed were among the data extracted.ResultsFrom the 703 titles, 48 full texts were chosen for review, yielding 14 articles for final inclusion. The review of these articles indicated the effective role of virtual reality dental simulators in improving students' knowledge and practical skills.ConclusionsBased on our findings, adding haptic technology to virtual reality can improve students' practical skills, hand skills, theoretical knowledge, self-confidence, and learning environment. Although a fair amount of research needs to be done, notably on cost-effectiveness, student satisfaction, and other potentially adverse effects, virtual reality is a growing phenomenon with immense potential.

ИННОВАЦИОННЫЕ ИССЛЕДОВАНИЯ ПРАКТИЧЕСКОЙ СРЕДЫ ОБУЧЕНИЯ ДЛЯ РАЗВИТИЯ ТАЛАНТОВ В ОБЛАСТИ СЕТЕВЫХ ПРИЛОЖЕНИЙ

In order to develop talents in the field of network applications and improve practical and innovative abilities, this article analyzes and examines the current situation in network engineering laboratories and existing problems in the practical learning environment, as well as combines the professional situation and the requirements of network practice courses. A laboratory integration plan is also being considered, measures for updating and expanding, as well as adding ADSL central office equipment to implement PPPOE certification services, configuring IP to provide dial-up Internet access, adapting to Internet access settings in remote areas, expanding pilot projects and improving the use of laboratories.

Research on the Construction of New Studio System Teaching Mode for Public Art Majors

The construction of a new studio teaching mode for public art majors can provide students with practical learning platforms and environments, which can help to cultivate high-quality and innovative artistic talents and provide new ideas and methods for the integration of engineering, industry-university-research fusion of talent cultivation. This paper analyzes the role of the new studio teaching mode for public art majors, the problems faced and the construction strategy, in order to cultivate more art talents with high quality and innovation ability.

The Influence of Infrastructure in Agricultural Subjects' Practical Learning Environment on ASPer UPM Students' Interest and Field of Study Selection

There is a growing global concern in agricultural education due to past findings on students’ lack of interest in studying and considering a career in agriculture. In spite of this, past local studies have shown an agricultural-related careers are getting more interest from students due to the practical learning environment provided by the Universiti Putra Malaysia (UPM) Agricultural Science Foundation (ASPer UPM) but there is no thorough explanation regarding the elements of practical learning environment that affects students' interest. This qualitative study was to provide additional insight into the learning infrastructure as a component of the agricultural subjects’ practical learning environment by examining how infrastructure in agricultural practical learning environment influences students’ interest and selection of agriculture as a field of study. Furthermore, it attempts to identify students' perceptions of practical learning infrastructure as part of the ASPer UPM learning environment. This qualitative study collected data through the focus group interview using an interview questions instrument. The study found that students perceive the provision of infrastructure and equipment as not uniform, and the technology adopted is inadequate and only sufficient to help with basic work. The students also perceive the instructors’ expertise and specialisation as helping them understand the course content and the specialised locations are aligned with the learning content. The study found that students' interest could be increased by changing the learning location and content, providing adequate, usable and conducive infrastructure and implementing clear teaching and practical learning procedures. At the same time, infrastructure can generate curiosity, provide early exposure to agriculture and change negative perceptions and interests to influence students to select agriculture as a field of study. Lastly, this study found an apparent relationship between Faculty of Agriculture cluster students' selection of fields of study and their foundation course CGPA. These results can be utilised as guidance for agricultural education institutions to design a high-quality practical learning environment via enhanced infrastructure.

Development of Simple and Efficient Virtual Lab Platform

Current technologies give us the flexibility to enhance and replace-in person classes with computer-based resources, often referred to as virtual labs. Before the pandemic, offline classes used to provide a practical learning environment for students. Because of the pandemic, it is not possible to arrange labs in-person for students where they can directly interact with the faculties. Nowadays, students prefer education from home as it is safe. Students can easily perform experiments from anywhere if they have proper access to an internet connection. There are many challenges in online to the mode of learning. Virtual Labs aids in conquering those challenges to some extent. Simulation-based study of subjects like physics, chemistry, and biology helps students to understand concepts in a better way. Virtual labs can enhance and increase students ‘problem solving, deep thinking, creativity, imagination understanding, scientific process skills, laboratory skills, interest, perception, and learning outcomes. Therefore, teachers need to apply virtual labs to improve teaching quality and student learning outcomes.

A qualitative exploration of Irish nursing students' experiences of caring for the dying patient.

To explore Irish nursing students' experiences of caring for dying patients and their families to understand these experiences and determine whether or not students felt prepared for this role. This study used a qualitative descriptive research design. One to one semi-structured interviews were used to collect data, implementing open-ended questions to explore seven student nurses' experiences. Five main themes emerged: Student's first experiences, emotional experience of caring, educational preparation, challenging aspects of caring for dying patients and their families and need for support in practice. Students' first experience of caring for a dying patient and their family was a confronting event for students, both personally and professionally. Nursing students require adequate and timely education on end of life care and a practical and supportive clinical learning environment to effectively support and prepare students for caring for a dying patient and their family.

Preventable Deaths Involving Medicines: A Systematic Case Series of Coroners' Reports 2013-22.

Medicines cause over 1700 preventable deaths annually in England. Coroners' Prevention of Future Death reports (PFDs) are produced in response to preventable deaths to facilitate change. The information in PFDs may help reduce medicine-related preventable deaths. We aimed to identify medicine-related deaths in coroners' reports and to explore concerns to prevent future deaths. We carried out a retrospective case series of PFDs across England and Wales, dated between 1 July, 2013 and 23 February, 2022, collected from the UK's Courts and Tribunals Judiciary website using web scraping, generating an openly available database: https://preventabledeathstracker.net/ . We used descriptive techniques and content analysis to assess the main outcome criteria: the proportion of PFDs in which coroners reported that a therapeutic medicine or drug of abuse had caused or contributed to a death; the characteristics of included PFDs; coroners' concerns; the recipients of PFDs; and the timeliness of their responses. There were 704 PFDs (18%; 716 deaths) that involved medicines, representing an estimated 19,740 years of life lost (average of 50 years lost per death). Opioids (22%), antidepressants (9.7%), and hypnotics (9.2%) were the most common drugs involved. Coroners expressed 1249 concerns, primarily around the major themes of patient safety (29%) and communication (26%), including minor themes of failures of monitoring (10%) and poor communication between organizations (7.5%). Most expected responses to PFDs (51%; 630/1245) were not reported on the UK's Courts and Tribunals Judiciary website. One in five coroner-reported preventable deaths involved medicines. Addressing coroners' concerns, including problems with patient safety and communication, should reduce harms from medicines. Despite concerns being raised repeatedly, half of the PFD recipients failed to respond, suggesting that lessons are not generally learned. The rich information in PFDs should be used to foster a learning environment in clinical practice that may help reduce preventable deaths. https://doi.org/10.17605/OSF.IO/TX3CS .

Improving nursing education curriculum as a tool for strengthening the nurse-client relationships in maternal and child healthcare: Insights from a human-centered design study in rural Tanzania.

There are growing evidence of poor nurse-client relationships in maternal and child health (MCH). The nursing curriculum forms an important entry point for strengthening such relationships, consequently improving client satisfaction with nurses' competencies, confidence in the formal healthcare system, healthcare-seeking practices, continuity with care, and MCH outcomes. MCH nurses and clients were invited to design an intervention package (prototype) to improve nurse-client relationships using a human-centered design (HCD) approach. A multi-step HCD approach was employed to first examine the contributors of poor nurse-client relationships using nine focus group discussions with nurses and clients and 12 key informant interviews with MCH administrators. Then, three meetings were held with 10 nurses, 10 clients, and 10 administrators to co-develop an intervention package to address the identified contributors. The solutions were validated by collecting qualitative information through six focus groups with nurses and MCH clients who were not involved in the initial HCD stages. Finally, refinement and adaptation meetings were held with 15 nurses, 15 clients, and 10 administrators. The data were managed with NVivo 12 software and analyzed thematically. Nursing curriculum challenges contributing to poor nurse-client relationships in MCH care included inadequate content on nurse-client relationships specifically topics of customer care, communication skills, and patient-centered care; an inadequate practice on communication skills within nursing schools; and the absence of specific trainers on interpersonal relationships. Consequently, improving the nursing curriculum was one of the interventions proposed during the co-design and rated by participants as highly acceptable during validation and refinement meetings. Suggested improvements to the curriculum included increasing hours and credits on communication skills and patient-centered care, including customer care courses in the curriculum and creating a friendly learning environment for clinical practice on strengthening interpersonal relationships. Improving the nursing curriculum was considered by nurses and clients as one of the acceptable interventions to strengthen nurse-client relations in MCH care in rural Tanzania. Nursing education policy and curriculum developers need to ensure the curriculum facilitates the development of much-needed interpersonal skills among nursing graduates for them to have positive therapeutic interactions with their clients.

Has novel coronavirus infection affected the professional identity recognised by medical students? - A historical cohort study

Introduction: The pandemic caused by the novel coronavirus (COVID-19) has produced dramatic changes in the learning environment for clinical practice in medical education, and the impact on medical students has been significant. However, few program evaluation studies involving professional identity, now emphasised in medical education, have compared current with pre-COVID-19 programs. Here, we compared the professional identity recognised by medical students in the years before and during COVID-19. Methods: Medical students who participated in clinical practice were evaluated using the Japanese version of the Professional Self-Identity Questionnaire (PSIQ), a 9-item inventory rated using 7-point Likert scales. They answered on the first day of a 4-week clinical practice module within a community-based medical education (CBME) program and at graduation in 2018-2019 (pre-COVID-19 pandemic) and in 2019-2020 (during-COVID-19 pandemic). We compared the mean difference in total PSIQ score of the 2019-2020 students to those of the 2018-2019 students as a historical cohort using an unpaired t-test. Results: Participants were 104 medical students in the 2018-2019 academic year and 92 in the 2019-2020 academic year. PSIQ was increased at graduation. Mean difference in total PSIQ score was statistically higher for the 2019-2020 students (13.5 ± 9.4) than for the 2018-2019 students (10.3 ± 8.1) (t =2.6, df =195, p = 0.01). Conclusion: Although clinical practice was restricted by COVID-19, this had some positive impact on the strengthening of professional identity recognised by medical students. This finding may have been influenced by the imprinting of professional norms and changes in society.

The listening project: A qualitative study on the experiences of pre-registered nurses during the Covid-19 pandemic in Scotland

BackgroundDuring the COVID 19 pandemic academic institutes worldwide were forced to shift to online or socially distanced learning. Nursing students faced unique challenges due to the limited practical learning environment and removal of supernumerary status to meet increased pressure on health care resources. AimTo explore the experiences and perceptions of pre-registered nurses in relation to their university education during the COVID-19 pandemic. MethodsUnderpinned by Lizzio (2006) [1] five senses of student success model, a novel qualitative approach using peer-to-peer discussion was utilized to explore the experiences of pre-registered nurses during the COVID-19 pandemic. Students who were on their second and final year in the nursing program were invited to participate. Interviews were conducted and transcribed using an online meeting platform. Data were analyzed using the five main stages of framework analysis. ResultsEleven peer-to-peer discussion with 22 students were conducted. The five themes were linked with the five senses student success model: capability, connectedness, purpose, resourcefulness, and culture. Six sub-themes emerged in the data: confidence and learning process, building relationships, communication, student as health professional and mental health consequences of COVID-19 pandemic. ConclusionWhilst there was strength in university provision, the pandemic was an opportunity for students and academics to reflect and learn about how to further programme resilience and enhance student support processes. We recommend that nursing programmes should include concepts of transition, pandemic preparedness, collaboration with professional partners, and provision of catch-up sessions to analyse gaps on their skills and knowledge.

Exploring Challenges, Teaching Strategies and Personality Traits to Implementing an Effective Agriculture-Based TVET Program in South Africa

Technical and Vocational Education and Training (TVET) is an educational field that emphasises on practical and lab-based learning environments. Equally important, TVET also makes a major contribution to the agriculture field. However, there are myriad issues that cause limited knowledge and skills for agricultural graduates, and these include butare not limited to the lack of resources, equipment, and infrastructure. The case study approach allows the in-depth collection of data through interviews and the observation of complex issues in their real-life settings. The research participants were purposefully and conveniently sampled due to their experience in agricultural programmes. The findings were presented using thematic analysis based on Mitzel's model which covers practical knowledge and skills, teaching skills, teaching styles, and personality traits. According to the study's findings, the lack of resources, equipment, and infrastructure restricted a lecturer's capacity to release their practical knowledge and skills, their teaching skills, teaching styles, and their personality factors when teaching agricultural programmes. The recommendation advises allocating the TVET colleges with adequate resources, equipment, and infrastructure to facilitate agricultural knowledge and skills.

The experiences of student physiotherapists applying a novel therapeutic tool within a simulated practice environment: a qualitative study

Current evidence suggests that despite being well placed to use psychological strategies to improve complex communication with patients, physiotherapists lack confidence in the application of such strategies [1]. Training to help them to navigate complex interactions with patients presenting with psychological distress is therefore recommended within prequalifying physiotherapy education [2]. A brief therapeutic interaction tool (the model of emotions, adaptation, and hope; MEAH) has been developed for this purpose [3]. The aim of this qualitative study was to explore the experiences of physiotherapy students applying the brief therapeutic interaction using the MEAH in an online setting compared to an in-person setting, within a simulated learning environment. An interpretive hermeneutic phenomenological study design was utilised. Two simulation learning environment settings were selected; (1) 25 final year physiotherapy students experienced the simulation-based activity in the in-person setting on a university campus, and (2) 13 second year physiotherapy students experienced the simulation-based activity in an online setting. A 50-minute pre-recorded e-training lecture was completed prior to all students participating in an individual 10-minute simulation. The simulated patient was played by the same actor in both settings. Two methods of data collection were used: (1) a single semi-structured interview, to consider the experiences of all students across both settings. This data was analysed using reflexive thematic analysis. (2) a live recording of 24 of the in-person student interactions were captured. This data was analysed using conversation analysis. Thematic analysis: Four major themes across both groups were identified: (a) the content and value of the e-training (b) the experience and perception of the simulation, (c) the application of the MEAH screening tool, and (d) future training needs. Conversational analysis: Three types of interaction were identified. Type 1 interactions (15/24, 62.5%) followed the form in a very exacting way. Type 2 interactions (3/24, 12.5%) used the tool as an aid to their conversation. Type 3 interactions (6/24, 25%) deviated from the main focus of the tool. Factors which influenced the interaction were identified. The simulated practice learning environment provided an ideal way to enhance students’ communication skills, through safe and deliberate practice with a simulated patient. Use of the MEAH tool demonstrated that brief and focused teaching enhanced the perceived confidence of physiotherapy students to undertake difficult patient interactions. Online experiences were perceived more positively compared to in-person training, making it a useful platform to develop student confidence that should be explored further within simulation-based education. 1. Driver C, Lovell GP, Oprescu F. Psychosocial strategies for physiotherapy: A qualitative examination of physiotherapists’ reported training preferences. Nursing & Health Sciences. 2021;23(1):136–47. 2. Lennon O, Ryan C, Helm M, Moore K, Sheridan A, Probst M, Cunningham C. Psychological distress among patients attending physiotherapy: A survey-based investigation of Irish physiotherapists’ current practice and opinions. Physiotherapy Canada. 2020;72:239–248. 3. Soundy A, Hemmings L, Gardiner L, Rosewilliam S, Heneghan NR, Reid K. E-learning communication skills training for physiotherapy students: A two phased sequential mixed methods study. Patient Education and Counselling. 2021;104:2045–2503.

Development and Evaluation of Two 3D-Simulated Practice Learning Environments

This paper discusses the evaluation of two 3D simulated practice learning environments, Tiny Oaks and Play2Do, focused on supporting people working with children, families, and vulnerable people in special educational settings. Pre-test/post-test evaluation methodology was employed consisting of a questionnaire with 16 questions covering knowledge and understanding, professional practice, and transferable skills. Tiny Oaks had 530 participants pre-test and 423 post-test from six European countries, and results show a significant increase in learning across all questions. Play2Do had 318 participants pre-test and 301 participants post-test from the UK and Bulgaria, and again results show a significant increase in learning across all questions. The system usability scale (SUS) questionnaire was also used to measure the usability of the two environments, and usability was found to be excellent. Findings suggest that 3D simulated practice environments can provide a valuable learning experience and can provide practice learning scenarios that may be difficult to encounter in real-life.