Exploring possibilities: virtual reality in nursing research.

This article describes the use of virtual reality (VR) as a method of measurement in nursing research. Virtual reality refers to the use of computerized displays to show a lifelike environment in which the user interacts. Although many disciplines are beginning to use VR environments in research, nursing has yet to embrace this technology. Nursing, as a profession that values the interaction between the environment, individual, and health, can benefit from the use of VR in research. Establishing reliability and validity of the VR tool selected for research is important and requires special consideration. Virtual reality testing can produce side effects, such as vertigo and discomfort, which must be anticipated in the research protocol. Keywords: virtual reality; nursing research; experiments; methodology The student nurse looks at the electrocardiogram (EKG) and notes regular sinus rhythm with an occasional premature ventricular beat. After putting oxygen on the patient and adjusting the rate, she asks the patient how much chest pain he is experiencing on a 1 to 10 scale. The patient reports back that his pain is a "5" and radiating down his left arm. Suddenly, the EKG alarm sounds, and the student looks up at the monitor and notes with alarm that it shows ventricular fibrillation. The patient's wife cries out, "What is happening?" as the student quickly pushes the code button and prepares to defibrillate. A team of medical and nursing professionals rushes into the room (McUsic, 2008). This scenario is an example of one that student nurses in virtual clinical experiences may have since the advent of this technology in higher education. Educators in many disciplines have quickly recognized the value and flexibility of the virtual world in preparing professionals, especially in the health fields. More recently, the benefits of virtual reality have been recognized beyond education into the research realm. Virtual reality (VR) presents a plethora of opportunities to study human behaviors, knowledge, and skills, and it has the potential to allow researchers to examine these factors in safe, yet realistic environments. Nursing, as a discipline, is intimately concerned with the interaction between the person, environment, and health (i.e., Dodd et al., 2001). In the current strategic plan for the National Institute on Nursing Research (NINR), there are four strategies that are identified for the advancement of nursing science. These include "integrating biology and behavior, designing and using new technology, developing new tools, and preparing the next generation of nurse scientists" (NINR, 2006, p. 9). The use of VR in research has the promise of helping nurse scientists meet these challenges. Virtual reality environments are ideally suited to the measurement of many variables of interest to nurses, such as complex cognitive, social, and psychomotor variables. Virtual reality is an excellent medium in which to observe interactions of individuals and groups within experimental contexts. Despite the opportunities that it affords, VR has rarely been used in nursing research as a tool for measurement. Yet, VR is being embraced by other disciplines as a powerful tool for measuring complex variables. This article will give an overview of the use of VR in health care and research, and give an exemplar of the use of VR in nursing research. BRIEF HISTORY OF VIRTUAL REALITY IN NURSING AND HEALTH CARE Fifteen years ago, Phillips (1993) wrote an editorial in which he predicted that VR would dramatically influence people's lives and as such, play a major role in nursing research. Since then, VR has been rapidly embraced by many individuals and groups, for uses such as video games, driving assessment, and even to augment health care delivery. Many health care professionals use traditional computer displays to provide VR environments as instructional methodologies (Martin, Phillip, & Thomas, 2002). …