The Effect of High Fidelity and Virtual Reality-Based Simulation Applications on Simulation-Based Learning, Reflective Thinking and Therapeutic Communication Skills in Undergraduate Nursing Students

Place of the research The research was planned to be carried out at Hacettepe University Faculty of Nursing. Scenarios will be based on diabetes mellitus so that the case topics to be managed in high fidelity and virtual reality-based simulation applications are equivalent. Nursing the faculty has a simulation laboratory to enable students to realize their professional skills in a high- fidelity environment. The laboratory has all the equipment that should be found in a clinic, such as a high- fidelity simulation mannequin, nurse's table, patient bed, shelves, monitors, bedside oxygen systems, treatment and emergency response carts. Lab; It consists of 3 sections: application room, control room and analysis room. As a result of the Research Infrastructure Project (No: TAY-2022-19754) supported by Hacettepe University Scientific Research Projects Coordination Unit, virtual reality-based simulation will be available as of 2023. Program is located in the infrastructure of the faculty of nursing. This program includes 3 different modular training on the topics of "Diabetes Mellitus", "Chemotherapy Treatment" and "Dementia" and virtual reality-based simulation scenarios for these topics. The modular education and virtual reality-based simulation program is currently actively available on the "hadi.hacettepe.edu.tr" website. Students who will benefit from this program can access the program after defining a username and password. The content of the module on the subject of "Diabetes Mellitus" within the scope of this program; It includes topics such as the definition of dementia, risk factors, signs and symptoms, complications, treatment and nursing care, and patient and/or caregiver education. Learning activities such as question and answer applications and gamification are also included to keep students active during the education process and to make interim evaluations. There are. After applying the Diabetes Mellitus module, students complete the program by switching to a virtual reality-based simulation program for Diabetes Mellitus. They will also implement a virtual reality-based interactive therapeutic diabetes mellitus patient education program here.

Universe of Research The universe of the research; It will consist of second-year students studying at Hacettepe University Faculty of Nursing in the 2023-2024 academic year. The main purpose of selecting this student group is that it is a group of students who have successfully completed the Nursing Fundamentals course in the second year, have basic knowledge and skills in nursing care, but are still not sufficiently equipped to intervene with the patient. While this student group is still at the beginning of education and applications, it is thought that by determining the effect of simulation applications based on high fidelity and virtual reality, it will raise awareness in this field and the use of this method in the following educational processes will make significant contributions to student education.

Sample of the Research G*Power-3.1.9.4 program was used to calculate the sample size and power of the study. Accordingly, taking α = 0.05 (Type I error), each test was determined at 85% power and 5% significance level. It was planned to complete the research with a total of 68 students, 34 in a group. Considering possible 10% data loss, the research was planned to be completed with 76 students. The group that will receive virtual reality application is 38 people; The group for which simulation + virtual reality application will be applied will be determined as 38 people.

Preparation of Data Collection Form In the research, data will be collected with the following tools. PRE-TESTS include personal information form, simulation-based learning evaluation scale, reflective thinking skill scale for problem solving, therapeutic communication skills scale for nursing students; POST TESTS include the simulation-based learning assessment scale, the reflective thinking skill scale for problem solving, and the therapeutic communication skills scale for nursing students.

Collection of Data Students who meet the inclusion criteria and agree to participate in the research will be informed, and any questions they have about the operation of the research will be answered. It will be explained during the interview that the information collected will not be stated or published in the research and will be kept as a record. The Voluntary Participation form will be explained, they will be asked to read the consent form, give their consent voluntarily and it will be recorded. Data will be collected through forms and scales hand-delivered to students by the researchers.