Positive Aspects and Potential Drawbacks of Implementing Digital Teaching/Learning Scenarios in Health Professions Using Nursing Education as an Example: A Research Report from Germany
, Lisa Nagel 1, Christian Cohnen 2, Leona Aschentrup 1,3,4, Marleen Schönbeck 1, Annette Nauerth 1, Patrizia Raschper 1, Tim Herzig 1,3 and Kamil J. Wrona 1,3,*Round 1
Reviewer 1 Report (Previous Reviewer 2)
Comments and Suggestions for Authors
The introduction to VR in nursing education is informative, however it could benefit from improved clarity and structure. Theoretical Background should enhance clarity by more explicitly linking theoretical concepts with practical applications in nursing education and addressing the balance between VR's advantages and its limitations in a more detailed manner. Materials and Methods, outlines the methodologies of two projects, DiViFaG and ViRDiPA, focusing on integrating Virtual Reality (VR) in health professions education. The chapter could benefit from a more detailed description of the VR technologies used specific examples of the learning scenarios, and a clearer articulation of how the projects' outcomes contribute to the field of nursing education. Additionally, discussing the challenges faced during implementation and how they were addressed would provide a more comprehensive understanding of the projects. Chapter 4-Results discusses the major positive aspects of using Virtual Reality (VR) in nursing education. However, the chapter could be improved by providing more specific data or examples demonstrating the effectiveness of VR in improving learning outcomes. Additionally, discussing any limitations or challenges encountered in implementing VR in nursing education would offer a more balanced perspective. Integrating feedback from students and educators on their VR experiences could also enrich the chapter's insights. The critical reflection should explore strategies for effective integration of VR into the curriculum and addressing how to overcome the barriers to its use would provide a more comprehensive understanding of its potential in nursing education.
Comments on the Quality of English Language
None.
Author Response
The introduction to VR in nursing education is informative, however it could benefit from improved clarity and structure.
Answer: This is a very helpful recommendation. We extracted the description of one of our examples out of the introduction and added it to chapter 3 to give an specific examples of the use of VR in learning scenarios (see below). Furthermore we restructured a section in the introduction to improve our clarity and structure.
Theoretical Background should enhance clarity by more explicitly linking theoretical concepts with practical applications in nursing education and addressing the balance between VR's advantages and its limitations in a more detailed manner.
Answer:To balance the advantages and limits of VR, we added a short list of disadvantages of VR. Additionally, we added the simulation-based learning as another theoretical concept in nursing education. Regarding the limits of scope of the manuscript we have to mention that there is no possibility to describe and discuss this concept in a detail manner.
Materials and Methods, outlines the methodologies of two projects, DiViFaG and ViRDiPA, focusing on integrating Virtual Reality (VR) in health professions education. The chapter could benefit from a more detailed description of the VR technologies used specific examples of the learning scenarios, and a clearer articulation of how the projects' outcomes contribute to the field of nursing education.
Answer:Thank you for this helpful comment. At the end of chapter 3 we shortly illustrate the contribution of both projects to the field as well as insert an example for the use of a VR scenario in blended learning.
Additionally, discussing the challenges faced during implementation and how they were addressed would provide a more comprehensive understanding of the projects.
Answer:Thank you very much for your comment. However, we slightly disagree on this as the challenges of the implementation are already presented in chapter 4 and 5 by illustrating the potential drawbacks of VR in nursing education. Therefore repeating this aspects in chapter “Materials and Methods” would be redundant.
Chapter 4-Results discusses the major positive aspects of using Virtual Reality (VR) in nursing education. However, the chapter could be improved by providing more specific data or examples demonstrating the effectiveness of VR in improving learning outcomes. Additionally, discussing any limitations or challenges encountered in implementing VR in nursing education would offer a more balanced perspective. Integrating feedback from students and educators on their VR experiences could also enrich the chapter's insights.
Answer: Thank you very much for your broad feedback. We fully understand the wish of presenting data and perspectives concerning learning outcomes by using VR. Nevertheless this contribution claims to be a report based on experiences from two research projects. If we supplement data or perspectives to the manuscript there will be need to detailly describe our methods collecting them. Regarding the limited scope of the manuscript we don’t think, that it is useful to add data and perspectives to the report. Against this background we only added a short sentence refering to one of our detailed presentation of our data collected with questionnaires and interviews.
The critical reflection should explore strategies for effective integration of VR into the curriculum and addressing how to overcome the barriers to its use would provide a more comprehensive understanding of its potential in nursing education.
Answer: We totally agree. Based on your comment we added a few sentences advising important aspects to overcome the barriers and limits of integration VR in nursing education.
Reviewer 2 Report (Previous Reviewer 1)
Comments and Suggestions for Authors
I confirmed that the revised paper satisfys my comments. So, I do not have any more comments for the authors.
Author Response
I confirmed that the revised paper satisfys my comments. So, I do not have any more comments for the authors.
Answer: Thank you for this appreciative comment.
Reviewer 3 Report (New Reviewer)
Comments and Suggestions for Authors
An important and fascinating article. Contributes up-to-date and exhaustive information on the integration of innovative technology in the education of health professions in general and nursing in particular.
Author Response
An important and fascinating article. Contributes up-to-date and exhaustive information on the integration of innovative technology in the education of health professions in general and nursing in particular.
Answer: Thank you for this appreciative comment.
Reviewer 4 Report (New Reviewer)
Comments and Suggestions for Authors
I am grateful for the opportunity to review this manuscript and I congratulate the authors on their excellent submission, which is well suited to this special issue. It is a very pertinent analysis and reflection on the integration of virtual reality in health teaching, clearly identifying its potential and shortcomings. The recommendations that follow are specific and do not detract from the value of the work presented.
Ln 15: please write out the expression in full before adding the acronym;
Ln 21: we recommend that the aim of this paper be presented in the background;
Ln 336: please identify the authors.
Author Response
I am grateful for the opportunity to review this manuscript and I congratulate the authors on their excellent submission, which is well suited to this special issue. It is a very pertinent analysis and reflection on the integration of virtual reality in health teaching, clearly identifying its potential and shortcomings. The recommendations that follow are specific and do not detract from the value of the work presented.
Ln 15: please write out the expression in full before adding the acronym;
Ln 21: we recommend that the aim of this paper be presented in the background;
Ln 336: please identify the authors.
Answer: Thank you for your hints We revised the manuscript as recommended.
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
This paper just treats two projects ViRDiPA and DiViFaG. It is difficult for me to understand research designs and methods of the two projects in the paper. The authors should describe them more clearly in the paper. Although the authors mention "Recognizable Potential" as the results in Section 4, there are only qualitative descriptions. Did you do any evaluations for them? It is better to show quantitative results rather than qualitative descriptions if you did any evaluations.
Author Response
Reviewer 1
This paper just treats two projects ViRDiPA and DiViFaG. It is difficult for me to understand research designs and methods of the two projects in the paper. The authors should describe them more clearly in the paper.
Answer: Chapter 3.1 and 3.2 now briefly discuss the piloting and evaluation of the scenarios and learning tasks in the two projects.
Although the authors mention "Recognizable Potential" as the results in Section 4, there are only qualitative descriptions. Did you do any evaluations for them? It is better to show quantitative results rather than qualitative descriptions if you did any evaluations.
Answer: Thank you for the important advice. Apparently we have a different understanding of "potentials", based on the German terminology. By this we basically refer to the positive aspects for professional practice based on the experience gained. Therefore, the research methods are not in the focus of the report either. To avoid further misunderstandings, we have revised the corresponding heading accordingly.
Reviewer 2 Report
Comments and Suggestions for Authors
The introduction section of the article effectively sets the stage for the article, introducing the research context, identifying gaps, and explaining the significance of the study. It provides a clear roadmap for readers, helping them understand what to expect in the subsequent sections. The Theoretical Background section sets the discussion on the use of VR in nursing education. It provides readers with a comprehensive understanding of the theoretical framework and the issues associated with the adoption of VR technology in healthcare education. However, the authors should consider including visual aids, such as diagrams or graphs, to illustrate how VR and 360° video technology work in healthcare education. Visuals can make complex concepts more accessible to readers. The authors should provide specific examples or case studies to demonstrate how VR is currently being used in nursing education. This can make the theoretical concepts more concrete. In addition to discussing the transfer of VR simulations into real-world practice, explore the practical implications of using VR in nursing education. How does it impact curriculum development, teacher training, and student assessments?
The Materials and Methods section provides a detailed overview of the projects "DiViFaG" and "ViRDiPA," including their objectives and methodologies. The descriptions of the two projects are informative and provide essential details, including funding sources and consortium leadership. However, the author can further enhance this section by including more specific information about the scope of each project, the number of participants, and the duration. The author should explain how the projects' methodologies align with the theoretical concepts presented in the previous section, and describe in more detail how VR technology was integrated into the projects. Explain the design and development processes, as well as the specific VR scenarios created. This will help readers understand the practical implementation.
The discussion section is well-structured and presents a clear argument about the use of VR in nursing education. However, it would be beneficial to have a brief introductory paragraph at the beginning to provide an overview of the discussion points. While the author correctly emphasizes that 360° VR scenarios are primarily suited for affective and cognitive learning outcomes, the author might briefly mention that other forms of VR, such as fully immersive VR with motion tracking, can be used for psychomotor learning outcomes. This can provide a more comprehensive view of VR's potential in nursing education. The author should consider summarizing the positive aspects and potential drawbacks of VR in nursing education. This will provide a balanced view and help educators make informed decisions.
Comments on the Quality of English Language
Minor editing of English language required
Author Response
Reviewer 2
The introduction section of the article effectively sets the stage for the article, introducing the research context, identifying gaps, and explaining the significance of the study. It provides a clear roadmap for readers, helping them understand what to expect in the subsequent sections. The Theoretical Background section sets the discussion on the use of VR in nursing education. It provides readers with a comprehensive understanding of the theoretical framework and the issues associated with the adoption of VR technology in healthcare education. However, the authors should consider including visual aids, such as diagrams or graphs, to illustrate how VR and 360° video technology work in healthcare education. Visuals can make complex concepts more accessible to readers.
Answer: Thank you, we have inserted two figures and referenced with “Perceived environment from the first-person perspective with interaction elements” and “Full-animated ward room from the first-person perspective”.
The authors should provide specific examples or case studies to demonstrate how VR is currently being used in nursing education. This can make the theoretical concepts more concrete.
Answer: We have provided a glimpse of a VR-supported learning unit for nursing training in chapter 1.
In addition to discussing the transfer of VR simulations into real-world practice, explore the practical implications of using VR in nursing education. How does it impact curriculum development, teacher training, and student assessments?
Answer: It is expected that the introduction of VR simulations - in the sense of individual lighthouse projects - will also have an impact on teacher training. In turn, this step should be seen as a prerequisite for the development of new curricula, which will ultimately also have an impact on nursing education. It is precisely this development that will need to be monitored in the future and that is addressed in the article in chapter 1 (corresponding source: 6 Walkenhorst, U.; Herzig, T. Relevance of media skills in teacher training for digitalisation in the human service professions. In: Friese, M. (Ed.). Care work 4.0. Digitalisation in personal service occupations (32-44). 2021. Bielefeld: wbv.)
The Materials and Methods section provides a detailed overview of the projects "DiViFaG" and "ViRDiPA," including their objectives and methodologies. The descriptions of the two projects are informative and provide essential details, including funding sources and consortium leadership. However, the author can further enhance this section by including more specific information about the scope of each project, the number of participants, and the duration.
Answer: Thank you for the comment. Chapter 3.1 and 3.2 briefly discuss the piloting and evaluation of the scenarios and learning tasks in the two projects. In addition, the number of people having been trained was inserted. The durations of the projects are already specified in brackets
The author should explain how the projects' methodologies align with the theoretical concepts presented in the previous section, and describe in more detail how VR technology was integrated into the projects.
Answer: In relation to the limitation of the scope of the submission and focusing our experiences, that we’ve made during the implementation, it is not indicated to describe in detail the alignment between the methodologies and the theoretical concepts. Nevertheless, we added a short description of the integration of the VR in the learning process in chapter 3.
Explain the design and development processes, as well as the specific VR scenarios created. This will help readers understand the practical implementation.
Answer: Thank you for pointing this out, we have added corresponding visualisations to enhance the understanding of the practical implementation. However, a detailed description is beyond the limits of this article, but would be exciting for further contributions.
The discussion section is well-structured and presents a clear argument about the use of VR in nursing education.
While the author correctly emphasizes that 360° VR scenarios are primarily suited for affective and cognitive learning outcomes, the author might briefly mention that other forms of VR, such as fully immersive VR with motion tracking, can be used for psychomotor learning outcomes. This can provide a more comprehensive view of VR's potential in nursing education
Answer: In section 5 now we mention the use of VR for psychomotor learning outcomes.
The author should consider summarizing the positive aspects and potential drawbacks of VR in nursing education. This will provide a balanced view and help educators make informed decisions.
Answer: This is a helpful feedback. In line with the suggestion, we have added a corresponding overview in chapter 5 to make the conclusions appear more coherent.
