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Why Your Nursing Students Crave Virtual Learning

Not Just For Millennials

You’ve likely seen headlines that state “millennials are technology-dependent” or “millennial attention spans are decreasing.” The science behind these claims is lacking and often disputed, though. The impact of technology on the learning environment is unquestionable.  However, it’s not just millennial learners that are affected.

Smartphone and computer use are nearly ubiquitous. 77% of adults in the United States own a smartphone – up from 35% of adults in 2011.1 And, more than three billion people are now using the internet.2 The search for information is no longer a time consuming one, with Google at our fingertips and in our very back pockets.

When looking at smartphone usage by age group, of millennials between 18-24 years old, 98% own a smartphone.3 Millennials aged 25-34 years old are following closely behind: 97% own a smartphone (Ibid). And, 96% of Generation Xers (aged between 35-44 years old) own a smartphone.4

What all of this means is that learners today, regardless of age,  are constantly seeking new information, are exposed to more information in a day than previous generations, and are more prone to multitasking.5 Adult learning theory dating back to the work of John Dewey, the father of progressive schooling, points to the need for experiential, experimental, and hands-on learning experiences. Because digital media has become all-consuming, emerging learning styles include a balance of experiential learning, guided mentoring, and collective reflection.6 Essentially, in order to meet the needs of modern-day learners, you need to deliver on their terms.

The typical baccalaureate nursing program is comprised of mostly millennial students, but even the 18% of students over 30 years old need more than didactic learning.7 Learners seek to interact with the material in a way they are comfortable with – and that’s online.

In this article, we explore why virtual simulation, a method of treating patients via eLearning, might be the missing piece in your nursing curriculum.


The Delivery Model Has Changed

Today, nursing programs rely most heavily on educational technologies like videos, online or distance learning, virtual simulation, and adaptive quizzes and tests.8


Within the next five years, nursing programs are predicted to adopt more advanced learning technologies, such as data analytic tools, mobile apps, and virtual reality.10 The primary reasons behind adopting these technologies are:11

  • To increase NCLEX pass-rates
  • To meet State/Board/Accreditation mandates
  • To cope with a reduction in the number of available clinical sites
  • To meet changes in the technology being used in practice
  • To serve the way incoming students learn

Nursing programs that have larger numbers of enrolled students tend to adopt new technologies more readily, compared to nursing programs that accept fewer students.12 It’s all about economy of scale.

If you’re a small organization, virtual simulation will allow you to leapfrog into new technology and leverage it where human teaching resources are not available. Online training methods can reduce the overall time and cost of a lesson, while maintaining learner satisfaction, confidence, and learning outcomes.13


Virtual Simulation Helps Students Walk Before They Run

David Kolb first published his experiential learning theory in 1984, based on the earlier works of John Dewey.14 His four-stage cycle of learning, and four learning styles that he defined, still heavily influence educational courses today. We, at Laerdal, were so inspired by his model that we used it as the basis to create our model, the Circle of Learning.

Kolb’s experiential learning cycle defines four stages that a learner should progress through:

  • Concrete Experience – A new experience or a reinterpretation of an experience.
  • Reflective Observation – Interpreting the inconsistencies between experience and understanding.
  • Abstract Conceptualization – The formation of a new idea or changes to an existing idea.
  • Active Experimentation – The learner applies knowledge in future situations, resulting in new experiences.

Essential to this theory is the idea that a student must progress through all four stages in order to effectively learn. This implies that no teaching strategy on its own should be the be-all and end-all to effective teaching. For nursing curricula, it is the combination of didactic, hands-on training, simulation, and clinical experience that prove most effective.

Virtual simulation allows learners to treat a virtual patient, gathering their medical history and practicing patient-centered care, without the threat of patient harm. Learners are immersed in an online experience that accomplishes the Reflective Observation stage of Kolb’s cycle. Drawing from textbook and lecture content, learners are engaged in the scenario and make critical decisions about the patient’s care.

Experts have recommended virtual patients as a learning activity that can support nursing students in their scientific knowledge, while helping them to integrate theory into practice.15 The repeatability of the scenarios, in conjunction with the debriefing, allows learners to back-track each decision and compare it to evidence-based practices and protocols.

Virtual simulation affords learners a chance to test their knowledge before participating in a full-fledged simulation and, more importantly, before they step foot into a hospital.


E-Learning Can Tell a Story – and Stories Stick

As the internet has grown into the mammoth source that it is today, the applications and effectiveness of eLearning have continued to improve. Research has shown that up to 60% better consistency of learning can be achieved through technology-based training.16



Virtual simulation, one of the most prominent forms of eLearning in the field of nursing education, requires learners to draw on what they’ve been taught and begin testing the application of their skills. Each scenario follows a storyline, integrating video, patient interactions, and pre- and post-simulation quizzes. While achieving the benefits of eLearning, virtual simulations that include the element of story provide additional advantages to the learning experience.

“Simulation and [stories] can move faculty from simply depositing content to using content in different creative ways as part of their teaching agenda and, ultimately, to match curriculum to course learning outcomes,” says Elaine Tagliareni, EdD, RN, CNE, FAAN, and Susan Forneris, PhD, RN, CNE, CHSE-A, from the National League for Nursing (NLN).18

Learners that can follow a story, from start to finish, and see the results of their decisions and actions will be better able to conceptualize safe practices. Virtual simulation provides a safe, effective, and simple online environment to practice critical-thinking and decision-making skills that every nurse needs.


  1. Rainie, L. & Perrin, A. (2017). 10 facts about smartphones as the iphone turns 10. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2017/06/28/10-facts-about-smartphones/
  2. Davidson, J. (2015). Here’s how many internet users there are. Time. Retrieved from http://time.com/money/3896219/internet-users-worldwide/
  3. Nielsen (2016). Millennials are top smartphone users. Retrieved from http://www.nielsen.com/us/en/insights/news/2016/millennials-are-top-smartphone-users.html
  4. Ibid
  5. American Press Institute. (2015). How millennials get news: Inside the habit of America’s first digital generation. Retrieved from https://www.americanpressinstitute.org/publications/reports/survey-research/millennials-news/
  6. Dede, C. (2005). Planning for neomillennial learning styles. Educause Quarterly, 1. Retrieved from http://www.wou.edu/~girodm/670/Dede_on_neo-millenials.pdf
  7. National League for Nursing. (2014). NLN biennial survey of schools of nursing. Retrieved from http://www.nln.org/docs/default-source/newsroom/nursing-education-statistics/percentage-of-students-over-age-30-by-program-type-2014.pdf?sfvrsn=0
  8. Wolters Kluwers. (n.d.). How nursing education programs are currently using educational technology. Retrieved from http://nursingeducation.lww.com/content/dam/wk-nes/images/Nursing-Education-Technology.gif
  9. Ibid
  10. Wolters Kluwers. (n.d.). Educator forecast for tech usage and growth in nursing education programs. Retrieved from http://nursingeducation.lww.com/content/dam/wk-nes/documents/Educator-Forecast-Tech-Usage.pdf
  11. Wolters Kluwer. (n.d.). What’s driving the adoption of technology in nursing education?. Retrieved from http://nursingeducation.lww.com/content/dam/wk-nes/documents/Adoption-of-Technology-in-Nursing-Infographic.pdf
  12. Wolters Kluwers. (n.d.) How nursing education programs are currently using educational technology. See Reference #8.
  13. Serwetnyk, T.M., Filmore, K., VonBacho, S., Cole, R., Miterko, C., Smith, C., et al. (2015). Comparison of online and traditional basic life support renewal training methods for registered professional nurses. Journal for Nurses in Professional Development, 31(6), E1-10. DOI: 10.1097/NND.0000000000000201
  14. McLeod, S. (2017). Kolb – learning styles. Retrieved from https://www.simplypsychology.org/learning-kolb.html
  15. Georg, C. & Zary, N. (2014). Web-based virtual patients in nursing education: Development and validation of theory-anchored design and activity models. Journal of Medical Internet Research,16(4). DOI: 10.2196/jmir.2556
  16. Urdan, T.A. & Weggen, C.C. (2000). Corporate elearning: Exploring a new frontier. Berwyn, PA: WR Hambrecht & Co.
  17. Ibid
  18. Tagliareni, E. & Forneris, S. (n.d.) Sim beyond the sim lab. Retrieved from http://www.nln.org/docs/default-source/professional-development-programs/sim-beyond-the-sim-lab-(pdf).pdf?sfvrsn=0