Executive Summary
Nursing education relies on a combination of pedagogical strategies to effectively develop students’ clinical competencies, analytical reasoning, and professional self-efficacy. Because no single instructional method can address all learning needs, contemporary nursing programs increasingly emphasize blended approaches that integrate traditional instruction with innovative technologies. One rapidly expanding instructional strategy is the use of remote online simulation laboratories, which allow nursing students to engage in clinical scenarios within virtual environments. These platforms enable learners to apply theoretical knowledge, practice clinical judgment, and interact with simulated patients while maintaining patient safety by eliminating real-world risk.
Although face-to-face clinical instruction and simulation remain essential components of nursing education, many students encounter barriers that restrict their full participation. Common challenges include employment obligations, family responsibilities, illness, transportation limitations, geographic distance from clinical sites, and restricted availability of clinical placements. Remote online simulation laboratories offer a flexible and scalable alternative that can be customized to course objectives and accessed regardless of location or time constraints.
This paper examines the integration of remote online simulation laboratories into the course The Role of the BSN Nurse in Promoting Community Health. Using evidence drawn from five peer-reviewed scholarly sources, the paper evaluates the impact of virtual simulation on student learning outcomes, engagement, satisfaction, and assessment performance. Three tables are used to synthesize the literature, identify technology gaps within the curriculum, and analyze implementation forces. Lewin’s Change Theory provides the conceptual framework for guiding implementation and sustaining change through collaboration among students, faculty, and nursing program leadership.
Remote Simulation Laboratories: Literature Review
The proposed adoption of remote online simulation laboratories is strongly supported by existing scholarly literature. Research demonstrates that virtual simulation can effectively complement traditional clinical instruction by supporting knowledge acquisition, psychomotor skill development, and affective learning outcomes. These technologies also increase learner engagement and satisfaction while offering flexibility for diverse student populations.
The following table summarizes five peer-reviewed studies that examine the effectiveness, strengths, and limitations of virtual simulation in nursing and higher education contexts.
Table 1
Summary of Peer-Reviewed Literature on Virtual Simulation in Nursing Education
| Author(s) | Year | Primary Focus | Key Outcomes | Level of Evidence | Identified Limitations |
|---|---|---|---|---|---|
| Tolarba | 2021 | Impact of virtual simulation on nursing education | Improved clinical reasoning, psychomotor skills, and learner confidence | High | Variation in simulation design |
| Reginald | 2023 | Virtual labs and self-regulated learning | Increased learner autonomy and knowledge retention | Moderate | Not nursing-specific |
| Medel et al. | 2024 | Virtual clinical skill development | Enhanced theory–practice integration and reduced anxiety | High | Limited sample size |
| May et al. | 2023 | Design and usability of virtual labs | Highlighted need for improved usability and faculty preparation | Moderate | Focused on challenges rather than outcomes |
| Garrison et al. | 2023 | Student experiences with online learning | Emphasized value of hybrid learning models | Moderate | Limited hands-on emphasis |
Research Findings Supporting Remote Simulation Laboratories
Tolarba’s (2021) systematic review analyzed 23 studies involving 1,929 participants and found that virtual simulation positively influenced cognitive, psychomotor, and affective learning domains. Students demonstrated improved clinical judgment, greater confidence, and enhanced emotional engagement—competencies that are essential for safe and effective nursing practice.
Reginald (2023) explored the role of virtual laboratories in fostering self-regulated learning and reported that students benefited from on-demand access to learning materials across multiple devices. This flexibility supported independent learning, improved information retention, and accommodated students managing academic, professional, and personal responsibilities.
Medel et al. (2024) found that nursing students who participated in virtual clinical simulations achieved higher levels of theoretical understanding and practical competence compared to peers receiving only traditional instruction. Students also reported reduced anxiety prior to entering real clinical environments and expressed greater satisfaction with their educational experiences, regardless of prior healthcare exposure.
May et al. (2023) identified usability and pedagogical challenges associated with virtual laboratories, including technology navigation difficulties and the need for faculty development. Despite these challenges, the study emphasized that well-designed simulations paired with appropriate faculty training significantly enhance learning effectiveness.
Garrison et al. (2023) reported that some students experienced feelings of isolation during fully online learning. However, the authors stressed that virtual simulations are most effective when used as supplements to, rather than replacements for, in-person clinical instruction, thereby supporting diverse learning preferences.
Areas Requiring Further Research
While existing evidence supports the integration of remote simulation laboratories, additional research is needed to strengthen implementation strategies. Comparative studies evaluating outcomes between virtual-only, traditional-only, and hybrid clinical models would clarify best practices. Research focusing exclusively on nursing students, rather than general STEM populations, would improve applicability to nursing curricula.
Further investigation into different simulation formats—such as desktop-based platforms versus immersive virtual reality—would support cost-effectiveness analyses. Addressing student concerns related to screen fatigue, reduced interpersonal interaction, and resistance to technology through hybrid instructional models and enhanced faculty support remains a critical area for future exploration.
Needs Assessment of the Nursing Curriculum
A comprehensive needs assessment indicates that remote online simulation laboratories effectively address persistent challenges within nursing education. Limited clinical placement availability, scheduling conflicts, and inconsistent learning experiences can be mitigated through standardized virtual scenarios that are accessible at any time.
These platforms promote experiential learning by allowing students to practice repeatedly, receive immediate feedback, and learn from errors in a risk-free environment. Such opportunities enhance student confidence, competence, and readiness for real-world clinical practice while supporting equitable access to education for students with diverse circumstances.
Curriculum Technology Need-Gap Analysis
The following table outlines the current technological limitations within the nursing curriculum and identifies targeted strategies to address these gaps.
Table 2
Technology Need-Gap Analysis in the Nursing Curriculum
| Current Technology | Desired Technology | Identified Gap | Proposed Intervention |
|---|---|---|---|
| In-person clinical and simulation labs only | Remote online simulation laboratories | Limited access due to time, location, and personal constraints | Pilot virtual simulations, train faculty, integrate into curriculum |
Collaboration With Key Stakeholders
Successful implementation of remote simulation laboratories requires coordinated collaboration among students, faculty, and program administrators. Students provide essential feedback regarding usability and learning effectiveness. Faculty ensure alignment with course objectives, integrate simulations into teaching strategies, and evaluate student performance. Program leadership facilitates funding, oversees implementation, and monitors outcomes to ensure sustainability.
Effective communication strategies—including email, in-person meetings, and virtual platforms such as Zoom—support transparency, shared decision-making, and continuous improvement throughout the implementation process.
Limitations of Current Educational Technologies
Existing instructional tools, such as high-fidelity mannequins and recorded lectures, contribute valuable learning experiences but present notable limitations. Mannequin-based simulations are costly, space-intensive, and restricted by scheduling availability. Recorded lectures offer convenience but lack interactivity, limiting opportunities for immediate clarification and active learner engagement.
Addressing Challenges Through Remote Simulation
Remote online simulation laboratories alleviate many of these constraints by offering flexible access, diverse clinical scenarios, and unlimited practice opportunities. Students can engage with cases involving pediatric populations, community health issues, and social determinants of health, thereby strengthening cultural competence and holistic assessment skills.
Summary of Curricular Technology Needs Assessment
The integration of remote simulation laboratories enhances educational equity, supports diverse learning styles, and builds student confidence. Immediate feedback mechanisms and repeated practice opportunities foster mastery of clinical skills and improve readiness for patient care, ultimately promoting patient safety.
Stakeholder Agreement
Through structured discussions and evaluations, students, faculty, and leadership reached consensus that the benefits of remote simulation laboratories outweigh potential limitations. Stakeholders identified the technology as a valuable enhancement to existing instructional methods rather than a replacement for traditional clinical experiences.
Factors Affecting Implementation
Table 3
Force Field Analysis for Implementing Remote Simulation Laboratories
| Driving Forces | Restraining Forces |
|---|---|
| Flexible, student-centered learning | Limited access to reliable technology |
| Enhanced cultural competence | Financial limitations |
| Increased opportunities for practice | Reduced physical hands-on experience |
Application of Lewin’s Change Theory
Lewin’s Change Theory provides a structured framework for implementing remote simulation laboratories through the stages of unfreezing, changing, and refreezing. This approach emphasizes readiness for change, effective transition management, and long-term integration of new practices.
Justification for Lewin’s Change Theory
Lewin’s model is widely applied in healthcare and educational settings due to its focus on human behavior, communication, and sustainability. The theory supports faculty engagement, systematic planning, and continuous evaluation, all of which are essential for successful technological integration.
Anticipated Resistance and Mitigation Strategies
Potential resistance may stem from financial concerns, increased faculty workload, or discomfort with unfamiliar technologies. These challenges can be mitigated through transparent communication, phased implementation, faculty development programs, and institutional support.
Implementation Plan Guided by Change Theory
Unfreezing
Conduct needs assessments, share evidence, and engage stakeholders to build readiness for change.
Changing
Pilot remote simulation laboratories, provide faculty training, and collect ongoing feedback.
Refreezing
Fully integrate simulations into the curriculum, supported by continuous evaluation and refinement.
Conclusion
The incorporation of remote online simulation laboratories into The Role of the BSN Nurse in Promoting Community Health course represents a significant advancement in nursing education. This approach promotes flexible, inclusive, and experiential learning while strengthening clinical judgment, cultural awareness, and student confidence. By addressing existing curricular limitations and accommodating diverse learner needs, remote simulation laboratories enhance patient safety preparedness and contribute to the development of a competent and adaptable nursing workforce. Broader adoption of this technology has the potential to improve the quality and consistency of nursing education across healthcare systems.
References
Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Change management. StatPearls.
El-Shafy, I. A., Zapke, J., Sargeant, D., Prince, J. M., & Christopherson, N. A. M. (2019). Decreased pediatric trauma length of stay with implementation of Lewin’s change model. Journal of Trauma Nursing, 26(2), 84–88.
Garrison, C. M., Hockenberry, K., & Lacue, S. (2023). Adapting simulation education during a pandemic. Nursing Clinics of North America, 58(1), 1–10.
May, D., Jahnke, I., & Moore, S. (2023). Online laboratories and virtual experimentation in higher education. Journal of Computing in Higher Education, 35(2), 203–222.
Medel, D., et al. (2024). Analysis of knowledge and satisfaction in virtual clinical simulation among nursing students. Nursing Reports, 14(2), 1067–1078.
Reginald, G. (2023). Teaching and learning using virtual labs. Cogent Education, 10(1), 1–14.
Tolarba, J. E. L. (2021). Virtual simulation in nursing education: A systematic review. International Journal of Nursing Education, 13(3), 48–54.