Abstract

Healthcare workers practice in volatile environments, where they are five times more likely to experience violence at work than any other profession in the United States (Jones et al., 2023). Approximately 72% of that violence has been classified as “verbal,” with physical violence being attributed to the other 28% (Sari et al., 2023). The Joint Commission (2019) (TJC) highlighted the need for de-escalation training in healthcare, especially given the rise of violence and aggression in U.S. healthcare settings.

Virtual reality-based simulations aim to provide real-world experiences in a simulated environment that provide students with safe learning environments to learn new skills and demonstrate competency (Shorey & NG, 2021). The National Council of State Boards of Nursing (NCSBN) recommends simulation as a “key component” of nursing education (Chen et al., 2020). While the use of simulated environments has been utilized in nursing education for the past 50 years, the use of virtual reality in nursing education is relatively new. VR environments can help participants learn physiological control while performing decision-making actions in a higher stress, simulated environment. VR, coupled with de-escalation training, can be an effective way at educating and training participants to engage in physiologic control to enhance their performance in high stress situations (Abele et al., 2022).

Students in the OSN Nurse Practitioner programs receive relatively little training/education on de-escalation. University Police services are subject matter experts in de-escalation training and the use of VR simulation in those training efforts (University of Nevada, Las Vegas, 2023). The use of non-traditional interprofessional collaboration can help to build bridges in the realm of nurse practitioner preparedness, as de-escalation techniques should be considered a core skill for both professions. Forty nurse practitioner students participated in the two day immersion experience. The students reported a greater sense of ease in their communication, as well as a better appreciation for the role of de-escalation in providing care to agitated and aggressive patients. Participants further reported a greater sense of gratitude for the non-traditional interdisciplinary collaboration, as well a deep respect for the simulated environment that the VR system provided in learning high-stakes communication skills.

Notes

References:

Abele, M., van Peer, J., Brammer, J., Nies, A., van Rooij, M., Oostenveld, R., D Dorrestijn, W., Smit, A., Roelofs, K., Klumpers, F., & Granic, I. (2022). Deep-breathing biofeedback trainability in a virtual-reality action game: A single-case design study with police trainers. Frontiers in Psychology, 13, 806163. doi: 10.3389/fpsyg.2022.806163

Chen, F., Leng, Y., Ge, J.F., Wang, D.W., Cheng, L., Chen, B., & Sun, Z.L. (2020).
Effectiveness of virtual reality in nursing education: Meta-analysis. Journal of Medical Internet Research, 22(9), e18290. doi: 10.2196/18290

Jones, C., Sousane, Z., & Mossbury, S. (2023). Addressing workplace violence and creating a safer workplace. Agency for Healthcare Research & Quality. Retrieved from https://psnet.ahrq.gov/perspective/addressing-workplace-violence-and-creating-safer-workplace

Sari, Y., Yildiz, I., Baloglu, S., Ozel, M., & Tekalp, R. (2023). The frequency of workplace violence against healthcare workers and affecting factors. PLoS One, 18(7), e0289363. doi: 10.1371/journal.pone.0289363.

Shorey, S., & Ng, E. (2021). The use of virtual reality simulation among nursing students and registered nurses: A systematic review. Nurse Education Today, 98. https://doi.org/10.1016/j.nedt.2020.104662

The Joint Commission. (2019). Quick safety issue 47: De-escalation in health care. https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-47-deescalation-in-health-care/

University of Nevada, Las Vegas. (2023). De-Escalation training program.
https://www.unlv.edu/police/ndtc

Note: Presentation file has been attached as a PDF for ease of access and a PowerPoint slide deck to retain an audio/video component.

Description

Virtual reality-based simulations aim to provide real-world experiences in a simulated environment that provide students with safe learning environments to learn new skills and demonstrate competency. Students in the Nurse Practitioner programs receive relatively little training/education on de-escalation. University Police services are subject matter experts in de-escalation training and the use of VR simulation in those training efforts.

Author Details

Carrie D. Hintz, DNP, PhD, RN, CEN

Sigma Membership

Nu Iota

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Virtual Learning, Teaching and Learning Strategies, Interprofessional Initiatives, Nursing Education, Emerging Technologies, Simulation, Virtual Reality, Competence, Clinical Competence, De-escalation Training

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-12-08

Click on the above link to access the slide deck.

Additional Files

4268598_Hintz_Oral.pptx (6403 kB)
Audio/Video Component Included

Share

COinS
 

Virtual Reality, De-Escalation Training & Non-Traditional Interprofessional Collaboration

Indianapolis, Indiana, USA

Healthcare workers practice in volatile environments, where they are five times more likely to experience violence at work than any other profession in the United States (Jones et al., 2023). Approximately 72% of that violence has been classified as “verbal,” with physical violence being attributed to the other 28% (Sari et al., 2023). The Joint Commission (2019) (TJC) highlighted the need for de-escalation training in healthcare, especially given the rise of violence and aggression in U.S. healthcare settings.

Virtual reality-based simulations aim to provide real-world experiences in a simulated environment that provide students with safe learning environments to learn new skills and demonstrate competency (Shorey & NG, 2021). The National Council of State Boards of Nursing (NCSBN) recommends simulation as a “key component” of nursing education (Chen et al., 2020). While the use of simulated environments has been utilized in nursing education for the past 50 years, the use of virtual reality in nursing education is relatively new. VR environments can help participants learn physiological control while performing decision-making actions in a higher stress, simulated environment. VR, coupled with de-escalation training, can be an effective way at educating and training participants to engage in physiologic control to enhance their performance in high stress situations (Abele et al., 2022).

Students in the OSN Nurse Practitioner programs receive relatively little training/education on de-escalation. University Police services are subject matter experts in de-escalation training and the use of VR simulation in those training efforts (University of Nevada, Las Vegas, 2023). The use of non-traditional interprofessional collaboration can help to build bridges in the realm of nurse practitioner preparedness, as de-escalation techniques should be considered a core skill for both professions. Forty nurse practitioner students participated in the two day immersion experience. The students reported a greater sense of ease in their communication, as well as a better appreciation for the role of de-escalation in providing care to agitated and aggressive patients. Participants further reported a greater sense of gratitude for the non-traditional interdisciplinary collaboration, as well a deep respect for the simulated environment that the VR system provided in learning high-stakes communication skills.