Engineering new tools to transform nursing education

Posted: July 22, 2022

In the real world of nursing, quick decisions and critical thinking are central to the role, especially during high-stakes situations.

But nursing curriculums rarely incorporate competency-based assessments or allow students to gain critical, real-world experience, including performing certain procedures, administering medicines or working night shifts.

Two female Ohio State nursing students wearing virtual reality headsets
The initiative aims to enable Ohio State nursing students to gain experience and practice their skills in low-stakes virtual environments.

The solution to this challenge may come from technology.

In a new collaboration between The Ohio State University Colleges of Engineering and Nursing, teams are pursuing the use of extended reality (XR), artificial intelligence (AI) and machine learning (ML) to revolutionize the way nurses are educated. The work is funded by a highly-competitive $1.5 million grant from the American Nurses Foundation’s Reimagining Nursing Initiative. The foundation funded just 10 projects out of 350 proposals that aim to transform health care by reimagining the nursing profession.

The three-year grant will support “Disrupting Nursing Education with XR, AI and ML,” a project that seeks to use cutting-edge technology to better prepare nursing graduates for critical, real-world situations. Deploying technology-enabled learning tools across the core nursing curriculum at Ohio State will enable students to have virtual experiences tailored to their learning needs and practice increasingly higher skills in a low-stakes, virtual environment. The AI/ML tool can address critical points in patient care when decisive nurse interventions make life-or-death differences.

“This initiative is Ohio State in a nutshell. Two seemingly separate disciplines collaborating and converging to improve the human experience,” said Ayanna Howard, dean of the College of Engineering. “We are seeing AI and machine learning already impacting health care in areas like drug delivery, imaging and diagnosis. Now it’s time for nursing education to benefit, and we are ready to partner and lead the way.”

Integrated Systems Engineering Assistant Professor Mike Rayo will lead the College of Engineering partnership with College of Nursing’s principal investigator Michael Ackerman, director of the Center for Healthcare Innovation and Leadership, and co-principal investigators Wendy Bowles and Amy Jauch.

The collaborative project is a natural fit for Ohio State’s Cognitive Systems Engineering Laboratory (CSEL), which specializes in designing systems that combine people, technology and work in complex settings.

“We have been studying how well new technologies can be integrated into nurses’ workflow for over two decades,” explained Rayo, who is the director of CSEL and leads two key efforts for the Disrupting Nursing Education project.

Rayo’s first charge is to create a simulation that allows nurses to use an AI/ML-infused decision support tool he and his CSEL team designed to better anticipate and detect which patients are in imminent danger of rapidly deteriorating, or crashing. The simulation will use real patient data from The Ohio State University Wexner Medical Center.

In the first year of the project, researchers will create a limited simulation in which nurses review individual patients on a computer workstation. In year two, the computer simulation will be embedded in an extended reality universe, where participants must take care of multiple patients and use the tool to determine who to prioritize.

“These simulations serve two purposes. First, student performance will be assessed each year to understand how well students and cohorts are learning,” Rayo said. “Second, their performance using the AI/ML-infused tool will be compared to their performance without it, which allows us to understand the relative benefits and drawbacks of using AI/ML tools to assist with patient diagnosis and response.”

Rayo’s team will also train a machine learning algorithm to dynamically place nursing students into in-person clinical experiences based on their performance in the previous year’s classes. “It is our aim to better connect students with the instructors and learning environments that they need to thrive,” he said.  

Several industrial and systems engineering undergraduate and graduate students are also involved, leading the design of the AL/ML algorithms, the integrated decision-support software, and both the real-world and extended reality simulations.

In addition, PhD students Dane Morey and Morgan Reynolds will lead the design of the research study, incorporating a number of AI/ML technologies that will interact in different ways with nursing students. Some technologies will give initial advice, some will critique students’ plans, and others will simultaneously display advice, the rationale for the advice and the underlying data for that advice.

“In this way, we will learn how best to instruct students on how to work with AI/ML,” Rayo explained. “And we will learn how to better design AI/ML to work with students!”

Researchers expect to launch a handful of extended reality nursing classes this fall, followed by a few more in spring 2023. Additional milestones will follow, with the College of Nursing/College of Engineering team expected to report results, deliver evidence demonstrating the project’s impact and provide resources to help scale the innovation within the profession by 2025.

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