Abstract
Hypertension is rapidly increasing in lower- and middle-income South African homes,
intensifying the prevalence of cardiovascular diseases. Therefore, it is imperative that
community service nurses (CSNs) entering or currently working with such patients are
equipped with the necessary theory and clinical skills to identify and treat these
patients. Newly qualified nurses (NQNs) are expected to complete a year of
remunerated community service and must perform at the same level as their senior
registered counterparts. They are required to use their clinical reasoning skills, clinical
judgement, critical thinking, and decision-making to provide quality healthcare to the
people of South Africa.
The purpose of this study was to gain an understanding of newly appointed CSNs’
experience using virtual reality (VR) to address and evaluate their experiential
knowledge gaps. The information was used to formulate recommendations to develop
and improve CSNs’ clinical reasoning when diagnosing and selecting appropriate
nursing interventions to manage hypertension. A qualitative, exploratory, and
descriptive phenomenological research design was thus used to describe CSNs’
experiential knowledge gaps when managing hypertensive patients. Furthermore, a
design science methodology was implemented in the development of the VR
prototype.
Purposive sampling was used to select nine participants, and data were collected
through focus groups, semi-structured individual interviews, observations, and field
notes. The study was conducted in three phases. Phase one consisted of a focus
group and four in-person semi-structured individual interviews to explore CSNs’
experiential knowledge gaps. In phase two, eight individual interactive sessions were
held, where the researcher used observation and field notes to document the
participants’ experience. Phase three entailed one focus group, four in-person semistructured
individual interviews and one telephonic individual interview to describe the
participants’ experiences regarding the use of VR in bridging the aforementioned
gaps. The researcher applied Colaizzi’s seven steps during data analysis.
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The following criteria were applied to ensure and maintain trustworthiness in the study:
credibility, dependability, confirmability, and transferability. The ethical considerations
taken by the researcher centred around the principles of non-maleficence and
beneficence, autonomy, privacy and confidentiality and justice. The explorative and
descriptive nature of the research design also assisted the researcher to comprehend the
experiential knowledge gaps CSNs experienced and their experiences of the use VR in
bridging these gaps. The process led to the development of recommendations to facilitate
the implementation and integration of VR simulation technology into nursing education
and clinical practice.
Keywords: Clinical, Education, Hypertension, Nursing, Virtual Reality