Online Computer-Based Clinical Simulations: The Role of Visualizations

Background: One of the great promises of computer technology for education is the ability to combine text, sound, and visualizations to create multimedia-based simulations. Therefore, an understanding of whether and how to implement the variety of multimedia technology in nursing education is fundamental. Method: This study compares the effectiveness of online computer-based simulations designed using three alternative multimedia approaches—video, animation, and agent-based visualizations—on learning of clinical reasoning skills. Participants in this study were undergraduate nursing students (n = 97). Results: Learning gains were significantly higher for simulation that incorporated exploration of agent-based visualizations than for video- and animation-based visualizations. Interestingly, low achievers made significantly higher learning gains after learning with agent-based simulation than high academic achievers. Conclusion(s): This study proposes that visualizations play an important role in the effectiveness of learning with computer-based multimedia environments. Learning with agent-based visualizations was superior to learning with animation- and video-based visualizations.