Calling Out the Shiny Object: How ‘Multiplayer’ Might Distract Nursing from Real Progress in VR

By Devin Marble, Director of Marketing & Expert in Residence at VRpatients

*Note: I interviewed a Nurse Practitioner about this shiny object; you can find the real uncut conversation at the end of this article, enjoy.

I’ve been thinking about something for a long time that has perplexed me: the sheer volume of nurse educators asking if the VR simulation has “multiplayer.” What I didn’t understand about their question was why they needed “multiplayer” (meaning multiple nursing students all in VR headsets treating a patient together) in the first place. What problem is it solving for them? Then it hit me: they’re not developers; they don’t know how to ask for what they need.

So, for the past six months, I’ve been testing a hypothesis with every nurse educator and simulationist I can find, and I have yet to find one who doesn’t concede that clinical simulation, in fact, does not need multiplayer; it needs “group work.” I’m sure that ruffles some feathers, so let’s dive into it.

The Assertion

For decades, nursing simulation has been designed around group simulations—multiple students gathered around one manikin trying to learn to be a nurse—because that was the only way to manage teaching large groups of students with limited resources. But traditional manikin simulation does not reflect the reality of 90 percent of bedside care; one nurse cares for six patients, not the other way around.

Now the industry is evolving, fast, and educators are having a hard time catching up. VR is here, AI is here, and the nurse staffing shortage is here. Yet educators are still thinking about immersive sim as if it is the same thing as manikin sim—which it is not. We need to flip the script and adopt what I call the Group–Solo–Group (GSG) Approach: focus on pre-briefing together with classmates and your educator, break off into one-on-one patient simulations, then regroup for a collaborative debrief—all in VR. That’s what nursing needs, because we have to train like it’s real to fully reap the benefits of VR simulation. Let’s be honest: nurses don’t burn-out because they share the load of a single patient with a group of nurses. In the real world, they are short-staffed, it is just them and the patient. Are you ready? Let's dive in.

Rethinking What Simulation Should Be

It’s no secret the healthcare industry is in dire need of more qualified nurses, paramedics, and clinicians. Having spent eight years as a hospital paramedic, I’ve seen firsthand how critical it is to have well-trained, confident caregivers at the bedside. Now, as Director of Marketing and Expert in Residence at VRpatients, I’m at the forefront of bringing AI and XR (VR/MR) simulations to nursing education—and I see a disconnect that needs to be addressed.

We’ve inherited the old “group simulation” mentality because, traditionally, a single simulator (often a high-cost manikin) is shared among multiple students in a single lab. While that model made sense when the only option was expensive, space-consuming manikins, VR technology can finally free us from those limitations. Yet, many in the industry keep asking for “multiplayer VR experiences,” effectively trying to replicate large-group simulation in a virtual environment.

Why “Multiplayer VR” Doesn’t Reflect Day-to-Day Nursing

1. Nurses Usually Work One-on-One Barring a true emergency (like a cardiac arrest or trauma code), the majority of care is delivered by one nurse, one patient. Sure, you might call in help for specific tasks, but that’s not the normal day-to-day scenario for most patient care.
2. High Value in Independent Decision-Making When six students crowd around a manikin—or in a virtual scenario—only one or two actively lead. The rest learn passively. But the real job demands each nurse to think critically and act decisively alone. They don’t have five colleagues stepping in to guide their every move.
3. Resource Constraints No Longer Apply Sim labs limit group sizes because of cost and physical space. VR removes that bottleneck. If every learner can have a headset, they can each experience a high-fidelity, fully immersive simulation without needing to share a single manikin.

Introducing the GSG (Group–Solo–Group) Model

The GSG Approach is built around three phases—Group Pre-Brief, Solo Immersive Simulation, and Group Debrief. It’s a simple and powerful way to harness the strengths of virtual reality while reflecting the real-world expectation that nurses must be independently capable of caring for their patients.

1. Group Pre-Brief: Just like a typical sim day, except in VR, with unlimited digital resources and assets at your disposal. The instructor and students are all together in a virtual environment, getting ready for a realistic patient encounter. No one knows the answers; there are no passing notes between students giving hints on what to expect. Everyone is in the same boat; their first encounter happens together. Enter the sim.
2. Solo Immersion:?You've been briefed; it's time to try being a nurse alone. You are transported into a patient's room, they are sick, and they are waiting for you. Mistakes aren't just expected, they are welcome. There is no one here to judge you, and when you finish your attempt, you have the comfort of knowing the rest of your class will shortly re-group to discuss their experience.
3. Group Debrief:?Regroup and talk about what went well and what could have gone better, and then try again. There is no setup, and there is no need to refill the manikins, reprogram them, or rotate team-lead. You are all the team lead, and you get to go again. This is practice time; ask questions and try new things; your instructor is always there for you in the briefing room.

By splitting out individual practice from group discussions, the GSG Model ensures each nurse gets focused “hands-on” time—while still benefiting from shared knowledge and debriefing insights.

When Multiplayer Does Make Sense

Yes, there are scenarios—like a?code, a birth, a pediatric emergency, taking in an ICU patient,?or a mass-casualty event—where multiple clinicians rush in simultaneously. These are important things to practice, and we still need to simulate them. But most of those are specialties, not day-to-day bedside nursing like geriatrics, med-surge, telemetry, urgent cares, elder care facilities, and so on. The specialties are an excellent use of a manikin, especially a birthing scenario. If the majority of your sim curriculum focuses on crisis-based group scenarios, you miss out on preparing nurses for those more frequent yet crucial solo responsibilities: medication administration, empathetic care, patient education, charting, and responding to subtle changes in vital signs.

Changing an Old Mindset

The emphasis on “multiplayer VR” stems from decades of group-based teaching around limited manikins in costly simulation labs. Now that VR has removed those constraints, we can empower each learner to get more individualized “hands-on” time. The risk of letting go of tradition is small compared to the massive payoff: producing more competent, confident nurses faster. And hey, it's good for the wallet too. Don't forget that a headset costs $400, and it can be loaded with an unlimited number of simulations.

How One-to-One VR Training Moves the Needle

• Scale & Access Instead of fighting over manikins or sim-lab scheduling, every learner can do multiple runs on their own schedule, re-attempting scenarios without fear of hogging resources. And when they come into the lab for their practical sim, they are more ready than ever because they have been practicing.
• Higher Clinical Relevance Most nurse-patient interactions are indeed one-on-one. That’s where critical thinking and communication skills are truly forged. Let's give learners a safe, solo environment to practice these daily-use important skills.
• Immediate Feedback & Debrief?Combine each immersive scenario with AI-driven metrics—did you provide empathetic care, did you ask open-ended questions, what was missed, why did the patient deteriorate, which dose was wrong—and then use group reflection to reinforce learning.

It’s Time to Shift the Paradigm

My assertion, restated: We’re hung up on designing VR simulation tools that mimic a crowded group training model of the past. We should be focusing on empowering every learner to practice independently—pre-brief and post-debrief as a team and replicate the real-world solo nurse-patient dynamic during the actual simulation.

This approach isn’t about ignoring the value of teamwork. It’s about designing a more authentic, frequent practice for the true day-to-day reality nurses face: taking complete ownership of patient outcomes and letting teamwork happen in a "classroom style" group work environment, not in the patient's room. Because this model works at scale, that’s how we help solve the nursing shortage crisis, better equip clinicians, and ultimately improve patient care.

Join the Conversation!

I’d love to hear your thoughts on adopting the GSG (Group–Solo–Group) Model. Do you think it has the potential to transform nursing education, or do you see challenges in your own institution? Let me know in the comments, or send me a message. Share this article with fellow educators and follow me here on LinkedIn to stay in the loop about new ideas in VR, AI, and healthcare training. Together, we can shape the future of immersive simulation—one competent, confident nurse at a time.

Bonus Interview!

I had the privilege to sit down with an experienced educator and nurse practitioner and askerd what she thought of my assertion, unedited and unprepared, this is the raw interview with Maggie Lysaght NP.

A Fireside Chat on Immersive Simulation with an Nurse Practitioner:

About the AuthorDevin Marble is the Director of Marketing & Expert in Residence at VRpatients, blending eight years of hospital paramedic experience and strategic leadership in XR/AI-driven simulation technology. He frequently speaks at major conferences, hosts the Immersive Medical Podcast, and collaborates globally to advance more effective, scalable clinical training for nurses, paramedics, and other care providers.