A Novel Integrated Nursing Ecosystem for Undergraduate Community Education: Development and Empirical Grounding of the Pitsachart Integrated Community–Virtual Living Nursing Model (PICVL-NM)

Abstract

Background: Undergraduate nursing education must prepare graduates for complex community-based practice environments, yet curricula remain predominantly oriented to hospital placements and simulation laboratories. Existing frameworks seldom integrate caring science, service quality measurement, digital health infrastructure, community co-creation and sustainability within a single educational ecosystem.
Objective: To develop and conceptualize the Pitsachart Integrated Community–Virtual Living Nursing Model (PICVL-NM) as an integrated ecosystem architecture for undergraduate community nursing education, and to empirically ground the model within a community-based Virtual Living Laboratory (VLL) rotation in Thailand.
Methods: A theory-development design with empirical grounding was employed. Conceptual synthesis integrated six core domains: Watson’s caring science, SERVQUAL-based service quality intelligence, joint venture community co-creation, VLL infrastructure, holistic nursing and the Sustainable Development Goals (SDGs). Empirical data derived from a convergent mixed-methods study in a Thai community VLL, involving 166 participants (patients n = 10; family caregivers n = 24; undergraduate nursing students n = 132). Quantitative data were collected using a validated, adapted SERVQUAL instrument (Cronbach’s α = 0.92), and qualitative data through semi-structured interviews analyzed using reflexive thematic analysis and joint display integration.
Results: The PICVL-NM was structured as a four-domain ecosystem architecture comprising theoretical foundations, VLL-based operational processes, measurable outputs and long-term outcomes. Satisfaction was high across stakeholder groups (mean = 4.06–4.17 on a five-point scale), with responsiveness and empathy rated very highly, while tangibles were moderately high but constrained by home environments and digital resources. Overall, 87.1% of students reported increased confidence in assessment, communication and home-based care. Thematic analysis identified three core themes: Accessibility and Responsiveness, Empathy and Trust-Building, and Community Co-Creation.
Conclusion: The PICVL-NM offers a novel, empirically grounded ecosystem architecture for undergraduate community nursing education, linking VLL-based community rotations with service quality, student competency and community engagement. The framework is scalable and adaptable across curricula and community health system contexts.