The Virtual Patient-Development, Implementation and Evaluation of an Innovative Computer Simulation for Postgraduate Nursing Students
Kiegaldie, Debra, White, Geoff, Journal of Educational Multimedia and Hypermedia
"The Virtual Patient is like a student pilot learning to fly--it draws all your assessment skills together and increases your confidence." (Student user)
The Virtual Patient, an interactive multimedia learning resource using a critical care clinical scenario for postgraduate nursing students, was developed to enhance flexible access to learning experiences and improve learning outcomes in the management of critically ill patients. Using real-time physiological animations, authentic content design and local online clinical experts, The Virtual Patient replicates the way in which clinical cues and patient data are presented in the critical care environment, allowing students to work in their own time, at their own pace, with expert support and without ever compromising real patients. This article reports the project's development, design features, and user-evaluation data, concluding with design recommendations.
PROJECT BACKGROUND AND AIMS
The complex and ever changing clinical contexts in which nursing students practice necessitates the introduction of innovative and flexible teaching strategies in order to improve student access to learning opportunities and learning outcomes. Postgraduate critical care nursing students are, in particular, required to develop advanced health assessment skills and knowledge of diagnostic and therapeutic interventions essential in caring for patients within highly technological environments. For the postgraduate student committed to the demands of her/his clinical workplace, the development of these competencies through course work requires engagement with clinically relevant case study content in contexts which facilitate learning and do not place real patients at risk.
The Virtual Patient was produced for rural and metropolitan postgraduate nursing students studying in critical care, emergency, and high dependency courses at Monash University's School of Nursing. The Virtual Patient is an interactive computer simulation that provides students with the opportunity to manage a complex clinical case study in critical care nursing. The aims of the project were to:
* provide students with the opportunity to manage complex clinical situations which they may not otherwise experience in their clinical practice; and
* enable students to interact with colleagues and leading nurse practitioners, who are not formally associated with the curriculum, via an online discussion group.
The educational objectives of The Virtual Patient were to facilitate professional learning by enabling students to:
* become familiar with the critical care workplace environment;
* develop clinical problem-solving abilities including:
** an understanding of assessment concepts and the significance of assessment findings;
** diagnostic interpretation skills;
** confidence in decision making;
** identification of appropriate therapeutic interventions; and
* participate in collaborative learning.
To achieve these objectives, the project's pedagogical approach used a student centred, case-based learning model, which required the students to take responsibility for constructing their own understanding of the clinical scenarios. This approach is premised upon two notions; students' professional learning is most effective when they are actively involved in creating their new understandings and competencies and learning is retrieved and remembered longer if undertaken in the context in which it is to be applied (Boud & Feletti, 1991). Use of a clinical case benefits the learners by providing them with an opportunity to reason in context, generate experiences that they may not otherwise have, and engage in problem solving with support and feedback from colleagues and experts (Sutyak, Lebeau, Spotnitz, O'Donnell, & Mehn, 1996; Thomas, O'Connor, Albert, Boutain, & Brandt, 2001). …