Simulation, Gaming Mechanics and Virtual Worlds in Nursing Informatics Education

INTRODUCTION
In nursing, there are a number of techniques used to teach and learn educational
material. Today, latex-based and virtual simulation, virtual worlds and game mechanics are
examples of methods of nursing education. These methods continue to increase, and has been
proven to enhance educational experiences for participants. In this presentation, I will focus on
Simulation and Game Mechanic methods.

BENEFITS OF SIMULATION TEACHING...

 Provides an opportunity for learners to have realistic hands on experience in the clinical
area.
 Learners will acquire readiness and decrease anxiety in the clinical area.
 Learners will be able to in-turn provide safer care to patients.

GAME MECHANICS AND LEARNING...

 Rules of the game must be clearly stated to learners to ensure learners are aware of the
expectations of the game.
 "The mechanics determine how the players or learners interact with the rules and how
the game responds to the players' or learners' moves or behaviors within the game, thus
connecting the players' or learners actions to the purpose of the game" (McGonigle &
Mastrian, 2018, pg. 448).

SIMULATIONS
According to McGonigle & Mastrian, "Simulations are imitations of real-life or circumstances; in
nursing education, simulations are used to replicate a clinical scenario to provide an
opportunity for practice in a mock situation" (2018).
Examples of Simulations include:
 Role Play
 Web based applications
 With manikins
 Virtual simulation

LATEX SIMULATION
A study done by Federal University in the South of Brazil on 32 students enrolled in a
Fundamentals for Professional Nursing Course analyzed how clinical simulations contributed to
the "development of clinical competence and practical skills of nursing undergraduates"
(Journal of Nursing, 2017).
"The simulation happened in the following steps:
presentation of the clinical case by the teachers to the team with specific information such as:
profile of the patient, type of illness or health problems, survey of nursing problems.
Each group interacts with the clinical case, working with the team, test of priority of care, listing
of necessary materials for interventions and carrying out of nursing notes.
Selection of materials and implementation of nursing procedures specific to the clinical case"
(Journal of Nursing, 2017).

CASE STUDY ...

Post simulation, students and instructors debrief, reflecting on the skills performed.
Based on the study, results demonstrated that clinical simulation "contributed to the
development of relational competence and practical skills among students" (Journal of Nursing,
2017).

VIRTUAL SIMULATION
 Simulation in the virtual world.
 Computer controlled setting

VIRTUAL SIMULATION
According to the article, "Online Nursing Education: Virtual Classrooms and Clinical Simulations
help meet Student Needs," virtual simulations such as the shadow health digital clinical
experience, allows for students to practice physical assessment, differential diagnosis and
medical management on the virtual patient, "Tina Jones." (Health Progress, 2017). "Along with
weekly assessments, students also perform an episodic exam and document their findings"
(Health Progress, 2017). Educators are able to view the learners clinical experiences and
provide feedback. Learners must be able to demonstrate their ability to perform history and
physical examinations, show clinical skills and document findings that correlates with Tina Jones
chief complaint.

COMPONENTS OF A SIMULATION
 PREBRIEF
 ENACTMMENT
 DEBREIF
 ASSESSMENT
PREBREIF: Learner receives simulation information. Goals, expectations and outcomes are
discussed in this phase. Background information and preparation for the simulation are
reviewed.
ENACTMENT: The simulation area is prepared by the educator and/or facility. Learner enacts
the activity/simulation within the timeframe given by the educator.
DEBREIF: "A student-centered discussion during which the participants and observers reflect on
performance during the scenario and make recommendations for future practice. The
debreifing can be done one-on-one and/or with entire teams" (McGonigle & Mastrian, 2018,
pg. 438).
ASSESSMENT: Learners receive feedback on their simulation performance. Educators provides
recommendations to learners on how they can improve their performance in future
experiences.
GAME MECHANICS
It is essential that educators ensure the games are engaging learners to make certain
information will be retained.
"Game mechanics are the rules, instructions, directions, and constructs that the learner
interacts with while play the game" (McGonigle & Mastrian, 2018, pg. 434).
Game mechanics allows for retention of knowledge by learners through this progress.

SUMMARY
Simulations are useful teaching methods in nursing education. It provides learners with an
opportunity to practice clinical skills in a realistic clinical setting. It also allows for learning to be
enjoyable, and more likely to be retained by learners. Students are able to practice thinking
critically, and make clinical decisions. Educators are able to provide feedback and/or
recommendations to their students. This in-turn allows for learners to provide safe patient care
in the clinical setting.