Ryerson University Virtual Healthcare Experience Review

Summary

Feature	Comments
Cost	Free
Target learner	Pre-licensure nursing students and registered nurses.
Format	Interactive videos of simulated participants in actual environments in-patient, out-patient and home settings.
Implementation	It is easy to navigate and requires little instruction for the user.
Noteworthy	Faculty will be required to supplement this product to meet the INACSL Standards of Best Practice
Website	https://de.ryerson.ca/games/nursing/hospital/

Characteristics

#	Content	Comments
1	Emergency	Triage of three patients
1	Pediatrics	Ten year old post-op
1	Medical-Surgical	Involving interdisciplinary team members
4	Maternal & Child	Prenatal, labor and delivery, postpartum and newborn
1	Mental Health	Home visit
1	Quality Improvement	Interdisciplinary discharge policy

✓	Considerations	Comments
X	Evidence of when the content has been or will be updated
X	Progression across multiple settings?
X	Health record (electronic or otherwise) integrated into scenarios?
✓	Includes psycho-social components?

Cost

✓	Pricing and Terms	Comments
Free	Individual Cost Per Student
–	Site License Option
✓	Simultaneous Use for Students
–	Contracts Required
–	Contract Length/ Options
–	Access Period
✓	Module can be accessed more than once
–	Payment Options
–	Refund Policy Available

Demo

✓	Question	Comments
–	Is a demo avaialble?
–	Is a trial period available?
–	Is the vendor’s demo required to obtain scenario objectives?

Equipment

✓	Feature	Comments
✓	Internet access required?
✓	Web-browser based?
–	Product website optimized for viewing on a smartphone or tablet?	Not yet evaluated
X	Mobile app available?
✓	No Special PC/Mac software required
✓	No Special Equipment required
–	Internet Speed Requirements	Not specified
–	Accessibility Standards Compliant?	Not specified

INACSL Standards

Based on INACSL Standards of Best practice: Simulation^SM[1],[2],[3],[4]

Criteria marked with an asterisk (*) are evaluated in this product review. Unmarked criteria are important INACSL Standards that should be incorporated as part of a complete simulation-based experience.

Criterion 1: Needs Assessment

Faculty should conduct a needs assessment, identify learning gaps, and select a simulation to meet their learner’s needs. A gap analysis, SWOT, survey results from stakeholders, outcome data from testing or standards from certifying bodies, or practice guidelines may be included Details.

Criterion 2: Measurable Objectives*

Objectives are necessary to identify learning outcomes. Broad objectives reflect the purpose, and specific objectives measure performance.

✓	Objectives	Comments
✓	Are learning objectives provided?
✓	Are learning objectives broad?
X	Are learning objectives specific?

Criterion 3: Format*

Theoretical /conceptual framework focused on learner needs is the underpinning of the format. The simulation has a designated start, purposeful activies and a clear end point.

✓	Structure	Comments
✓	Targeted Participants Identified
✓	Formative Design (informal diagnostic tool provides learning opportunity, no point value)
X	Summative Design (measurable, comparable, or has point value)
✓	Beginning, Middle and End to Simulation

Criterion 4: Scenario Design*

The simulation uses content experts and evidence-based practice to create a backstory, clinical progression and cues, timeframes to facilitate progression, and identification of critical actions or performance measures for evaluation.

✓	Scenario Context	Comments
✓	Does the simulation provide a report, patient file, or appropriate responses during the simulation to provide context to the case?
✓	Are cues embedded in the scenario to progress the case?
✓	Does the learner have a reasonable amount of time to achieve the objectives?
✓	Are critical actions/performance measures clearly identified?
✓	Was a content expert used in the development process of the simulation?

Criterion 5: Fidelity*

Elements of physical,conceptual, and psychological fidelity should be used to create realism.

✓	Fidelity type	Comments
✓	Physical - replicates environment where situation would occur (e.g. manikin, bed, equipment)
✓	Conceptual - elements relates to each other in a realistic way (e.g. vitals are consistent with diagnosis)
✓	Psychological - mimics the contextual elements (e.g. noise, lighting, family members, distractions, time pressure)

Criterion 6: Facilitative Approach

The facilitator should maintain an approach that is participant-centered and driven by the objectives, participant’s knowledge or level of experience, and the expected outcomes.

Criterion 7: Pre-briefing

Simulation experiences should begin with a structured pre-briefing to create trust, integrity and respect. Learner’s are provided expectations, orientated to the space, equipment, simulator, method of evaluation, roles, and time allotment.

Criterion 8: Debriefing*

Debriefing, based on theoretical framework, should immediately follow the experience. A trained debriefing facilitator will support confidentiality, trust, open communication, self-analysis, feedback, and reflection.

✓	Debriefing Context	Comments
✓	Are resources provided for integration in the debriefing process?	Summary report for each learner and suggested reflection questions.
X	Are there faculty-specific guidelines to facilitate debriefing?
X	Is the debriefing structures and theory based?	Not clearly identified.
✓	Are the debriefing points congruent with the objectives and simulation?

Criterion 9: Evaluation*

Simulation should include an evaluation of the participant(s), the facilitator(s), the experience, the facility, and the support team. A valid and reliable tool should be used to measure expected outcomes.

✓	Evaluation Context	Comment
✓	Are evaluation tools provided?	Learners receive a summary report with their responses.
–	Are evaluation tools valid and reliable?
–	Are participants notified prior to the simulation about the evaluation tool?
–	Are evaluation tools clearly identified as formative, summative, or high stakes?

Criterion 10: Preparation Materials

Participants should be provided preparation materials and resources to meet identify objectives and expected outcomes. Activities address knowledge, skills, attitudes, and behaviors expected.

Criterion 11: Pilot Test

All simulation-based experiences should be pilot tested to ensure intended purpose achievement.

Faculty & Student Support

✓	Faculty Training and Support	Comments
✓	No training required
✓	Easily navigated?
X	Implementation guide?
X	Clinical replacement plan provided?
X	Customization available?

✓	Student Training and Support	Comments
✓	No training required
✓	Easily navigated?
✓	Automated feedback?
✓	Interactive?	Participants must answer questions correctly in order to progress.
✓	Time estimates for completion?

Other Features

✓	Feature	Comments
X	QSEN mapping?	Not explicitly met.
X	NCLEX Test Plan mapping?	Not explicitly met.

References

INACSL Standards Committee (2016, December). INACSL standards of best practice: SimulationSM Simulation design. Clinical Simulation in Nursing, 12(S), S5-S12. [http://dx.doi.org/10.1016/j.ecns.2016.09.005]
INACSL Standards Committee (2016, December). INACSL Standards of Best Practice: SimulationSM Outcomes and objectives. Clinical Simulation in Nursing, 12(S), S13-S15. [http://dx.doi.org/ 10.1016/j.ecns.2016.09.006]
INACSL Standards Committee (2016, December). INACSL standards of best practice: SimulationSM Debriefing. Clinical Simulation in Nursing, 12(S), S21-S25. [http://dx.doi.org/10.1016/ j.ecns.2016.09.008]
INACSL Standards Committee (2016, December). INACSL standards of best practice: SimulationSM Participant evaluation. Clinical Simulation in Nursing, 12(S), S26-S29. [http://dx.doi.org/10.1016/ j.ecns.2016.09.009]
Healthcare Simulation Dictionary (2nd ed.). Healthcare Simulation Dictionary, pg. https://www.ssih.org/dictionary

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