Virtual Gaming Simulation: What is it?

In 2013, a team from Centennial College, Ryerson University and George Brown College began making virtual gaming simulations for nursing students to practice clinical decision-making in safe learning environments.

Since that time, the team has developed a suite of virtual gaming simulations designed to augment in-person clinical practice experiences. The virtual gaming simulations are housed in the Virtual Healthcare Experience, an open access resource (or see below). Educators and learners can access the simulations individually or as a group at any time.

The virtual gaming simulations offer learning opportunities in different clinical areas such as pediatrics, mental health, gerontology, emergency, medical-surgical, and maternal health, and new virtual gaming simulations are continually being added. The virtual gaming simulations are based on learning outcomes related to course outcomes (including clinical courses) and their content is relevant to nursing students, practicing nurses, and potentially, other healthcare professionals.

The team defines virtual gaming simulation as, “High fidelity, 2D immersive simulation using videos of simulated patients (played by actors) in which the user can make clinical decisions for learning in healthcare” (Verkuyl et al., 2019, p. 1). The virtual gaming simulations are ‘serious games’ in that their purpose is to promote learning (Lapum et al., 2018).  Integrated in the virtual simulations are gaming elements designed to pique interest and challenge the learner to make decisions where the outcome affects client health. The learner encounters the client’s health storyline and then works through eight to seventeen decision points with two to four options or choices regarding how best to assess or provide care. This branching scenario design engages learners and allows them to see the consequences of their decisions.

Some of the virtual gaming simulations in the Virtual Healthcare Experience include learning objects where the learner practices a specific skill. For example, in the prenatal virtual gaming simulation the learner listens to a fetal heartbeat as long as needed to determine the rate. In most of the simulations, the program saves each decision made by the learner and, at the end, the learner receives an individualized summary report outlining all decisions made during the game. The ones created in H5P have a summary page at the end.

The current term for persons teaching with virtual gaming simulation is ‘simulationists’. The Simulationist Code of Ethics (2013): indicates ‘simulationists’ are professionals involved in providing simulation activities, products, and services (Kardong-Edgren, 2013, p.e561). However, in this text we will use the term educator or facilitator as these terms are more familiar to our readers and more broadly describe that role. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards Committee (2021) states “A facilitator is the educator that assumes responsibility and oversight for managing the entire simulation-based experience” (pg. 22).