vSim for Nursing

VSIM
PACKAGE-
EDITH JACOBSEN

STUDENT RESOURCES
 vSim for Nursing

vSIM PACKET FOR STUDENTS Est. Time: 4-6 Hours

STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT

This activity packet is intended to be used with your assigned virtual patient found in vSim. The Six Step learn flow in
vSim is to be followed as instructed below. Once you have completed the Six Steps, in addition to this VSIM Packet,
submit for grading as instructed.

LEARN FLOW - STEP ONE

➢ Finish the Suggested Readings, then complete the following four activities:
❖ Clinical Worksheet
❖ Plan of Care Concept Map
❖ Pharm4Fun Worksheet (one per medication)
❖ ISBAR Worksheet
LEARN FLOW – STEP TWO
➢ Take the Pre-Simulation Quiz
❖ Student may take several times using the answer key to provide immediate remediation prior to the virtual
simulation. Quiz is recorded as complete.
LEARN FLOW – STEP THREE
➢ Launch the virtual simulation
❖ Suggest student complete the vSim Tutorial prior to launching Step Three.
❖ Each clinical experience in the simulation lasts a maximum of 30 minutes.
❖ Student is to complete the simulation as many times as they need to to fully understand the care of the
patient.
LEARN FLOW – STEP FOUR
➢ Complete the Post-Quiz
❖ The answer key is not visible to the student until after they have submitted the quiz.
❖ The quiz grade is recorded as a percentage
LEARN FLOW – STEP FIVE
➢ Document
❖ The student documents the clinical events that occurred during the simulation using the information
contained in step five.
❖ If using DocuCare, the instructor assigns the same vSim patient which can be found in DocuCare cases.
LEARN FLOW – STEP SIX
➢ Reflection Questions
❖ Students are to complete the reflection questions and submit to instructor post clinical replacement (see
syllabus for details).
❖ The quiz grade is recorded as a percentage
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 vSim for Nursing

CONCEPT MAP/ PLAN OF CARE Est. Time: 30 Minutes

This activity creates an opportunity for you to organize the nursing care required for the patient care presented in your
assigned vSim.

STUDENT LEARNING OUTCOMES

At the end of this activity, student will be able to:

1. Describe pathological events associated with the patient’s disease process or condition.
2. Create a plan of care and prioritized nursing interventions based on patient care needs.
3. Identify anticipated diagnostic and physical assessment findings related to the identified condition or disease
process.
ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management
system (LMS).
2. Review the information contained in the patient information.
3. Review the smart sense links associated with Nursing Care, Diagnostics, and Pharmacology found in the
suggested reading area.
4. Create the following “concept map”. List the pathophysiology associated with the patient’s disease process or
condition, the anticipated physical assessment findings, vital signs, diagnostics, specific nursing interventions,
and other patient information associated with the patient situation.
5. Utilize the smart sense links throughout the vSim to complete the worksheet.
6. Submit your concept map for review.

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 vSim for Nursing

CONCEPT MAP WORKSHEET

DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(Include Pathophysiology of Disease Process)

Osteoporosis- Metabolic bone disorder that is characterized by the loss of bone mass, increased bone fragility, and increased risk of fracture.
Associated with aging results from inadequate calcium intake. Woman are 4x more likely to to develop osteoporosis. Osteoporosis affects the
diaphysis of the bone and the metaphysics. The pathophysiology is not clear but it is known that there is an imbalance in the activity of the
osteoblasts to form new bone, and less activity of the osteoclasts reabsorbing old bone. Falling is one of the most common link to injury in an older
adult. Falls can lead to disabilities and long recovery time. Fall risks include fractures and broken bones, most commonly the hip.

DIAGNOSTIC TESTS PATIENT INFORMATION ANTICIPATED PHYSICAL FINDING

(Reason for Test and Results)
X-Ray of hip showing fracture and will
determine if surgery will be needed to fix
Bone Scan to find any fractures or breaks that
the c-ray did not show
PATIENT IS EDITH JACOBSON
FEMALE; 85 YEARS OLD; 152 CM IN HEIGHT AND
WEIGHS 47.6KG LOSS OF HEIGHT/ LENGTH IN LEG
DOB 9/20/1934 LIMITED ROM/ PAIN IN HIP
NO KNOWN ALLERGIES / FULL CODE STATUS
UNABLE TO MOVE OR WALK
MORSE SCALE ASSESSMENT FOR FALL RISK SCORE 45

ANTICIPATED NURSING INTERVENTIONS

BEST REST UNTIL SURGERY, AFTER SURGERY ASSESSMENT OF MOBILITY AND ADJUSTED THERAPY FOR RECOVERY
BONE DENSITY TESTING YEARLY
A CALCIUM RICH DIET, ADDED IN VITAMIN D SUPPLEMENT, SUN EXPOSURE, AND HEALTHY DIET CHOICES
KNOWING RISK FACTORS ASSOCIATED WITH OSTEOPOROSIS AND BEING ABLE TO IDENTIFY AND PREVENT THEM
MODIFY HOME AND ANY AT RISK ACTIVITIES TO DECREASE FALLING

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 vSim for Nursing

ISBAR ACTIVITY Est. Time: 30-60 Minutes

This ISBAR activity assists you in building the skill of communicating pertinent information when caring for a patient.
Appropriate actions you should do to complete this activity include finding appropriate data to provide a thorough ISBAR
report.

STUDENT LEARNING OUTCOMES

At the end of this activity, student will be able to:

1. Identify pertinent data from the patient information area of the vSim suggested reading section.
2. Communicate pertinent information for a patient using ISBAR.

ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management
system (LMS).
2. Review the information contained in the patient information area of the suggested reading section.
3. Review the smart sense links found within the Nursing Care, Diagnostics and Pharmacology areas of the
suggested reading.
4. Navigate and fill out the data in the following document using the patient information provided in the suggested
reading area.
5. Submit for review.

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 vSim for Nursing

VSIM ISBAR ACTIVITY Student Worksheet

INTRODUCTION Hello this is Rachael the RN in ortho taking care of Mrs. Jacobson in unit 1555.

Your name, position (RN),

unit you are working on

SITUATION
Patient’s name, age, specific
reason for visit
Mrs. Jacobson is an 85 year old Caucasian female that has been admitted last night after falling
and fracturing her hip. She had an Xray which showed a left interrochanteric hip fracture and she
has been scheduled tomorrow for surgery.

BACKGROUND The patient has a history of osteoporosis for the last ten years, she has had reported recent dizzy
spells.
Patient’s primary diagnosis,
date of admission, current
orders for patient

ASSESSMENT
Current pertinent
assessment data using head-
to-toe approach, pertinent
diagnostics, vital signs.
The patient has stable vitals and is being monitored for pain. Her pain is being controlled with
morphine every 4 hours as needed. She reports a pain level of 2. She was last given a dose of
morphine at 1400. Her skin is intact, color and sensation around the hip is within normal limits. A
morse fall scale has been performed on her and she received a score of 45. Fall precautions are in
place.

RECOMMENDATION The patient will need to be repositioned every 2 hours and a focused musculoskeletal assessment
performed. Safety should be reinforced to Mrs. Jacobson and education about fall risk. Pain level
assessment should be completed and medication administered as needed.
Any orders or
recommendations you may
have for this patient

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 vSim for Nursing

PHARM4FUN Est. Time: 30 Minutes (per medication)

This activity provides you with the opportunity to create pertinent patient education on the pharmacological agents
associated with the vSim activity. You will utilize this worksheet for each drug listed under the pharmacology area of the
suggested reading section.

STUDENT LEARNING OUTCOMES

At the end of this activity, student will be able to:

1. Explain purpose for taking the identified pharmacological agents.

1. Discuss pertinent patient education related to all the listed pharmacological agent.

ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instructions posted on your Learning
Management System (LMS).
2. Review the information contained in the patient information.
3. Review the smart sense links associated with the Pharmacological agents found in the suggested reading area.
4. Use the smart sense link to complete the following “patient education” worksheet for each pharmacological
agent listed in the Pharmacology are of the suggested reading section.
5. Submit for review..

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 vSim for Nursing

PATIENT EDUCATION WORKSHEET

NAME OF MEDICATION, CLASSIFICATION AND INCLUDE PROTOTYPE
MEDICATION: ENOXAPARIN SODIUM

CLASSIFICATION: ANTICOAGULANT

PROTOTYPE: LOVENOX

SAFE DOSE OR DOSE RANGE, SAFE ROUTE

Oral: 30mg every 12-24 hours after surgery or 40mg once a day starting 12 hours before surgery continue for 7-14 days
Injection: 30mg/0.3mL 40mg/0.4mL-prefilled syringes

PURPOSE FOR TAKING THIS MEDICATION

prevention of thromboembolism or DVT/PE

PATIENT EDUCATION WHILE TAKING THIS MEDICATION

Educate patient/ family for correct technique of self injecting and disposal of equipment
report any symptoms such as bleeding, bruising or dizziness
Do not take aspirin naproxen or ibuprofen while on this medication

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 vSim for Nursing

CLINICAL WORKSHEET

This activity creates an opportunity for you to prepare for a virtual clinical experience. This activity provides you with the
opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be delegated.

STUDENT LEARNING OUTCOMES

At the end of this, student will be able to:
1. Describe pathological events associated with the patient’s disease process or condition.
2. Create a plan of care that is prioritized and is based on the patient’s care needs.
3. Identifies path to healing or health and path to death or injury.
4. Describes aspects of care that can be delegated and appropriate personnel to complete delegated tasks.

ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instructions posted on your learning management
system (LMS).
2. Review the information contained in the patient information.
3. Review the smart sense links associated with the Nursing Care, Diagnostics, and Pharmacology, found in the
suggested reading area.
4. Complete all areas of the attached clinical worksheet.
5. Submit the completed worksheet.

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VSIM WORKSHEETS GRADING RUBRIC
5 Points 4 Points
dge • Follows all • Follows all
requirements for the requirements for the
assignment. assignment.
• Major points of topic are
• Conveys well-rounded
mostly covered in the
knowledge of the topic.
required assignment
• Content well organized,
areas.
logical.
• Content organized,
• Easy to read and
logical flow.
understand throughout
• Easy to read and
all of worksheet.
understand through
most of worksheet.
• Concisely explains • Explains each content
each content area. area.
• Analyzes information,
• Presents information
connects data points to
about the topic.
provide accurate,
• Some analysis, insight
concise information.
present, some data
• Scholarly work.
points threaded
together.
• Scholarly work.
• An occasional spelling • Some minor errors (1-3
error present. errors) with spelling,
• Grammar, readability, grammar and/or
sentence structure, not
and sentence structure
consistent throughout
is error free. worksheet.
• Errors do not interfere
with the readability or
comprehension of
information.
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vSim for Nursing
3 Points 2 Points 1 point
• Knowledge of topic is • Knowledge of topic is • Knowledge of topic
partially covered. general in more than is general
• Key information is three areas of the throughout entire
missing from 2 or more worksheet, and/or
worksheet.
assignment areas. does not cover all
• One or more areas of the required
• Worksheet difficult to
worksheet left blank. assignment areas.
follow in two or more
• Content unorganized
areas. • Two or more areas
throughout worksheet.
• Information is • Left blank on
• Difficult to understand
incomplete in two or worksheet.
content of paper.
more areas. • Unable to follow flow
of worksheet.
• Major aspects of the • Few aspects of the • Information is basic.
content areas are content areas presented. • No aspects of the con
presented, but content • Few insights presented, present in the worksh
lacks insight and lacking analysis. • Lacks insight, analysi
analysis. and conclusions.
• Data points not
• Few data points connected to information • No understanding fro
connected to provide the content presented
provided.
information.
• Little Understanding
gained from information
presented.
• Frequent errors (4-5 • Numerous errors (5-6 • Excessive errors
errors) with spelling, errors) with spelling, (>6 errors) occur
with spelling,
grammar and/or grammar and/or
grammar and/or
sentence structure. sentence structure
sentence
• Errors effect ability to throughout worksheet. structure,
comprehend throughout
information present on • Difficult to understand
worksheet.
worksheet and information presented
• Unable to understand
readability. due to numerous errors.
• information presented
in the worksheet.
TOTAL POINTS: _____
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 vSim for Nursing
CLINICAL WORKSHEET
Date: Student Assigned
Name: vSim:

Initials: EJ Diagnosis: HCP: Isolation: IV Type: Critical Labs: Other Services

Age: Hip fracture Standard right hand Nutrition and PT

85 Precautions Complete blood
years count,
old chemistry
panel,
M/F: Length of Stay: 3 Fall Risk: yes Location: Ortho coagulation
Femal days unit screening,
e blood type and
screening.
Code Status: Consults: Consults Needed:
Full Code Allergies: No Transfer: Fluid/Rate:
Status allergies 84mL /hr

Why is your patient in the hospital (Answer in your own words and include the History of present illness)? The
patient Presents with a fractured hip and osteoporosis and is in the hospital after taking a fall. The patient is scheduled to
have surgery tomorrow.
Health History/Comorbidities (that relate to this hospitalization): Has been diagnosed with osteoporosis for the past ten
years. Patient has been experiencing spells of dizziness.

Shift Goals/ Patient Education Needs:

1. Pain education - Teach patient ways to manage pain
2. Infection Risk- no infection during duration at hospital
3. Head to Toe assessment/ turn patient every two hours
4. Educate patient on falls and safety

Path to Discharge: Patient and family education on diagnosis, prognosis and treatment plan. Medial team plan of care
for patient, education on plan and outcome. List of medications and education. Answering all questions patient and family
have before discharge. Making sure patient understands proper wound care and healing.
Path to Death or Injury: Understand patients current status and mental status after injury and how injury will affect the
patient longs term and short term. Provide patient with options for help if needed.

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 vSim for Nursing

CLINICAL WORKSHEET
Alerts:

What are you on Alert for with this patient? (Signs & Management of Care: What needs to be done for this Patient
Symptoms) Today?
1. Fall Risk/ Monitoring 1. Vitals
2. Infection 2. Head to toe assessment
3. 3. Muscular skeletal focused assessment
4. Neuro Assessment
5. Pain Management
What Assessments will you focus on for this patient? 6. Medication
(How will I identify the above signs & symptoms?)
1. Head to toe
2. Muuscularskelatal assessment
3. Medication Management

List Complications may occur related to dx, procedure, Priorities for Managing the Patient’s Care Today
comorbidities:
1. 1. Maintain comfort
2. 2. Reduce and maintain pain

1. 1. Turn patient/ reposition every 2 hours

What nursing or medical interventions may prevent the What aspects of the patient care can be Delegated and who
above alert or complications? can do it?
1. 1.
2. 2.
3. 3.

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 vSim for Nursing

GRADING RUBRIC FOR DOCUCARE ENTRY: VSIM

Purpose: This rubric analyzes the components of the electronic health record that students
would utilize when documenting the care of a patient during a simulated event.
Components: Each criterion contains performance criteria to demonstrate the critical thinking
and clinical reasoning utilized during a simulated patient care encounter. The performance
criteria describe the traits that are linked to a level of performance. There are four levels of
performance as well as a “not applicable” column. The levels of performance indicate the
degree to which the student documented the events of the simulated patient care situation.
Using the Rubric:
➢ Students: Prior to the simulation experience, the students can use the rubric to prepare
for the documentation requirements associated with a simulated experience. The
emphasis on thorough, systematic documentation of the nursing care provided during the
simulation will facilitate clinical reasoning and critical thinking development. The
student can utilize the rubric to perform a self-assessment of their documentation of the
simulated events prior to submitting their DocuCare assignment. The rubric provides
transparency related to the expectations for documentation and the grading of the
student’s submitted work.
➢ Faculty: The simulation documentation is only graded in whole numbers. The minimum
accepted score is an 80%. The student will need to resubmit the simulation
documentation if the total percentage is less than 80%. The student receives one attempt
to remediate and edit their documentation.

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Patient Information:
Demographics, Diagnosis,
Allergies, Provider,
Consults, Isolation, Fall
Risk, Intravenous Therapy,
Medical History:
Why patient is in the
hospital, History of present
Illness, Past
Patient Education/Goals:
Shift Goals, Patient
Education Needs
Disease Progression:
Pathway to Death or
Injury Pathway to
Health
AACIP:
Alerts, Assessments,
Complications,
Interventions and
Nursing Care Plan:
Management of Care,
Priorities for Patient Care,
Delegation
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RUBRIC FOR GRADING VSIM CLINICAL WORKSHEET
All documented areas 100%
complete and provide thorough
information.
100% of HPI, Past
Medical/Surgical History and
Comorbidity Factors completed
with thorough, relevant
information.
Thorough and detailed patient
education. Patient shift. goals
are SMART, relevant, and
detailed goals. 100% of
worksheet area is complete.
Pathway to death and health is
identified with detail. Information is
concise, relevant, accurate and
portraits appropriate timeframe for
occurrence. 100% of the information
Alerts, Assessments,
Complications and
Interventions/Preventions
identified thoroughly. Answers
Management of Care is
relevant to case scenario
and detailed. Priorities for
scenario are identified.
Identifies all aspects of
care that can be delegated
and identifies appropriate
vSim for Nursing
Three listed
areas completed
OR documented
areas 75%
complete.
75% of HPI, Past
Medical/Surgical History and
Comorbidity Factors completed.
Information relevant to
scenario.
Provides patient education but
lacks thoroughness or details.
Patient shift goals missing 1-2
components of SMART goals. 75%
of information needed for
Pathway to death and health is
identified. Information is
relevant and accurate. Missing
timeframe for occurrence. 75%
of information needed for
Alerts, Assessments,
Complications and
Interventions/Preventions
identified. Most answers
Management of Care,
Priorities or delegation
sections relevant to
scenario. Answers generic
to situation. Some evidence
of critical thinking present.
Less than three listed area
completed OR documented
areas less than 50%
completed.
50% of HPI, Past
Medical/Surgical History
and Comorbidity Factors
completed. Information
basic and lacks relevancy.
Patient education lacks
thoroughness and details.
Patient shift goals missing
– 4 components of SMART
goals. 50% of the informati
Missing over 50% of neede
information for worksheet
area present. Pathway to
death and health identified
but content either not relev
Missing 2 – 3 areas on
worksheet. Answers not
relevant to scenario. 50%
of the information needed
Missing relevant data
in one or more
categories
(management of care,
prioritization,
delegation). Answers
basic without detail.
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 vSim for Nursing

LASATER CLINICAL JUDGMENT RUBRIC FOR VSIM FOR NURSING

Purpose: This rubric analyzes the components of the stages of clinical judgment formation. It
identifies multiple criterion and sub-criterion associated with the different levels of clinical
judgement formation. The Lasater Clinical Judgment Rubric allows faculty to analyze student
performances and identify what level of clinical judgment formation the student is exhibiting.

Components: Each criterion contains performance criteria to demonstrate the clinical

judgment level of performance related to the actions taken by the student during the vSim for
Nursing simulated event. The performance criteria describe the traits that are linked to a level
of performance. There are four levels of performance: Beginning, Developing, Accomplished
and Exemplary. The levels of performance indicate the degree to which the student utilized
clinical judgment during the vSim for Nursing activity.
Using the Rubric:
➢ Students: Prior to the simulation experience, the students can use the rubric to review
the different levels of clinical judgment and the defining characteristics for the sub-
criterion found within the rubric. The student can utilize the rubric to perform a self-
assessment of their clinical judgment skills after completing the vSim for Nursing
activity. This self-assessment then can be compared with the instructor’s assessment of
the student’s clinical judgment formation.. The rubric provides transparency related to
the defining characteristics of the different levels of clinical judgment.

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LASATER CLINICAL JUDGMENT RUBRIC FOR VSIM FOR NURSING
Exemplary (20-25)
gularly recognizes subtle
anges and obvious
anges in patient’s objective
d subjective data
cuses on the most relevant
d important data; able to
ke sense of patterns,
tify interventions
erventions are tailored for
individual patient;
nitors patient and is able to
ust treatment as indicated;
monstrates safety at all
es
aluates and analyzes
formance, elaborating on
ernatives; accurately
ntifies strengths and
aknesses and develops
ecific plans to eliminate
aknesses
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Accomplished (13-19)
Recognizes most obvious
patterns and deviations in
data; may miss the most
subtle
Generally focuses and
interprets the most important
data but also attends to less
pertinent data
Completes interventions on
the basis of relevant data;
monitors patient but does not
expect to have to change
treatments; could improve
accuracy
Evaluates and analyzes
performance, alternatives are
identified; identifies strengths
and weaknesses; could be
more systematic in evaluating
weaknesses
Developing (7-12)
Identifies obvious patterns
and deviations in data;
missing some important
information
Makes an effort to prioritize
data and interpret, but attends data are most important; has
to less relevant or useful data difficulty interpreting or
Completes interventions on
the basis of the most obvious
data; monitors progress but
unable to make adjustments
as indicated by the patient’s
response
Demonstrates awareness of
the need for ongoing
improvement; makes some
effort to learn from experience
but tends to state the obvious
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vSim for Nursing
Beginning (0-6) Score
Fails to collect important /25
subjective and objective data;
misses most patterns and
deviations from expectations
Appears not to know which /25
making sense of data
Focuses on a single /25
intervention; some monitoring
may occur; unable to select
interventions; demonstrates
unsafe practice
Appears uninterested in /25
improving performance; is
uncritical or overly critical of
self; unable to see flaws or
need for improvement
/100