Review of “vSim for Nursing (LPN/LVN)” by Laerdal Medical, Wolters Kluwer

Score: 93/100 (9.3 out of 10)

Are you a nursing student looking to get an edge on your SIM course(s)?
Want to practice your nursing skills from the comfort and convenience of your own home?

vSim for Nursing (LPN/LVN) is an innovative virtual simulation platform co-developed by Laerdal Medical and Wolters Kluwer! It is designed to enhance clinical reasoning skills, competence, and confidence among nursing students. By immersing learners in realistic patient scenarios, it offers a safe and accessible environment for practicing essential nursing interventions.

It functions a bit like a point-and-click video game, which is perfect for nursing students who just want to dip their feet in and learn at home. It requires no SIM dummy (like the ones Laerdal Medical also produces), no microphone, and no serious hardware—just you, your computer/laptop (with a speaker/sound output), and maybe a mouse!

That's a huge win in terms of convenience!

It's also quite a promising and effective program to practice nursing with.

Students engage with lifelike patient cases, allowing them to apply theoretical knowledge in practical settings. These scenarios are authored by the National League for Nursing (NLN), ensuring relevance and authenticity. By simulating real-world nursing scenarios, students can develop and refine their clinical judgment and decision-making skills in a controlled setting.

The platform provides access to pre- and post-simulation quizzes, suggested readings from reputable sources, documentation assignments compatible with Lippincott DocuCare, and guided reflection questions to promote critical thinking.

Actions taken during simulations are recorded, resulting in individualized feedback logs that help students identify strengths and areas for improvement.

Embedded throughout the simulation scenarios, “Smartsense” links offer instant access to evidence-based content from Lippincott Advisor and Lippincott Procedures, providing additional information at the point of learning.

For the most part, this program achieved its primary objectives. It succeeds at being a tool that nursing students can use to prepare for nursing practice.

At the same time, it left a lot of room for improvement, which we'll point out for the remainder of the review.

To give you context, let's look at a few of the SIM scenarios in vSim for Nursing (LPN/LVN).

The first SIM scenario is a relatively simple assessment of a patient named Vernon Russell, a stroke patient with a history of hypertension, coronary artery disease, and type-2 diabetes. The simplicity of this scenario is good because it helps the user to ease-into the program, sorta like a tutorial level. And a tutorial-level was much needed! Progressively—through questioning and assessments—the user realizes that Vernon is weaker on one side of his body (the left side), suggesting that he's still feeling the ill-effects of his stroke. It may also become apparent that his range of motion and overall health have been impacted by his smoking and lack of physical exercise.

Something that stood out to us about this scenario were the physical assessments. This scenario expects the user/nurse to assess all of the patients limbs: his arms (upper & lower), legs (upper & lower), and feet. We found this to be a little tedious (like, why couldn't we just inspect the upper & lower arms at the same time?), but then again, that may just be us being impatient and wanting to get to the action. It added maybe three to five minutes to the process, which kinda seemed like a small eternity.

It should be briefly noted that the user's view is from a top-down, third-person perspective. This is in stark contrast to the first-person, virtual-reality perspective of some of the software used in vSIM programs used in other nursing schools. At the same time, we honestly preferred this perspective. It was less... intimidating and creepy. One of the things about SIMs that may never not be creepy are the dummies. They look just life-like enough to represent a human patient, yet look distinctly non-human and non-living. It's the uncanny valley effect—an unsettling phenomenon.

At least with this vSIM, you don't have to face the dummy patient (and their lifeless eyes and disembodied sounds/voices) directly (like you would in class or with other vSIM programs). Instead, you get a little buffer, having a nurse/character model stand between you and the patient.

Also, while the patients (or nurses) don't look particularly great in video game or animation terms, they aren't terrible. At least they look sorta like living people (unlike the SIM dummies), albeit somewhat deformed ones at times, particularly with characters like Millie later on. These are maybe late-PS2 level graphics. Don't expect to be wowed by them. At the same time, users probably aren't here for the graphics, they're here to learn.

Hey, at least the characters blink. That's something we humorously only noticed in the Henry Williams scenario because his family kept staring right at us. 

Another thing that needs to be pointed out are the voices. There doesn't seem to be actual voice-acting in this program. All of the voices seem to be artificial. Think Stephen Hawking. Ok, maybe not that bad. They sound somewhat human and somewhat robotic.

As you might expect from artificial voices, they sometimes get the tone and emphasis wrong. There was a time working with a patient later on when they sounded annoyed out of nowhere (it was something like “Ok, fine then”) but it was likely because the artificial voice decided to place emphasis on a sound without needing to.

At least there are some characters, like Millie, who have accents. One of the nurses also has an accent (if we remember correctly). But they still sound a little robotic.

This does disrupt the immersion a bit, since the characters only sound somewhat human. We get it: voice-actors cost an arm and a leg, especially if you need multilingual ones for an international distribution. Maybe this could be updated with the latest AI voice technology—which is substantially better than the voices here?

There are also funny and strange lines. For example, if you inspect hair on a patient's limbs, your nurse might conclude something like, “The patient has fine hair.”

Obviously, this isn't something a real person in real life would say out loud, but it serves as exposition and provides the needed information.

One other thing that both comforted and bugged us was how the nurse always talks with the same monotonous tone of voice no matter what's happening. The patient could be dying, yet the nurse still says things blandly like, “Perhaps we should focus on resuscitation efforts” and “stand clear...”

On one hand, it teaches the user to stay calm and controlled. It also doesn't panic them in an emergency.

On the other hand, it seems to ignore the gravity of the situation.

At least patients and nurses give the user gentle hints and nudges when they make a poor choice. For example, if you try to inspect the oxygen on a patient who doesn't need supplemental oxygen, they say, “I don't take any supplemental oxygen. Should I?” If you try to inspect the wound dressings on a patient who doesn't have a wound or dressings, they'll say, “Do I have any dressings?” Humorously, this sometimes leads to your nurse revealing the patient's bare skin anyway, only to say, “No, you're right. Sorry.”

Something bizarre is how you can remove all of the oxygen therapy from a character like Lucy Grey, yet her oxygen level remains unchanged and she doesn't succumb to the lack of supply at all. That's a bit odd. You can even do all the assessments without washing your hands, putting on gloves, or even identifying the patient correctly, all of which are very dangerous. Yes, this will cause you to fail in the very end, but there doesn't seem to be any nudging or reprimanding along the way. Another dangerous thing your character is somehow allowed to do is administer sizable doses of epinephrine or morphine without reprimand (in the moment) or even a witness. Again: shouldn't there be more consequences for these actions? Like, imagine if the police or security entered the room and escorted the nurse away.

Anyway...

There are “Helpful Tips” a the bottom before each SIM scenario begins, so make sure you read those along with the briefing! It helps. Thankfully, there's also a big, shiny green “X” button at the bottom of fields that you can click out of, so that's idiot-proof.

However, what's unfortunate is that it's really easy to lose your progress in a scenario, and you might end up having to do it all over again. Say you accidentally click the “X” on your tab, closing it. Well, that scenario's progress is lost. The system doesn't seem to save for you. You have to start the scenario over—every question, every physical assessment, washing hands, identifying the patient, putting on gloves, etc. See how that can get a bit tedious and frustrating? Imagine if you were two or three tasks away from completing the scenario, then your laptop's battery died or you accidentally closed the tab. Well, it's back to the beginning for you.

Another way in which that impacts the user is that it's harder to reach the post-simulation quiz and debriefing because of that. Honestly, we sometimes found ourselves never reaching the post-SIM quiz and debriefing because we'd get to the end of scenario (at 75+%) and it would lock for some reason. Oh, well, it's not the biggest deal. We're here for the vSIM, not the quiz and reading stuff (which you could probably do on Quizlet or a textbook anyway), but it's still a bit of a hindrance.

At least if you get stuck or confused, you can access the “Search” feature by the seeing-eye glass. That's helpful, especially considering that there are tabs on top of tabs on top of tabs like it's a 1990s RPG game at times. If you want to ask a specific question, you need to go to a certain tab, then scroll down and look for it, or you can type it in the “Search” field. It's like the testers realized they had a problem with over-complexity on their hands and decided to insert a “Search” feature. The same can be said for the aforementioned shiny-green-X. At least they addressed/patched some of the issues.

Anyway, moving on... Let's talk about the Millie Larsen Gerontology scenario for a bit. We were looking for a challenging scenario which might mirror real-life issues. In this case, Millie Larsen was an elderly patient suffering from confusion and urinary tract infection. She came to the hospital with her daughter, Dina, at her side.

At first, we were ready for a challenge. We were braced. In real life, the family of patients can provide some unique challenges like questioning what you are doing and if you should be doing it. Unfortunately, Dina (the daughter) didn't seem to do much. Yes, she looked in the same direction that Millie did, but she didn't seem to object or try to stop us from doing things like some family members might. For example, when we insert the IV or prick her finger to test her glucose, neither she nor Millie objected. In real life, a patient like this might have serious objections!

Keep in mind, Millie literally starts this scenario by saying that she doesn't think she needs to be in the hospital and can treat herself at home. However, that whole attitude is mostly gone for the rest of the scenario. She just agrees with you, saying, “Ok” and “that's fine” like the other patients do.

That was a bit strange. We expected more push back.

Maybe we didn't ask enough of the wrong questions or do enough of the wrong assessments to get on her (or her daughter's) nerves.

On one hand, we thought this was a huge missed opportunity.
On the other hand, we're grateful that this warped-looking crazy lady didn't come at us like a geriatric female slasher in a horror movie! We would've jumped!

At least in the Henry Williams scenario, his wife and daughter chime in from time to time, and Henry objects to them, saying that what they're saying makes him nervous. That's pretty interesting. 

We wanted to briefly mention that one of the coolest yet underutilized features of this software is the "Interprofessional Communication" function, which is supposed to allow you to contact the provider, physical therapist, rehab center, home health, ICU, or even the funeral home! Honestly, we didn't really have opportunities to utilize most of these and are morbidly curious when we'd be able to. 

Anyway, there are ten scenarios in this vSIM software, all with their own unique angles and areas of emphasis.

However, perhaps the one that shocked and surprised us the most was the last one—and we're grateful for that! The last scenario is a Medical-Surgical scenario involving a man named Carl Shapiro. He came to the ER complaining of chest pain and shortness of breath. We're not sure what we did to trigger it—if we may have taken too long, perhaps—or if it was preprogrammed to happen, but Carl suddenly starts fading!

He goes from speaking rather calmly and normally to saying, “I don't feel very good...” He then seems to stop breathing all of a sudden!

The user is then challenged with one of the scariest scenarios for any healthcare provider: a patient is dying, what do you do?

This is an actual thing that happens in hospitals, more often than healthcare providers would like to admit. A seemingly-healthy individual might just have their eyes roll back all of a sudden. They might start convulsing, clutching at their chest, foaming at the mouth, shaking, struggling to breath, or stop breathing altogether. But the question remains: what do you do?

Do you call the “Code Blue” (emergency team)? Do you start doing CPR? Do you use the Automated External Defibrillator (AED)? Do you administer oxygen via the nasal canulla or breathing mask?

These are all good to know! And thankfully, this scenario challenges the user to keep their composer and do what needs to be done for the life and safety of the patient.

One of the best things about this vSIM program is that it points out the precise things you did wrong and right, as well as pointing out areas for improvement. For example, if you missed or forgot to do something, the SIM will highlight that at the end of the scenario so you can do it in the retry.

This really gives meaning to the concept of learning from your mistakes!

Check it out HERE!