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Table 1 Outline of VP scenarios in VSPR

From: Exploring undergraduate nursing student interactions with virtual patients to develop ‘non-technical skills’ through case study methodology

VP title

VP topic

Positive patient outcomes

Negative patient outcomes.

Target learner audience


Preventing patient falls in the clinical practice setting.

Patient assisted to toilet. Patient discharged 2 days later.

Patient falls when toileting independently. Sustains laceration to forehead, fractured right neck of femur and head injury. Patient remained in hospital for several weeks for treatment and rehabilitation.

Novice learner

Ward round

Interprofessional teamwork including patient as a member of the team.

Correct diagnosis and management and patient commenced on appropriate medication. Patient discharged 3 days later.

Incorrect diagnosis and management. Patient experiences acute pulmonary oedema and requires emergency medical team intervention. Patient admitted to high-dependency unit and follow-up rehabilitation for several weeks.

Advanced beginner

Aggressive patients

Recognising and responding to aggression.

Patient frustration and agitation correctly identified and managed resulting in de-escalation of the situation.

Patient frustration and agitation is not recognised. Patient behaviour escalates into aggressive violent outburst. Security measures are required to manage patient situation.

Advanced beginner


Managing warfarin therapy in the community post coronary artery bypass grafts.

Patient receiving warfarin therapy has high International Normalised Ratio identified and emergency medical treatment instigated.

High international normalised ratio not identified. Patient sent home from clinic with no emergency treatment. Patient experiences large cerebral haemorrhage and dies shortly after.

Advanced beginner

Administering blood products

Risks associated with administering blood products in the clinical setting.

Incorrect patient identification is recognised. Correct patient is located and verified. Blood product administration proceeds without incident.

Following incorrect patient identification, wrong patient administered blood product. Patient experiences severe haemolytic transfusion reaction and admitted to intensive care unit.

Advanced beginner


Recognising and responding to patient deterioration in the immediate post-operative period.

Patterns and trends are recognised early with appropriate treatment implemented. Normal fluid balance returned in post-operative phase.

Patterns and trends are not recognised and no treatment implemented. Patient experiences acute kidney injury post-operatively.



Woman with epidural analgesia in labour experiences episode of hypotension.

A pathological fetal heart rate pattern is detected following episode of hypotension. Fluid resuscitation is initiated and a change to maternal position. Normal vaginal birth.

There is a delay in recognising, reporting and responding to a pathological fetal heart rate pattern. Fetal compromise ensues resulting in emergency caesarean section and neonate resuscitation.