Patient Introduction
Carl Shapiro is a 54-year-old male who travels frequently. He was seen in the Emergency Department at 1:30 p.m. for complaints of chest pain, diaphoresis, and shortness of breath. He was treated in the Emergency Department with aspirin and two doses of sublingual nitroglycerin. Chest pain improved with nitroglycerin administration. IV infusion of normal saline was started in the Emergency Department and is running at 25 mL/hour. Ordered lab values are pending. Provider wants to be called as soon as the labs are available. Patient is receiving oxygen at 4 L/min with SpO2 values at 97%. Chest pain was last rated as a “0” following second nitroglycerin dose and nitroglycerine patch 0.4 mg. He has been admitted to the Telemetry Unit.
STUDENT
CLINICAL
REPLACEMENT
PACKET
Student Resources
2
vSim CLINICAL REPLACEMENT PACKET for STUDENTS
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 additon to this Clinical Replacement Activity Packet, submit for grading as instructed in your syllabus.
LEARN FLOW – STEP ONE
Finish the Suggested Readings, then complete the following four activities:
o Clinical Worksheet
o Plan of Care Concept Map
o Pharm4Fun Worksheet (one per medication)
o ISBAR Worksheet
EST. TIME: 4 –
6
HOURS
LEARN FLOW – STEP TWO
Take the Pre-Simulation Quiz
o 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
o Suggest student complete the vSim Tutorial prior to launching Step Three.
o Each clinical experience in the simulation lasts a maximum of 30 minutes.
o Student is to complete the simulation as many times as it takes to meet an 80% benchmark.
LEARN FLOW – STEP FOUR
Complete the Post-Quiz
o The answer key is not visible to the student until after they have submitted the quiz.
o The quiz grade is recorded as a percentage
LEARN FLOW – STEP FIVE
Document
o The student documents the clinical events that occurred during the simulation
using the information contained in step five.
o If using DocuCare, the instructor assigns the same vSim patient which can be
found in DocuCare cases.
LEARN FLOW – STEP SIX
Reflection Questions
o Students are to complete the reflection questions and submit to instructor post
clinical replacement (see syllabus for details).
o The quiz grade is recorded as a percentage
2
1
3
4
5
6
STUDENT LEARNING OUTCOMES
ASSIGNMENT
This ac�vity creates an opportunity for you to organize the nursing care required for the pa�ent care
presented in your assigned vSim.
At the end of this ac�vity, student will be able to:
1. Describe pathological events associated with the pa�ent’s disease process or condi�on.
2. Create a plan of care and priori�zed nursing interven�ons based on pa�ent care needs.
3. Iden�fy an�cipated diagnos�c and physical assessment findings related to the iden�fied
condition or disease process.
1. Log into thePoint and launch the assigned vSim, following all instruc�ons posted on your learning
management system (LMS).
2. Review the informa�on contained in the pa�ent informa�on.
3. Review the smart sense links associated with Nursing Care, Diagnos�cs, and Pharmacology found in the
suggested reading area.
4. Create the following “concept map”. List the pathophysiology associated with the pa�ent’s disease
process or condi�on, the an�cipated physical assessment findings, vital signs, diagnos�cs, specific
nursing interven�ons, and other pa�ent informa�on associated with the pa�ent situa�on.
5. U�lize the smart sense links throughout the vSim to complete the worksheet.
6. Submit your concept map for review.
CONCEPT MAP/ PLAN OF CARE EST. TIME: 30 MINUTES
DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
CONCEPT MAP WORKSHEET
DIAGNOSTIC TESTS
(REASON FOR TEST AND RESULTS)
PATIENT INFORMATION ANTICIPATED PHYSICAL
FINDINGS
ANTICIPATED NURSING INTERVENTIONS
IS AR EST TIME MIN
This SBAR ac�vity assists you in building the skill of communica�ng per�nent informa�on when caring for a
pa�ent. Appropriate ac�ons you should do to complete this ac�vity include finding appropriate data to provide a
thorough SBAR report.
STUDENT LEARNING OUTCOMES
At the end of this ac�vity, student will be able to:
1. Iden�fy per�nent data from the pa�ent informa�on area of the vSim suggested reading sec�on.
2. Communicate per�nent informa�on for a pa�ent using ISBAR.
ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instruc�ons posted on your learning
management system (LMS).
2. Review the informa�on contained in the pa�ent informa�on area of the suggested reading sec�on.
3. Review the smart sense links found within the Nursing Care, Diagnos�cs and Pharmacology areas of the
suggested reading.
4. Navigate and fill out the data in the following document using the pa�ent informa�on provided in the
suggested reading area.
5. Submit for review.
INTRODUCTION
vSim ISBAR ACTIVITY
Your name, posi�on (RN), unit you are
working on
SITUATION
Pa�ent’s name, age, specific reason for visit
BACKGROUND
Pa�ent’s primary diagnosis, date of
admission, current orders for pa�ent
ASSESSMENT
Current per�nent assessment data using head
to toe approach, per�nent diagnos�cs, vital
signs
RECOMMENDATION
Any orders or recommenda�ons you may
have for this pa�ent
STUDENT WORKSHEET
PHARM-4-FUN EST. TIME: 30 MIN (PER MEDICATION)
This ac�vity provides you with the opportunity to create per�nent pa�ent educa�on on the
pharmacological agents associated with the vSim ac�vity. You will u�lize this worksheet for each drug
listed under the pharmacology are of the suggested reading sec�on.
STUDENT LEARNING OUTCOMES
At the end of this ac�vity, student will be able to:
1. Explain purpose for taking the iden�fied pharmacological agents.
2. Discuss per�nent pa�ent educa�on related to all the listed pharmacological agent.
ASSIGNMENT
1. Log into thePoint and launch the assigned vSim, following all instruc�ons posted on your learning
management system (LMS).
2. Review the informa�on contained in the pa�ent informa�on.
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 “pa�ent educa�on” worksheet for each
pharmacological agent listed in the Pharmacology are of the suggested reading sec�on.
5. Submit for review.
PATIENT EDUCATION WORKSHEET
NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE
MEDICATION:
CLASSIFICATION:
PROTOTYPE:
SAFE DOSE OR DOSE RANGE, SAFE ROUTE
PURPOSE FOR TAKING THIS MEDICATION
PATIENT EDUCATION WHILE TAKING THIS MEDICATION
STUDENT LEARNING OUTCOMES
ASSIGNMENT
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.
At the end of this ac�vity, 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.
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.
CLINICAL WORKSHEET
vSim Worksheets Grading Rubric
Criteria 5 Points 4 Points 3 Points 2 Points 1 point Total Points
Content
Knowledge
-Follows all requirements for
the assignment.
-Conveys well-rounded
knowledge of the topic.
-Content well organized,
logical.
-Easy to read and understand
throughout all of worksheet.
-Follows all requirements
for the assignment.
-Major points of topic are
mostly covered in the
required assignment areas.
-Content organized, logical
flow.
-Easy to read and
understand through most
of worksheet.
-Knowledge of topic is
par�ally covered.
-Key informa�on is missing
from 2 or more assignment
areas.
-Worksheet difficult to follow
in two or more areas.
-Informa�on is incomplete in
two or more areas.
– Knowledge of topic is
general in more than
three areas of the
worksheet.
– 1 or more areas of
worksheet le� blank.
-Content unorganized
throughout worksheet.
-Difficult to understand
content of paper.
-Knowledge of topic is
general throughout
en�re worksheet,
and/or does not cover
all the required
assignment areas.
-Two or more areas le�
blank on worksheet.
-Unable to follow flow of
worksheet.
Cri�cal
Thinking
-Concisely explains each
content area.
-Analyzes informa�on,
connects data points to
provide accurate, concise
informa�on.
-Scholarly work.
-Explains each content
area.
-Presents informa�on
about the topic.
-Some analysis, insight
present, some data points
threaded together.
-Scholarly work. -Major aspects of the
content areas are presented,
but content lacks insight and
analysis.
-Few data points connected
to provide informa�on.
-Few aspects of the
content areas presented.
Few insights presented,
lacking analysis.
-Data points not
connected to informa�on
provided.
-Li�le understanding
gained from informa�on
presented.
-Informa�on is basic.
-No aspects of the
content present in the
worksheet.
-Lacks insight, analysis,
and conclusions.
-No understanding from
the content presented.
Wri�ng
Composi�on
(Spelling,
Grammar,
Sentence
Structure)
-An occasional spelling error
present.
-Grammar, readability, and
sentence structure is error
free.
-Some minor errors (1-3
errors) with spelling,
grammar and/or sentence
structure, not consistent
throughout worksheet.
-Errors do not interfere
with the readability or
comprehension of
informa�on.
-Frequent errors (4-5 errors)
with spelling, grammar
and/or sentence structure.
-Errors effect ability to
comprehend informa�on
present on worksheet and
readability.
-Numerous errors (5-6
errors) with spelling,
grammar and/or
sentence structure
throughout worksheet.
-Difficult to understand
informa�on presented
due to numerous errors.
-Excessive errors (>6
errors) occur with
spelling, grammar
and/or sentence
structure, throughout
worksheet.
-Unable to understand
informa�on presented in
the worksheet.
Total Points:_________
Clinical Worksheet
Date: ________________________ Student Name: _____________________________ Assigned vSim: ___________________________
Initials:
Age:
M/F:
Code Status:
Diagnosis:
Length of Stay:
Allergies:
HCP:
Consults:
Isolation:
Fall Risk:
Transfer:
IV Type:
Location:
Fluid/Rate:
Critical Labs: Other Services:
Consults Needed:
Why is your patient in the hospital (Answer in your own words and include the History of present Illness):
Health History/Comorbities (that relate to this hospitalization):
Shift Goals/ Patient Education Needs:
1.
2.
3.
4.
Path to Discharge:
Path to Death or Injury:
Clinical Worksheet
Alerts:
What are you on alert for with this patient? (Signs & Symptoms)
1.
2.
3.
What Assessments will focus on for this patient?
(How will I identify the above signs &Symptoms?)
1.
2.
3.
List Complications may occur related to dx, procedure, comorbidities:
1.
2.
3.
What nursing or medical interventions may prevent the above Alert or complications?
1.
2.
3.
4.
Management of Care: What needs to be done for this Patient Today?
1.
2.
3.
4.
5.
6.
Priorities for Managing the Patient’s Care Today
1.
2.
3.
4.
What aspects of the patient care can be Delegated and who can do it?
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.
Grading Rubric for DocuCare Entry: vSim
Rubric for Grading vSim Clinical Worksheet
5 3 1 0
Patient Information:
Demographics, Diagnosis,
Allergies, Provider, Consults,
Isolation, Fall Risk, Intravenous
Therapy, Critical Labs, Services
and Needed Consults
All documented areas 100% complete and
provide thorough information.
Three listed areas completed OR
documented areas 75% complete.
Less than three listed areas completed
OR documented areas less than 50%
completed.
Patient information area blank.
Medical History:
Why patient is in the hospital,
History of present Illness, Past
Medical/Surgical History,
Comorbidity Factors
100% of HPI, Past Medical/Surgical
History and Comorbidity Factors
completed with thorough, relevant
information.
75% of HPI, Past Medical/Surgical History
and Comorbidity Factors completed.
Information relevant to scenario.
50% of HPI, Past Medical/Surgical
History and Comorbidity Factors
completed. Information basic and lacks
relevancy.
25% of HPI, Past Medical/Surgical
History and Comorbidity Factors
completed. Information not
relevant, or content areas left blank,
Patient Education/Goals:
Shift Goals, Patient Education
Needs
Thorough and detailed patient education.
Patient shift. goals are SMART, relevant,
and detailed goals. 100% of worksheet
area is complete.
Provides patient education but lacks
thoroughness or details. Patient shift
goals missing 1-2 components of SMART
goals. 75% of information needed for
worksheet area present.
Patient education lacks thoroughness
and details. Patient shift goals missing 3
– 4 components of SMART goals. 50%
of the information needed for worksheet
area present.
Missing patient education and/or
patient shift goals. Patient shift
goals lack all components of
SMART goals. 25% of the
information needed for worksheet
area present.
Disease Progression:
Pathway to Death or Injury
Pathway to Health
Pathway to death and health is identified
with detail. Information is concise, relevant,
accurate and portraits appropriate
timeframe for occurrence. 100% of the
information needed for worksheet present.
Pathway to death and health is identified.
Information is relevant and accurate.
Missing timeframe for occurrence. 75% of
information needed for worksheet area
present.
Missing over 50% of needed information
for worksheet area present. Pathway to
death and health identified but content
either not relevant or accurate for
situation present in scenario.
Pathway to death and health
contains information not relevant or
accurate to the scenario or section
left blank.
AACIP:
Alerts, Assessments,
Complications, Interventions
and Prevention
Alerts, Assessments, Complications and
Interventions/Preventions identified
thoroughly. Answers relevant to scenario.
100% of the information needed is present.
Alerts, Assessments, Complications and
Interventions/Preventions identified. Most
answers relevant to scenario. 75% of the
information needed for worksheet area
present.
Missing 2 – 3 areas on worksheet.
Answers not relevant to scenario. 50%
of the information needed is present.
Missing 4 or more areas on
worksheet. Answers not relevant to
scenario. 25% of the information
needed for worksheet area is
present.
Nursing Care Plan:
Management of Care, Priorities
for Patient Care, Delegation
Management of Care relevant to case
scenario and detailed. Priorities for
scenario identified. Identifies all aspects of
care that can be delegated and identifies
appropriate personnel to delegate activities
to. Answers detailed, Critical thinking
evident.
Management of Care, Priorities or
delegation sections relevant to scenario.
Answers generic to situation. Some
evidence of critical thinking present.
Missing relevant data in one or more
categories (management of care,
prioritization, delegation). Answers basic
without detail. Little to no evidence of
critical thinking present.
Information provided not relevant to
scenario. Answers are basic
without detail. No evidence of
critical thinking. Missing answers in
one or more area.
TOTAL POINTS