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All virtual simulations are not created equal

July 26, 2022 | 3 min read

By Elsevier Connect contributors

Medical images superposed on the body of a nurse

Although in-person education and clinical time is still key, it may not be as meaningful on its own.

Learners may spend too much time observing versus doing—or interacting with the same types of patients again and again. Simply put, new nurses are not getting enough time to truly practice their clinical reasoning and therapeutic communication.

But what type of simulation provides the best outcomes for new graduate nurses?

There can be a large gap from what nurses learn in school to what they need to know in practice. One of the biggest challenges for nurse leaders is getting them prepared to provide quality patient care. Novice nurses typically lack sufficient practical experience with patient care and can fail to identify subtle changes in the patient condition causing them to miss the big picture—in fact, 40% of new graduate nurses report making medication errors [1].

While it’s clear that they need to log as much in-person education and clinical time as possible, it may not be enough. In those scenarios, new nurses may spend the bulk of their time watching instead of doing—a scenario that doesn’t help them truly sharpen their clinical reasoning or therapeutic communication skills. According to Elsevier’s market research [2], a significant number of nursing leaders believe simulation training would help round out their new nurse training program, and that it would be well-received by novice nurses.

  • 76% of nursing leaders believe that simulation training would help round out their nursing program

  • 88% of nursing leaders believe that simulation training would be well-received by novice nurses

Choosing the right simulation to complement in-person learning

Today, organizations have a wide range of simulations to choose from; however, certain types of approaches have proven more effective, particularly ones that offer high fidelity and a high level of interactivity for the learner. Virtual patient simulations have been found to be comparable or superior to other high-fidelity traditional simulation methods due to a variety of reasons.

An integrative review of 12 studies found that virtual patients and simulated scenarios were comparable or superior to traditional simulation methods for teaching diagnostic reasoning and assessment skills in terms of increased student learning, satisfaction, and engagement [3].

Support the needs of your organizations and improve practice readiness for novice nurses

With Elsevier’s Shadow Health, you can put the patient at the forefront of the learning experience with state-of-the-art, screen-based simulations. Your new nurses will work with virtual patients that have rich, complex personal and medical histories. These patients have been built to incorporate advanced diversity and inclusion principles, which can improve communication for healthcare professionals.

Although more and more hospitals are returning to in-person learning, they still need virtual simulation to enhance the learning experience, improve therapeutic communication skills, and strengthen critical thinking, which can often be underdeveloped, particularly in nurses new to the rigors of the clinical setting.

Ready to learn more about giving your new nurses unmatched experience interacting with patients from a wide range of backgrounds and experiences?


  1. del Bueno D. (2005). A Crisis in Critical Thinking. Nursing Education Perspective, 26(5) 278-282.

  2. Elsevier interviewed 14 and surveyed ~100 Executive/Director of Nursing Programs, Nurse Educators, Preceptors & Managers

  3. Duff, E., Miller, L., & Bruce, J. (2016). Online virtual simulation and diagnostic reasoning: A scoping review. Clinical Simulation in Nursing, 12(9) 377-384.


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Elsevier Connect contributors