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Virtual Pain Manager (VPM)

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The Virtual Pain Manager (VPM) is a simulation of a patient control analgesia (PCA) machine, and teaches both the use of the machine and the provision of associated nursing care in a hospital setting. Naturally, student nurses cannot be allowed free rein of real patients as the risks are too great. They cannot be allowed to make mistakes with the health of real people. However, in the virtual world they are free to make mistakes and—crucially—learn from them in an environment in which no harm can be done. There is great value in being able to learn from your mistakes, and often more may be learnt from understanding an error than through success. Scenario VPM allows student nurses to experience a clinical situation which in real life they would not be able to undertake: managing acute pain in a postoperative surgical setting. VPM is designed to follow lectures on the theory of pain management. In the simulation, students adopt the role of a nurse who has been assigned to a patient who is in pain, having returned from an operating theatre. It is the nurses’ responsibility to reduce the pain to an acceptable level and keep the pain level controlled, so that the PCA unit can be withdrawn and the patient given oral analgesia instead. Complications such as chest infections, DVT, pneumonia and respiratory arrest can occur as result of poor patient care, sometimes with fatal results. The occurrence of complications represents failure for the user, with feedback given regarding the nature of the complication and the consequences for both patient and nurse. Success is judged on achieving the conditions for withdrawal of the PCA unit: pain is at a comfortable level; pain is stabilised; and the patient is not requesting doses of analgesia from the PCA unit. Ideally, the nurse should establish these conditions within 48 (simulated) hours to succeed. If this situation has not been reached within 72 (simulated) hours, the simulation terminates and the student is judged to have failed in the care of the patient. The virtual world Behind the scenes of VPM is a robust model of interactions between human organs, pain, pharmaceuticals and psychology. The model has been developed with great care and accuracy to replicate the processes at work in the human body. Where real-world calculations and data exist for these interactions they have been employed within the model. VPM has even prompted questions for further research, such as an investigation into the psychology of the use of the PCA unit. Delivering such complex learning in an engaging manner would be unachievable without a high fidelity, interactive simulation such as VPM. As there was no empirical model as a basis for the simulation, the academic on this project, Gareth Parsons, used his considerable knowledge and experience to develop an appropriate model. The learning experience In using a computer-based learning package, student nurses can replay the VPM simulation time after time, varying their strategy, analysing the strengths and weakness of different approaches and developing best practice. As they do so, the student nurses become increasingly engaged in the simulation and the care of their patient: “The first time my patient died and the second he was fine felt bad the first time, like I had failed I would have carried on reapeating[sic] it until I had a surviver[sic] lol” The comments we have received from student nurses (and qualified nurses who have tested VPM) has been very positive: “…enables us to assess our abilities within an environment which is safe to do so, is good for our confidence and may identify areas in which we need to develop better skills.” “I think it is great… it helps us put the theory we learn into practice in a safe way.” “I think its a great way to practice without pressure.” “I think that this is an excellent way of learning. Espically[sic] when getting to grips with controlled drugs, such as morphine.” These responses indicate that student nurses have been able to take their theoretical knowledge and put it into practice. VPM can therefore be said to provide an effective arena in which students can learn about the PCA unit and pain management. The learning benefits VPM has been designed from the beginning to have a highly reusable pedagogical approach. While the logic of the model in VPM is contained with the application, most of the variables are stored outside in an XML file. This file can contain multiple patient scenarios, which can be configured for differing levels of difficulty. Where multiple patient scenarios exist, VPM randomly selects a patient at the start of the simulation. Within each scenario the model itself applies variance to certain variables. By introducing this random element, student nurses are prevented from learning how to ‘play’ the simulation and are encouraged to apply their learning and knowledge as they would in real life. The random nature of VPM’s scenarios also provides a more realistic situation, as patients—even those presenting with the same symptoms—will respond to treatment differently depending on their physiology and psychology. VPM provides student nurses with an experience that would otherwise be unavailable to them, and challenges them to put their theoretical knowledge into practice in a safe environment where they can learn from their mistakes and develop their professional skills.

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Attribution-Noncommercial-No Derivative Works 2.0 UK: England & Wales