Nigel Wynne

  • Development and evaluation of an immersive online patient assessment simulation

    Nigel Wynne, University Of Central England, UK

    Tim Badger, University of Central England, UK

    Francesca Jovanovic, University of Central England, UK

    Matthew Aldridge, University of Central England, UK

    Emma Winterman, University of Central England, UK

    Session 5g, Wednesday 09.30

    Research seminar

    Themes addressed:

    • Teaching methods
    • e-Learning

    This paper describes the development and evaluation of a multimedia online patient assessment simulation called the Virtual Ward.

    The Virtual Ward (VW) is used within a range of on-campus and distance learning modules within pre-registration nurse education. Most students (approx. 600 per year) use it within a level five pre-registration acute adult nursing module. The resource presents students with a visual representation of a clinical environment in which is contained sources of patient information. Students are asked to find the information, critically examine it and relate it to their existing knowledge. They are then asked to make links with new knowledge and ideas in order to arrive at an interpretation.

    Drawing upon the work of Biggs (1999), Ramsden (1992) and Entwistle (1988) the VW seeks to foster a deep approach to learning that enhances students' problem solving skills and their ability to apply theory to practice. The context-rich multimedia design aims to increase student motivation and satisfaction and to promote self-directed study. The key outcome of the resource is that it better prepares students to assess patients and to interpret the significance of this assessment.

    Initial findings from a questionnaire survey demonstrate that this application was well integrated with other teaching methods (81%). Over 60% reported that the use of technology within the module encouraged more study in between classes with further data indicating the promotion of consistent rather than assessment-focused learning. The majority of students (83%) indicated that the technology enabled them to learn what they wanted to learn and for 74% to learn things for themselves without being told. However despite an increase in the number of A and B summative assessment grades there has been little change in the number of students failing the module.

    Informal observation indicates that a minority of students are not prepared to handle multiple sources of information and apply these as described above. Some students may not have achieved the same level of knowledge acquisition prior to the module as their peers and would require more support during their interaction with the Virtual Ward if they were to attain the deep learning that many of their peers had demonstrated. The challenge to designers of immersive multimedia resources such as this is how this additional support can be provided without detracting from the situated non-linear learning the resource aims to facilitate.

    Cognitive Load Theory (Sweller, 1998) states that optimum learning occurs in humans when the load on short term memory is kept to a minimum. Sweller found that where information is more familiar to the student it will be linked to the long term memory more effectively and makes a number of design suggestions that may facilitate this. Drawing on Sweller’s work and Mayer’s (2001) Multimedia Theory a number of design changes are planned in order to optimise cognitive load and promote deeper learning amongst struggling students. These changes will be informed and evaluated through video ethnography and methods from the field of human computer interaction.

    The current outcomes of this work will be shared and ideally participants would have an opportunity to interact with the resource in both its current and future state in order to compare and feedback on how the new design enhanced their learning experience.


    • Biggs J (1999). Teaching for Quality Learning at University, Buckingham: SHRE and Open University Press.
    • Entwistle N (1988). Styles of Learning and Teaching. London: David Fulton.
    • Mayer RE (2001) Multimedia Learning. Cambridge: Cambridge University Press.
    • Ramsden P (1992). Learning to Teach in Higher Education, Routledge.
    • Sweller J (1988). Cognitive load during problem solving: Effects on learning. In Cognitive Science, 12, 257-285