Student Name

Capella University

NURS-FPX6112 Technology Integration for Nursing Education

Professor Name

Submission Date

Evaluation of a Virtual Simulation Scenario

Virtual simulation technology has revolutionized how students are educated in nursing as it provides students with realistic experiences in a risk-free environment. Sentinel U has created an evidence-based online simulation platform that is specifically designed for pre-licensure nursing students to help them learn how to develop their clinical reasoning and decision-making skills in a realistic simulation. This may involve the Liza Herzog scenario, for example, which involves a 27 wk pregnant female with a known history of hypothyroidism and presents with fatigue, allowing students to practice skills from the physical assessment, pharmacology and pathophysiology areas and make decisions about their patient care. The studies demonstrate that simulated environments can enhance student outcomes by giving students an opportunity to apply their skills in an academic environment while also simulating situations in the real world (Damaševičius & Sidekerskienė, 2024). This report is to assess the effectiveness of the Liza Herzog simulation in developing critical thinking skills of students in the three learning areas of nursing competencies (cognitive, affective, and psychomotor).

Scenario Context

As simulation technologies continue to evolve, they have become an essential element in preparing nursing professionals around the world. As an illustration, Sentinel U is creating a clinical simulation platform to engage both nursing instructors and students in clinical simulations via the Internet as part of their nursing education. For this site, Liza Herzog, a 27 year old female, a virtual patient case has been developed, who has a diagnosis of hypothyroidism and is currently 27 weeks into her pregnancy. The clinical scenario is designed using real-life experiences of patients and the clinical guidelines (Duncan et al., 2026). This Liza Herzog simulation has been developed by an educational institution for pre-licensure undergraduate nursing students. The Liza Herzog Simulation is designed to provide a clinical learning opportunity for nursing students in a structured format prior to their professional practice. Simulation helps nursing students create and use clinical judgment skills in a safe, repeatable, standardized environment without the risk of an actual patient. It is a simulation using Kolb’s Experiential Learning Theory, giving opportunities to students to actively experiment and reflective feedback about their experiences in a simulation that is as close to reality as possible, with real world interaction with patients.

Physical Assessment

One of the skills that should be taught is how to do a comprehensive physical assessment, which is part of the student’s preparation in nursing to be able to move into clinic. Beyond the data recorded initially in the Liza Herzog simulation framework, the Liza Herzog simulation takes a systematic approach to the assessments, starting with obtaining vital signs and collecting a health history. Additionally, the students will learn to assess tachycardia and pallor/light-headedness and will also examine the same as it applies to the state of pregnancy. A recent study indicated that using simulation-based training to perform physical assessments has positively impacted both accuracy and confidence levels in students’ abilities to perform physical assessments (Costa & Monger, 2024). The physical assessment component of the Course will give the students a firsthand exposure to clinical practice to enable them to attain a high level of knowledge of the subject matter and plenty of practical experience to become a highly competent clinician.

Students can gain an understanding of systems and conduct a targeted evaluation of the symptoms of pregnancy through simulated experiences. For instance, students who studied Liza Herzog discovered minor details such as “pagophagia” and “tachycardia” and drew inferences between these findings and “iron deficiency anemia” and showed better prioritization of clinical assessment data. Students may relate their observations (increased breathlessness, fatigue, increased heart rate) to the pathological explanation. Developed by noted expert Dr. Carol Dash, Pagophagia (craving ice) is a subtle but very important clinical symptom of iron deficiency anemia that is included in the simulation. Pagophagia and other such characteristics will emphasize the diversity of patient presentations that can be seen in clinical practice (Duchac, 2025). All of these parts of the evaluation will help the student understand and prioritize clinical findings rapidly and accurately.

Pharmacology

In order to deliver safe and effective patient-centered nursing care, nurses must have a thorough understanding of pharmacology. The medication prescribed to Liza is a simulation of what could be prescribed once she receives further evidence-based results to support that Liza will benefit from receiving ferrous sulfate as treatment for her iron deficiency anemia. Considering Liza’s pregnancy status, nutritional deficiency, and documented low hemoglobin level, Ferrous sulfate is an appropriate medication to use in treating a pregnant woman with iron deficiency anemia. Oral iron supplementation is recommended as the first line of treatment in the management of iron deficiency anemia during pregnancy (Auerbach, 2023). The pharmacological decision-making for Liza is clinically appropriate and matches well with the patient’s profile.

In the simulation, docusate sodium has been added to treat any gastrointestinal issues the patient may be having due to oral iron intolerance. Learners must also consider intravenous iron infusion if oral therapy does not work, which enhances their clinical decision-making skills. Drug-drug interactions are demonstrated within the scenario as well; one example is the need to avoid using calcium products along with iron. Constructivist learning theory supports this approach, as students build pharmacological knowledge by actively engaging with realistic patient scenarios rather than passively receiving information (Khurshid et al., 2023). Pharmacotherapy simulations that provide for adverse effect management enhance the learner’s preparedness to interact with real patients (Phanudulkitti et al., 2023). All these components will enable learners to develop a thorough and applicable knowledge base about the use of iron therapy during pregnancy.

Pathophysiology

To deliver quality care and make effective clinical decisions, a solid understanding of disease processes is required. The simulation adequately reflects the pathophysiology of IDA during high-risk pregnancy. The mother has a past history (7 pregnancies), poor nutrition, and poor thyroid function, which all contribute to her anaemia. Anemia in pregnancy is due to the rates of fetal iron requirements (which is the total amount of iron required for normal fetal development) exceeding the amount of iron stored in the woman and the amount of iron available in her diet (Benson et al., 2024). This scenario is particularly useful at helping to illustrate the complexity of an individual’s clinical presentation when a variety of physiologic factors come together.

This simulation starts with the patient’s arrival with symptoms and the interpretation of the laboratory results and the development of a treatment plan for the disease. Through this process, students are able to understand how the production of decreased amounts of red blood cells leads to symptoms of fatigue, pallor, compensatory tachycardia, etc. Lab results (such as low hemoglobin, low hematocrit, low serum ferritin, low iron) are accurately depicted in the simulation. The disease process paired with the clinical data adds educational value to the simulation, as it enhances the ability for clinical reasoning by nursing students and accurate diagnosis (Smith et al., 2022).

Integration

All three aspects of nursing (assessment, pharmacology, & pathophysiology) need to be successfully integrated for the nursing students to have a successful educational experience. This integration is achieved in the Liza Herzog simulation, where several clinical cues are related to an underlying physiological mechanism. As an illustration, if the finding is a tachycardia, the diagnostic test is ordered directly, and the medically indicated choice of intervention (medication) is identified. Integrated simulation based learning (ISSBL) is an effective approach which is evidenced in literature and has been shown to be a positive contribution on how well the student can think clinically as well as understand the outcome of patient’s care (Sim et al., 2022), thus with this cohesive approach of learning, students will be able to think clinically in a more holistic approach rather than fragmented knowledge of domains.

The students recognize the pallor, fatigue, and pagophagia from a physical exam of Liza Herzog, relate those findings to the pathophysiology of decreased red blood cell production, and then conclude that ferrous sulfate is a pharmacological intervention that would be appropriate. The order in which the processes of reasoning are carried out is similar to the order in which real-life clinical processes are performed every day in nursing practice.

General Observations

The entire SentinelU platform in this design and usability process leads to a positive learning experience for the nursing students. A clear goal is set forth for each section, and the information in each section is organized in a logical progression from assessment to treatment planning. The length of time the scenario took was suitable for a clinical-type case (1 hour and 12 minutes). After each open-ended response section, feedback was very detailed and specific and in an educationally constructive manner (Bauer et al., 2025). The reliability of the platform was very good throughout the simulations, and no noteworthy technical problems occurred throughout the entire simulation.

Each part of the application had crystal clear instructions which made student navigation through the program very easy, with minimal confusion. The transitions between various components of the simulated hospital visit, including vitals, inquiry, diagnostics, and plan of care, were intuitive and not too technical. The program was web-based, meaning it could be accessed by all students at very low cost (a basic Internet connection and current Web browser), making it very easy for all students to use. However, the details of information in the review of systems section in the application were not clearly mentioned in the instructions (Khurshid et al., 2023). Therefore, on this initial attempt, the students with this Review of Systems section received 0 out of 4. These will be closed, and Sentinel U will be a more functional and effective tool for nursing education.

Recommendation

The important finding of the evaluation was that a major recommendation is the use of Sentinel U in the pre-licensure nursing programs, as it has proven to be successful in supporting the development of a student’s clinical reasoning and decision-making abilities. Sentinel U aligns and supports Kolb’s Experiential Learning Theory, an approach to learning that is based on the premise that learning comes from experiences and structured reflection. Immediate feedback for reflection and active conceptualization of Kolb’s cycle is also given to each student after every section. Studies again suggest that nursing students engage in simulations with virtual tools, showing improved clinical abilities and achieving better scores on standardized tests and assessments compared to those who relied on conventional teaching methods (Mallick & Dalia, 2025). This platform will allow a nursing program to continually provide students with clinical education in a safe, scalable, and evidence-based way, regardless of the student population.

The second recommendation is to consider using Sentinel U to recreate challenging patient scenarios, which will afford opportunities for higher-level nursing students to think about clinical care scenarios. With the adequate application of simulation as a learning method, many peer-reviewed research articles have demonstrated that clinical competence, critical thinking, and confidence in nursing education are enhanced regardless of the educational background of each individual involved (Bauer et al., 2025). Being able to present more complex patients in the scenarios will build student’s critical thinking and assessment skills from cases like Liza Herzog and better prepare students for the uncertainty of actual clinical practice. Simulations in learning have been demonstrated to enhance the clinical reasoning skills of clinicians and understanding of patient outcomes (Sim et al., 2022). Embedding simulation in all courses within the nursing program will help students build a deeper knowledge and skills in assessment and pharmacology/pathophysiology, and provide a variety of patient scenarios to successfully demonstrate these skills.

The third recommendation is for Sentinel U to make consideration of the identified gap in instructional design before it’s fully implemented. In simulation education, consistent and unambiguous instructional design is pivotal to maximize students’ engagement and to achieve the desired learning outcomes (Khurshid et al., 2023). Sentinel U will work with the Nursing faculty to clarify the concepts that are not clear and to design student-directed examples for those that students consistently struggle with. In addition, the constructivist learning theory addressed in this paper states that the construction of well-structured instructional contents with scaffolding is very necessary for the construction of student learning as students can learn effectively from learning tasks in a well-structured context and with high contextualization level (Khurshid et al., 2023). These gaps will be filled in order to have Sentinel U 100% operational as a high-quality education resource for nursing education programs.

Conclusion

Sentinel U Liza Herzog is a simulation that illustrates the value of simulations, the educational importance & validity of simulations & the integration of nursing across many disciplines into an accurate & educationally appropriate format for nursing education. Because of the extensive & detailed feedback, combined with the alignment of AACN competencies & NCLEX categories, the educational value of these simulations is greatly enhanced. Suggestions for improving the usefulness of these simulations include: review an entire system with the student and teach/coach the student to answer the question by making an answer. Ultimately, Nursing Education’s future should have an emphasis on the use of simulation technology in nursing education as a crucial component of nursing education.