1. Michel Désilets, PhD and Mona Allan, RN, MScN
Dept. Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa
Virtual Laboratories in Nurse Education of Pathophysiology
Educational
Goals
for
Virtual Labs
Conceptual
Understanding
Social
Skills
Design
Skills
Professional
Skills
INTRODUCTION
Pathophysiology is historically a difficult subject matter for many nursing
students. However, studies show that student and staff nurses feel that
biosciences are important to their practice since increased understanding
facilitates effective communication with patients and the interdisciplinary team.
This in turn promotes safe patient care. While nursing skill labs have long been
included in the nursing curricula, an extension must be made to include
biological science labs to promote understanding. With the advent of
technology, virtual labs provide a new paradigm to nursing simulation training at
the conceptual level of understanding pathophysiology.
1. To assess the extent to which students perceive the labs assisted in their
learning of pathophysiology.
2. To evaluate the impact of the Web-Human virtual lab on the student’s
conceptual understanding and ability to solve problems related to key
concepts taught in the classroom.
3. To encourage the students’ to solve open-ended problems through design
and construction of abnormal human processes.
4. To assess the extent to which students perceive the understanding of
pathophysiology will have when practicing in their profession.
5. To examine students perception of a teamwork approach to facilitate the
learning of pathophysiology in a virtual lab environment.
OBJECTIVES
GOAL
To increase the conceptual understanding of pathophysiology by facilitating
students to explore the nature of science through design skills.
Objective 1 Results
Over the course of the four semesters
that the labs were given, 70% of
students felt that the labs assisted in
their learning of pathophysiology.
Objective 3 Results
Objective 4 Results
Objective 5 Results
METHODOLOGY RESULTS
THEORETICAL FRAMEWORK
Conceptual
Understanding
envisions to illustrate
concepts and principles
thereby assisting
students to understand
and solve problems
related to key concepts
taught in the classroom.
Professional Skills
envision a goal of
application of knowledge to
practice assisting students
with technical skills that they
are expected to have as
practicing clinicians.
Social Skills
acquisition is based on
a constructivist
perspective where
team behaviours are
enhanced through
communication, team
interaction, problem-
solving, and leadership
skills.
Design Skills
has a goal to assist
students in their ability to
design, investigate, and
understand the nature of
science thereby increasing
their ability to problem-
solve.
There was a total of 54% of the 222
surveyed students that were
satisfied with the labs. Particularly,
students would recommend use of
these laboratories in PHS4700.
Of the 67 students who were
surveyed in 2014, there was a total of
51% of students who perceived the
labs would assist with their
professional practice competencies,
while only 19% indicated “no”.
There was a total of 58% of
surveyed students (2014, n = 67)
who perceived the labs would be
better in a group format.
(Professional Skills)
(Social Skills)
(Design Skills)
Objective 2 Results
There was a significant increase in understanding of cardiovascular patho-
physiology by nursing students with pre-lab sessions (2009-2011) means at
50% ± 21% (n = 367) and post-lab (2012-2014) means at 67% ± 17% (n =
360). The data represent the difficulty of cardiology questions.
(Conceptual Understanding)
(Conceptual Understanding)
Positive Negative Neutral
58%
22% 19%
Percentage
Responses
Would labs enhance understanding if done in a
group format?
Negative
Neutral
Positive
19%
30%
51%
Percentage
Response
Did virtual labs help me develop competencies as
a future healthcare professional?
Positive Negative Neutral
54%
24% 22%
Percentage
Responses
Overall Satisfaction
Positive Neutral Negative
70%
21%
9%
Percentage
Responses
Did virtual labs faciliate understanding?EXAMPLE OF A VIRTUAL LAB
The effect of hemorrhage on heart rate
This simulation reproduces the effect of losing 2L of blood
within 3 min. The hemorrhage resulted in a rapid increase
of heart rate that stabilised at around 100 pulses/min.
Explain this increase and show the variables that
support your arguments.
Fig 1. Changes induced by the blood loss.
Loss of blood caused a decrease of preload (red) and stroke
volume (green), leading to a decrease of cardiac output (blue)
and systemic blood pressure (purple).
Lab report
Fig2. Homeostatic response following hemorrhage.
Both heart rate and peripheral resistance increased, as a
compensation for the drop of blood pressure.
Fig 3. Sympathetic activation induced by blood loss.
The increase of heart rate follows a strong activation of the
sympathetic system triggered by the drop in blood pressure.
Scenario
PEDAGOGIC APPROACH
 Classes:
 2nd year Nursing students; Pathophysiology course; Main Topics: Metabolism, Blood,
Cardiovascular, Respiratory, Renal and Nervous systems
 Class size: 60 to 90 students.
 Simulations related to cardiovascular and pulmonary pathophysiology were presented as specific
experimental observations to the students. Simulations used were hypovolemic and cardiogenic
shocks (left or right heart failure).
Students had to explain in the form of a lab report the given experimental observation after
planning and conducting their own experiments.
 Simulation program: “web-Human”, by R. Meyers and L. Geoffrion, Skidmore College, based on
the physiology model of T. Coleman (U. Mississippi Medical Center).
SURVEYS AND EXAMS ANALYSES
 Surveys: conducted to assess students’ interest and perception of the virtual labs.
 Students from the last 4 groups (2012-2014) were invited to evaluate anonymously the virtual
labs by answering a paper-based survey distributed during their final exam.
 The surveys consisted of 6 MCQs that were given as statements, with 5 possible answers
ranging from “I strongly agree“ to “I strongly disagree”. Students were also asked to estimate
the time spent (in hours) to write each of their lab reports.
 The 2014 survey included two additional questions related to the students’ perceptions on
professional and social skills (see Objectives 4 and 5 of Results).
 Exam analyses: conducted to assess the impact of the virtual labs on student learning.
 Results of the exams were analysed for all 4 classes that had the virtual labs (2012-2014) and
compared to the results of the 4 classes that preceded them (2009-2011).