This document provides an overview of a 3D nursing simulation for emergency department pain management. The simulation allows trainees to take on the role of an emergency room nurse assessing and treating three animated patient cases that vary in ethnicity, age, and emotion. The scenario takes place during a day shift where the patients were injured in a golf cart accident. The simulation was developed using 3D modeling software to create the environment and objects, motion capture for movements, and facial capture to express emotions. It aims to help nursing students and professionals practice correctly identifying patients, evaluating vital signs and pain levels, and determining appropriate pain management plans.

1. A Nursing Simulation:
Emergency Department Pain Management

3. Authors
Enilda Romero-Hall, Ph.D.
Assistant Professor at the University of Tampa
Ginger Watson, Ph.D.
Associate Professor at Old Dominion University
Yiannis Papelis, Ph.D.
Hector Garcia and Menion Croll
Virginia Modeling, Analysis and Simulation Center

4. Purpose
In this 3D simulation environment trainees take
on the role of an emergency department nurse
assessing and managing the pain of patients.
In the simulation environment, the trainees
interact with three emotionally expressive
animated patients. The three patients vary in
their ethnicity, age, and emotion.

5. Patients
Arthur Smith Jose Rodriguez Lin Chan

6. Objectives
Correctly confirm a patient’s identity
Apply proper nursing actions to initiate care of a
patient.
Evaluate a patient, including vital signs and pain
assessment
Determine the nursing care for a patient based on
assessed patient condition as well as, reported and
observed pain
Implement appropriate and safe pain management care
of a patient

7. Learners
Nursing Students
Professional Nurses

8. Scenario
The scenario transpires during the day shift at
an emergency department of a local hospital.
The nurse provides care to patients who came to
the facility after their golf cart flipped over
earlier in the day.

9. Design Decisions
Performance measures of the evidence-based pain
management critical path were translated into simulation
actions in the 3D interactive environment
Specifications were established for the 3D simulation
environment:
– Location Settings (emergency room and patient room)
– User’s view point and camera position
– Menu selection options (clickable pop-up menu)
– Users’ narrative communication (pop-up narratives)
– clickable critical path objects (thermometer, stethoscope)

10. Development
The emergency department environment was
completed using AutoDesk Maya. This software
allowed the rendering of the 3D virtual
environment and objects such as the patient
room, emergency department hallway, and all
medical equipment.

11. Development

12. Development
The motion capture was conducted using the
OptiTrack Optical Motion Capture System and
processed with AutoDesk Motion Builder. This
software allowed 3D object motion tracking,
real-time streaming, and a multi-camera
configuration.

13. Development

14. Development
The facial capture of emotion expression were
captured using the FaceShift software and an
Xbox Kinect. The audio captures were
conducted using a simple iPhone audio
recording application.

15. Development

16. Development
Unity 3D Game Engine was used to integrate
the 3D virtual environment, the virtual objects,
and the animated agents.

17. Implementation

18. Funding
The design and development of this 3D
simulation was funded through a research
program at the Virginia Modeling Analysis and
Simulation Center (VMASC).