JMIR Publications

ABSTRACT

Background. Although one core competency of HIV nursing care is supporting people living with HIV in managing their antiretroviral therapy, no educational interventions target its development. Thus, a simulation featuring a virtual patient having difficulty adhering to treatment was codeveloped to support the relational skills nurses require in such situations. Objectives. This viewpoint paper aimed to describe the codevelopment process and the assumptions of a virtual patient simulation, its content and features, and the challenges and the strategies used to overcome these challenges. Methods and content. A collaborative and iterative approach was used. Simulation is based on qualitative evidence, conceptual and theoretical knowledge, such as motivational interviewing and experts’ recommendations. Two main phases were carried out: 1) planning the simulation development, 2) designing the content, sequence, and format of the intervention. The simulation consisted of prebriefing, the patient’s electronic file, a glossary, and a simulated nurse-patient consultation that includes quizzes and feedback loops. Discussion. A major challenge was the insufficient guidance in operationalizing and conveying the relational skills into preprogrammed nurse-patient dialogues while also integrating elements to optimize the nurses’ active and transformative learning experience. To overcome this challenge, many strategies were used. We formed a team with expertise in providing HIV care, in using motivational interviewing, and in virtual patient simulation. We then wrote the script using a narrative approach: we started to write the green pathway ie, a dialogue in which a virtual nurse uses relational skills, such as asking open-ended questions and summarizing, to open up communication with the virtual patient. Afterwards, we selected strategic places in the script to write the red pathway ie, relational skills that shut down the communication, such as the “expert trap”, supported by quizzes and feedback loops that could change the direction of the nurse-patient dialogue. Conclusion. Sharing this experience can be helpful to any stakeholders interested in having practical cues and guidance when developing virtual patient simulations. Relational skills are used by all nurses—from novices to experts—and by all other healthcare practitioners. Focusing on this clinical behaviour is a good way to ensure the adaptability, sustainability, and efficiency of this simulation.