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We report here the experimental development of a set of interactive computer simulations of patient management cases in nursing, with the help of a generic authoring program for IBM-PC compatible microcomputers, named MEDTEST I. The purpose of these cases is to improve the training of practical nurses vis-a-vis realistic situations of clinical problem solving, including patient data collection, nursing diagnosis, planning and execution of patient management and care, etc.; in several areas of practical interest in nursing education. Initially, we have developed simulations in two typical areas of nursing problem solving: emergency care and intensive care. The simulated cases developed so far try to emphasize those aspects which are pertinent to the sphere of action of nurses in developing countries, and include the appearance of unexpected situations, which may evolve, depending on the students' responses, to other favorable or unfavorable patient health status. The structure of a simulation allows for case presentation frames, case summaries, multiple choice and numeric questions, etc., as well as immediate or delayed student reinforcement and case review. Comments to each right or wrong question introduce the student to theoretical and practical discussions on the medical and physiopathological background of the case. A cummulated scoring is performed, which is divided into relevant case handling sections (i.e., data collection, diagnosis, management, etc.)
We are currently evaluating the validity and impact of such methodology on nursing education in our milieu.
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