Free Nursing simulation scenarios are a foundation of simulated nursing in the education of nurse students. In accordance with the INACSL Healthcare Simulation Standards of Best Practice Scenario Design(2021), a simulation scenario should be designed with purpose to meet the identified objectives to meet the expected outcomes. As part of the criteria necessary to meet this Standard, pilot test simulation-based experiences should be conducted before full implementation. One of the ways to achieve this is to use scenarios that have been vetted and tested outside the educator’s institution. This HealthySimulation.com article by HealthySimulatio .com Content Manager Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN, will review some resources for free nursing simulation scenarios for simulation educators to incorporate into their simulation programs.
Healthcare Simulation Standards of Best Practice: Simulation Design
The International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards of Best Practice were developed and designed to advance the science of clinical simulation, to share best practices, and to provide evidence-based guidelines for the practice and development of a comprehensive standard of practice. These Standards are reviewed, edited, and published around every two years as more data is available.
The Simulation Design Standard states the clinical simulation scenario should be designed and developed based on the highest level of evidence to meet the desired outcome and objectives of the simulation. Each scenario should be developed with subject matter experts after a needs assessment demonstrates the simulation scenario is needed. SMART objectives (specific, measurable, achievable within the time frame, realistic, have a pre-brief and debrief session, and pilot tested prior to implementation.
Free Nursing Simulation Clinical Cases and Resources
There are many resources for nursing simulation programs and simulation scenarios. This list will continue to grow and evolve as resources are identified or removed. Some of the free nursing simulation resources are provided here, and are listed in alphabetical order. If you know of other free nursing simulation resources that can be included, please email us.
Acadicus Open RN VR Scenarios: The Open RN project is led by Chippewa Valley Technical College as part of the Wisconsin Technical College System (WTCS) consortium. OER nursing textbooks and virtual simulations are collaboratively developed by faculty based on the WTCS State Nursing curriculum and the current NCLEX-RN Test Plan. Textbooks undergo national peer review by faculty, deans, industry members, and nursing students to ensure the content is accurate and relevant, written in clear language for pre-licensure nursing students, and based on current, evidence-based practices. All Open RN materials have CC-BY 4.0 Creative Commons licensing. Open RN textbooks are published in Pressbooks where they are free and accessible in online or downloadable formats. The textbooks are also uploaded to LibreTexts where they can easily be “remixed” by faculty and aligned to their curriculum. Affordable print versions are published by XanEdu and available in college bookstores and on Amazon. There are currently 25 cases, including OB, end-of-life, ethical issues, medical-surgical, and some complicated issues.
Affinity Learning Scenario Learning Experiences: Affinity Learning offers a number of healthcare simulation scenarios at no cost for an individual learner. Affinity Learning has many different categories of clinical simulation online scenarios available at no cost for a basic membership with many features. There are a number of different health professional groups which have categories available for learners to access. Categories on offer for learners include: nurse, paramedic, medical lab, Social Worker, sonography, and public safety. The Affinity community is a free and open collection of virtual scenarios that are created by domain experts and notable institutions. Creators of virtual simulation scenarios are always clearly credited for their educational contributions. Other features of note available on Affinity includes: Vimeo and YouTube integration, rich text editor, iframe Support, cross-browser compatibility, mobile-friendly scenarios, inline edit mode, and the ability to send scenarios as links, and LMS.
Association of Standardized Patient Educators (ASPE) Case Development Template: Clinical educators should recognize that Standardized Patient cases have multiple components that reflect the different users of a case, such as SP educators, SPs, learners, raters, and administrators. The development of these materials is optimized when employing a collaborative, multistep process, utilizing a set of best practice guidelines for designing simulations, Healthcare Simulation Standards of Best Practice: Simulation Design, as well as guidelines relevant to the professional regulations. ASPE offers a free SP Case Study template to help guide the scenario or OSCE case.
Elevate Healthcare (formerly CAE Healthcare) Scenario Resources: Elevate Healthcare wants to assist simulation professionals with the development of simulation scenarios. Elevate Healthcare provides some resources to save time and effort in the development of high-quality healthcare simulations. The resources developed are meant to support your Elevate Healthcare simulators and simulation practices. Whether designing a simulated clinical experience or evaluating the effectiveness of your simulation, educators can use some of these resources to build or enhance the simulation program. The resources available are recommended sizes for simulator clothing to increase realism, the Simulated Clinical Experience (SCE) Development form, the Simulation Effectiveness Tool – Modified (SET-M), recommended sizes for clinical supplies, and fluid amounts for reservoirs/tanks. Elevate Healthcare has COVID-19 SCE cases with supporting files to enhance the simulation scenarios. The website offers video tutorials, webinars, and virtual demos for educators. Simulation scenarios are available as packages with manikin purchases, too.
EM Sim Cases**:**Most emergency medicine residency programs use emergency simulation in some capacity. The goal of EM Sim Cases is to showcase peer-reviewed cases that are already being used across the country. The main goals for sharing the simulation scenarios are to create a large database of cases for EM educators around the world to use and map all cases to clear educational objectives. EM Sim Cases range from pediatric to geriatric and multiple specialties that present in emergency medicine. There is a wide array of cases ranging from dysrhythmias, endocrine emergencies, weather related events, traumas, and mental health.
View the LEARN CE/CME Platform Webinar How to Implement INACSL’s Healthcare Simulation Standards of Best Practice Into Your Program to learn more!
eTV Learning Technologies – Turbulent Sky: This is a 360-degree disaster management exercise named “Turbulent Sky.” The scenario begins with a video of an emergency medical scenario under which learners will be instructed to use emergency triage. This scenario is complete with an overview, theory, quiz, and debrief.
Kansas State Board of Nursing (KSBN) Simulation Scenarios: The KSBN Simulation Scenario Library houses nursing clinical simulation developed by Kansas nursing faculty as a free service for use in nursing programs. Currently, there are more than 15 simulation scenarios, from skills check-off scenarios to newborn complications, and all systems for the adult lifespan. The scenarios include a history and physical, labs, orders, notes, and a physical chart. The current scenarios available are:
- GI Bleed or “Blood & Guts”
- “It’s all in the Head” Meti-meningitis/seizure
- Femur Fracture with Pulmonary Embolism
- Ischemic Stroke with Increased ICP
- IV – IV Medication Review
- Head Injury Scenario – 2 Parts
- Head Injury / Heart Failure Scenario
- Code Pink Simulation
- Air Leak Syndrome With Infant
- Code Pink With Meconium Simulation
- Respiratory Therapy Code Pink Simulation
- Simulation of Pediatric Diabetic Patient
- Placenta Previa – Remediation
- Pre-scenario Worksheet and List of 14 Scenarios
- Skills Check-off Scenario
- Basic Medical / Surgical Nursing
- Intermediate / Complex – 2 Medical / Surgical Scenarios 2 Sessions Each
Laerdal Complimentary Simulation Scenarios: Simulation training with the use of scenarios enables instructors to provide a consistent, safe, and realistic way for learners to practice nursing care and skills. Laerdal offers simulation scenarios for their simulations. To obtain the clinical scenarios, the educator should select the manikin associated with the scenario. Simulation scenarios include SimNewB, SimBaby, Nursing Anne, and LSUS 2.0. These simulation scenarios have an overview and the scenario. The LSUS 2.0 provides the educator with initial state templates to allow for build your own scenarios in SimDesigner for SimMan and SimMom. Simulation scenarios packages are also available with manikin purchases. Laerdal also has a scenario cloud with a scenario library. These simulation scenarios were developed for improved outcomes by simulation experts. The Laerdal Scenario Cloud is a digital library of hundreds of expert-developed scenarios from clinical professionals. Scenario Cloud provides a productivity boost, as you spend less time authoring content and more time improving educational outcomes. This product has a 90-day trial period that simulation professionals can sign up. These simulations have learning objectives, a detailed case narrative printable patient charts, setup and debriefing guides, and evidence-based references.
Massachusetts Nursing Initiative Simulation Scenario Library: The Massachusetts Department of Higher Education (DHE) has funded the development of the following scenarios for SimMan and SimBaby high-fidelity human patient simulators to be utilized by healthcare facilities and academic programs to integrate into their educational programming. Currently, 26 high-fidelity manikins have been awarded to participating nursing programs to assure every nursing student can learn through simulation. Nine grants were awarded to develop a Simulation Scenario Library. The simulation cases include stroke, multicultural, infant to geriatric, delirium, palliative care, postpartum hemorrhage, post-surgical care at home, infant SVT, and pain assessment.
MedPro Group Patient Safety & Risk Solutions: Simulation Training Sample Scenarios PDF: MedPro Group is a Medical Insurance company. In 2017, they produced the Patient Safety & Risk Solutions: Simulation Training Sample Scenarios for anesthesia and surgical team, behavioral health de-escalation, emergency medicine pediatric patient, healthcare practice emergency, medical-surgical sepsis, senior care fall assessment, OB shoulder dystocia, and dental practice aggressive patient. These cases include a scenario background, learning objectives, target participants, expected outcomes, facilitator notes, equipment and supplies, patient & room scenario setup, handoff report, scenario phases with patient and SP responses, debriefing, and resources.
Medscape MedSim Patient Scenarios: Medscape offers free MedSim Scenarios for varying patient medical conditions, including pediatric and behavioral health. MedSims allows the participant to conduct immersive patient interviews, choose from more than 800 tests, select from 2000 potential diagnoses, consider 1.2 billion possible treatment options, conduct a decision review, and gain insight into the epidemiology, disease presentation, and treatment. To access these scenarios, participants first need to create an account. Then they will be able to review charts and complete the patient assessment component of a chosen scenario to ultimately develop a plan of care. There are approximately 200 patient scenarios to choose.
Montgomery College Nursing Simulation Library: The Nursing Simulation Scenario Library is a resource for nursing educators in all settings and made possible by the generosity of the Healthcare Initiative Foundation. The library is being expanded through the support of the Nurse Support Program (NSPII) funded by the Maryland Health Services Cost Review Commission (HSCRC). Please read the Terms & Conditions of Use. Montgomery College of Nursing welcomes your feedback on the library and encourages educators to utilize and share this resource with other nurse educators. Each library listing contains video, accompanying document(s) for realism and learning, and documents guides for educators to recreate content in areas relevant to practice. The topics include adult & pediatric telehealth, assessment, briefing, Code Blue, debriefing, eating disorders, end of life, implicit bias in healthcare, incivility, medical error, opioid withdrawal, postpartum hemorrhage, sepsis, stress & coping, and transgender care.
MPROVE Academy Neonatal Video Training: MPROVE stands for MultiPROfessional Neonatal Education, which is trademarked and all the educational content produced is copyright to MPROVE but available for use under creative commons distribution. MPROVE was established in 2012 as a platform for delivering simulation-based education in neonatology. The MPROVE academy was established as a platform for delivery of multidisciplinary neonatal education, simulation and technology enhanced learning to neonatal teams worldwide. Neonatal QI toolkits, videos and education packages are available through the MPROVE academy portal. The videos and modules include neonatal airway, difficulty neonatal airway, preterm care, and neonatal respiratory care.
National League for Nursing Simulation Innovation Resource Center (NLN SIRC): The NLN SIRC site is a collaborative effort between NLN and Laerdal Medical for nurse educators that develop simulation teaching and learning skills. The purpose of NLN SIRC is to assist with the professional development of nurse educators to use simulation effectively to educate nurses and nursing students. This site has many tools and resources for simulation, including HomeGrown solutions. Under the Resources tab, educators can find:
- SIRC Tools and Tips Simulation Design Template – Revised February 2023
- ACE.S Cases Mapped to the AACN Essentials
- RNovating the Classroom
- Social Determinants of Health Crosswalk (SDOH-C)
- Virtual Simulation Resources
- Operationalizing Extended Reality Toolkit
- Mindfulness in Prebriefing
- Pre-briefing Checklist
- Faculty Development Toolkit: Simulation Resources
- Multi-patient Simulation Template and Toolkit
- Simulation Design Template Adapted for IPE Simulations
- Leveling Simulations: Integrating QSEN and ACE.S
- Simulation Centers Survey
- Orienting Learners to the Simulator: Introduction to SimMan
- Simulation Design Template – Revised February 2023
- ACES Unfolding Cases Mapped to the AACN Essentials
- RNovating the Classroom
- Social Determinants of Health Crosswalk
- Virtual Simulation Resources Undergraduate and Nurse Practitioner students
- Operationalizing Extended Reality Toolkit
- Mindfulness in Prebriefing
- Pre-Briefing Checklist
- Faculty Development Toolkit: Simulation Resources
- Multi-Patient Simulation Template and Toolkit
- Simulation Design Template Adapted for IPE Simulation
- Leveling Simulations: Integrating QSEN and ACE.S
- Orienting Learners to the Simulator: Introduction to SimMan
NurseKey Pediatric Nursing Care Clinical Simulation Scenarios for Prelicensure Students: NurseKey is the fastest nurse insight engine to provide nurses with the best answer to their questions in the shortest time possible. There is a complete pediatric nursing simulation available. In addition, by typing nursing simulation in the search bar over 2000 simulation topics populated with links to the resource.
QSEN: Quality and Safety Education for Nurses Teaching and Practice Stategries: The QSEN Institute was in place from 2012-2022. The QSEN Institute initiatives ended as the AACN implemented the 2021 Essentials which included all the QSEN competencies for pre-licensure and graduate nurses. See the crosswalk on the QSEN.org website. Resources for Quality and Safety Education for Nurses is now housed and maintained by Case Western University Frances Payne Bolton School of Nursing. This site offers search strategies to help with simulations and education strategies to educate nurses. Nurse educators can submit simulation scenarios to help build cases. These submissions are blind peer-reviewed by a QSEN Strategy reviewer. These materials are freely available for educational use, but the original content must be cited. This site allows for the educators to filter by QSEN Competency Domains, Learner/Participant Level, Setting, and Strategy type.
SimBox, SimBox EMS, and Tele SimBox**:**SimBox is a free online simulation resource for everyone who leverages technology for learning anywhere. SimBox provides a step by step guide for simulation facilitation. This can be utilized to supplement in-person, hybrid, or distance simulation with low to no technology needed. The booklet will provide an overview, pre-brief, and debrief guides along with scenario resources. Then play the simulation YouTube simulation video. Some cases have an interactive video. There is a structured pre-brief and debrief to facilitate the participant’s discussion. The current cases include severe head injury, pediatric wheezing, infant respiratory distress, newborn resuscitation, postpartum complication, burn, vomiting baby, fussy baby, pediatric trauma, sick neonate, seizing infant and child, anaphylaxis, and altered mental status. Other resources include a pediatric cardiac rhythm generator video, other websites that can be beneficial for a simulation program, and telesimulation resources.
Simulation Canada SIM Scenario Exchange: The SIM Scenario Exchange is an open repository of resources, including free simulation scenarios, links to free virtual simulations, scenario development tools & templates, and assessment/evaluation tools. The Exchange fosters collaboration amongst simulationists for the sharing, improvement, and adaptation of resources. Currently, there are approximately 200 scenarios available. A free Simulation Canada website account is required to access the simulation materials.
Simulation Canada Virtu-WIL Virtual Scenarios: In 2021, a free and open-access Canadian virtual healthcare simulation program was created called Virtu-WIL. Colleges and Institutes throughout Canada collaborated with Simulation Canada, which is an interprofessional but not-for-profit network dedicated to the advancement of healthcare simulation. Simulation Canada led the development of the Virtu-WIL virtual healthcare simulation program. The program was government funded with contributors to the project from 24 colleges and institutions and 13 universities across Canada.The virtual clinical simulations in the Virtu-WIL program are based on and created from simulated clinical experiences. The process of creation of these virtual clinical simulations from a clinical backstory is done by Canadian educators. All of the virtual clinical simulations are based on clearly defined pedagogical objectives, which great time has been taken to consider. Most of the virtual clinical simulations can be operated on a desktop computer, but some of the virtual scenarios require a virtual reality (VR) headset.
The SimTech Nursing Simulation Scenarios: Recently under new leadership, TheSimTech provides a collection of donated scenarios for learners to use or modify. Scenarios include abdominal trauma from a motorcycle crash, bradycardia, difficult airway, sepsis, and more. There are currently 18 simulation scenarios available.
Toronto Metropolitan University**:**Toronto Metropolitan University (TMU) has developed online learning modules for full access to a variety of faculty-designed online modules created for students at any institution and life-long learners. This resource requires the learner to register to access modules and some resources. An email contact is listed if any issues are experienced with the modules. Some of the modules are Therapeutic Communication and Mental Health Assessment, Learning Primary Midwifery Care, and Vital Signs.
UHN Virtual Interactive Case (VIC) System: The VIC System creates simulations of encounters with patients in clinics. VIC cases are clinical reasoning exercises with feedback. Their role is to provide a bridge between theory and seeing learners in a clinic (or ER), providing learners with “deliberate practice” as a way of gaining clinical expertise. The strength of VIC is that it is optimized for rapidly creating a large number of cases, by using a patient template and creating variations of cases with different differential diagnoses for the same presenting complaint.
University of Washington Simulation Team Training Toolkit: The University of Washington’s Center for Healthy Sciences Interprofessional Education Research and Practice offers two nursing simulation scenario resources. The first, “Simulation Scenario Building Templates & Tools,” includes simulation scenario building templates and tools intended for educators involved in developing comprehensive and customized interprofessional simulations for health sciences students and trainees. These tools were developed by members of the UW Macy Grant Team with funding from the Josiah Macy Jr. Foundation. The second, “Simulation Scenario Library,” includes interprofessional simulation scenarios developed at the University of Washington and are available for free to download and use. The scenarios can be modified to meet your needs and objectives.
USC Virtual Standard Patient: This project is a freeware Virtual Standardized Patient (VSP) community for medical learners, residents, continuing medical education and medical educators. VSPs are virtual human avatars that can be conversed with (through typing or speech), that talk back, tell a story, and are coupled with a feedback system that allows learners to improve their performance. VSPs can tell their stories and can answer the most common medical questions that would be asked in a clinic environment. For learners, this resource offers the Standard Patient Hospital. For the educators, the Standard Patient Studio, the healthcare educator can learn to create an interactive virtual standard patient in less than one day and have access to published cases.
UTC Simulation Scenarios for Nurse Practitioner Educators: A Faculty Guide: Simulation provides a safe environment for students to practice clinical and communication skills needed in advanced practice nursing. Faculty at the University of Tennessee at Chattanooga (UTC) formally incorporated simulation into the nurse practitioner (NP) program curriculum. This project was made possible by a Department of Health and Human Services (DHHS), Health Resources and Services Administration (HRSA), and Advanced Nursing Education Workforce (ANEW) grant. Before the grant, simulation was utilized in multiple courses. However, logistics, briefings, scenarios, fidelity, feedback, assessments, and evaluations varied among courses and faculty members. The UTC NP simulation program was developed utilizing the Healthcare Simulation Standards of Best Practice, Simulation Guidelines and Best Practices for Nurse Practitioner Programs, and the Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP) (International Nursing Association for Clinical Simulation and Learning [INACSL], 2021; Lewis, 2017; Lioce et al., 2020a). The 15 simulation scenarios were developed and integrated into the UTC NP program curriculum plan to ensure consistency and standardization across faculty members and cohorts.
Other Nursing Simulation Scenario Resources for a No-to-Low Cost
California Simulation Alliance Scenarios and Tools: The California Simulation Alliance has a subscriber-only section for scenarios and tools. The scenarios that have been developed, validated and tested by CSA subject matter experts. QSEN and TeamSTEPPS competencies have been integrated in all scenarios where appropriate. Scenarios are to be used by subscribers only. If you are considering becoming a subscriber and would like to view a sample scenario, please contact CSA. Cases available include ambulatory care, critical care, implicit bias, LGBTQ, perioperative, leadership, peri-natal, emergency department, fundamentals in nursing, family nurse practitioner, medical-surgical, pediatrics, and interprofessional. In addition to these resources, white papers, IP release forms, scenario validation checklist CSA sim scenario template, CSA sim leadership scenario template, CSA sim storyboard sample, CSA abbrev template, and apprentice application. The California Simulation Alliance Simulation Scenario Template can be downloaded for free.
Canadian Alliance of Nurse Educators Using Simulation (CAN Sim) Sim Scenarios: CAN Sim has a repository of approximately 75 simulation scenarios available for their members. These scenarios include acute critical care, cardiology, community care nursing, maternal child, medical, mental health, palliative care, pediatric, and surgical cases. Specifically, the organization offers acute critical care nursing simulation scenarios. These scenarios include scenarios such as acute exacerbation of asthma in adults, brain attack, client with unmanaged pain, hypovolemic shock, multiple patient trauma, and more.
Practical Clinical Skills from MedEDU LLC: Access ranges from free to $19 for Essentials and $38 for Advanced access. The practical skills offered are ECG Interpretation, Heart Sounds, Lung Sounds, Blood Pressure, Medical Terms, and Ultrasound. Depending on the module, there are opportunities for the learner to practice interpretation of diagnostic skills, and graded quizzes to test their knowledge.
If you know of other free nursing simulation resources that can be included, please email us.
