1. Draude, Barbara J. MSN, RN

Article Content

Textbook:Medical-Surgical Nursing: Assessment and Management of Clinical Problems Workbook (Text and CD-ROM):Virtual Clinical Excursions Mosby, Inc, A Harcourt Health Sciences Company 11830 Westline Industrial Dr St. Louis, MO 63146 Telephone: 800-545-2522 E-mail: Web: Price: $89 (textbook); $39.95 (workbook)


Several electronic resources to assist faculty members and students to teach and acquire knowledge of medical-surgical nursing content accompany the textbook, Medical-Surgical Nursing: Assessment and Management of Clinical Problems. These resources include a student CD-ROM with key terms, case studies, and questions; access to the Mosby Merlin Web site that provides faculty and student with additional information and supplemental resources for each chapter; and a student workbook/CD-ROM. The subject of this review is the workbook, Virtual Clinical Excursions, a combination paper workbook and CD-ROM set that is available to supplement the main textbook. This resource provides simulated activities for students to experience clinical data gathering and decision-making opportunities.


When the student "enters" the virtual clinical experience, he/she is given the opportunity to interact with 5 patients (diagnoses: type II diabetes mellitus, respiratory infection, HIV, multiple trauma, and spinal cord injury). Data are gathered by reading the "patient chart," the "electronic patient record," to access the patient's current listing of physician's orders, assessments data, laboratory results, and medication records. This data gathering mimics the process that would be used in the traditional clinical setting as students prepare for their clinical experience. Students "travel" through the simulated hospital (Red Rock Canyon Medical Center), visiting the supervisor's office to choose a patient assignment, the nurse's station to read patient information, patient rooms to "meet" their assigned patient, and conference rooms to attend simulated healthcare team meetings and patient reports. Video clips allow the student to "see" the physical assessment as completed, to "sit in on" shift reports and case conferences with the case manager, social worker, and clinical nurse specialist; and to "eavesdrop" on interviews as subjective information data are gathered from each patient. The video clips can be seen in their entire sequence, or in individual sections that can be repeated as necessary for the student to understand the activity. One item that could have been added to the videos would have been audio clips that provided findings such as heart and lung sounds as they were being assessed. The video clips provide valuable role modeling of nurse-patient interactions and provide students with experiences such as shift reports and team meetings that they may not have the opportunity to participate in during traditional clinical experiences. The five virtual patients represent a wide variety of ages and cultural backgrounds.


The materials available on the disk and in the workbook and text are well coordinated. Each chapter in the workbook directs the student to the virtual clinical experience and to the textbook information about the content covered in that chapter. In this way, the combination of the three sources gives the student a patient to reference when studying that information. By putting a virtual face on the content being covered, the student can draw a mental picture about that patient, giving context to the information.


To get started with the virtual experience, the "Installation Disk" must be installed first and then the "Patient Disk" inserted to access the specific clinical information. On the first visit, viewing the "Quick Tour" is essential to provide instructions on how to interact in the virtual world of the experience. The "Quick Tour" instructs the user how to move about in the simulated clinical setting, detailing how to move from room to room and how to access data from a variety of resources. Students should be instructed that the "Quick Tour" is required before starting the course work. When ready, students can log in and access the patient data. On subsequent visits, the student can return to the patient with whom he/she had been interacting on a previous access or return to the supervisor's office for a new assignment.


The program is easy to follow and, once the "Quick Tour" is completed, easy to navigate. The experience provides two main advantages to student learning: it supplements the traditional clinical experience by broadening the patient care situations that may be available to students, and provides a clinical context to each chapter in the textbook. If used in coordination with the textbook and incorporated as an integral part of the delivery of course material, this workbook/CD-ROM set would be a valuable teaching and learning method for a medical-surgical nursing course.


Minimum System Requirements: Windows: Windows 2000, 95, 98, NT 4.0, IBM-compatible computer, Pentium II processor (or equivalent), 300 mHz or faster, 98 MB, 800 x 600 screen size, 256 color monitor, 100-MB hard drive space,12 x CD-ROM drive, Soundblaster 16 sound card compatibility, stereo speaker or headphones. Macintosh: MAC OS 9.04, IBM-compatible computer, Apple Power PC G3, 300 mHz, 98 MB, 800 x 600 screen size, 256 color monitor, 100-MB hard drive space, 12 x CD-ROM drive, Soundblaster 16 sound card compatibility, stereo speaker, or headphones.