Table 1: Virtual scenarios. Roles Situation (1) Bedside day nurse (2) Charge nurse (3) Bedside night nurse (1) Bedside nurse (2) Charge nurse (3) Physicia (played by faculty) (4) Assistiv personnel Patient family member Nursing Research and Practice Expected actions The scenario starts at the beginning of the shift as the itaabdpﬁnonreainﬀsrdtttdtiiihevsrebriaueenidensoctpne.ttaeatiinWtocmtauitnoenhhprsnrtseetidttenyb’obesiiberhsohiedanetgadgis/tincisrvfdohgaoaeefventrateatnatnhhcoeheyuesd ((((3142)))) rceanansetamnsoooasrdttepcreiisytffrpstyyigohroetttoneuhnhhvetaceetiondyappcnethaithinyhtbaayitenrioeseoginyarrctedvntiincaeentfe;nniorubcsrtreaiigosoasneistnvda;iecsr;ny; line. The antibiotic hanging (5) complete an incident tpppwmoaaaaletttdsdiiieeenitnnncooatttt’,ptsiihosronoraanadscl.mleeaeTerrneedhgodoieatcnhfssottetoiurtrhdttaehhenyeendttihse (6) raanfoetnuplttlrhioosbeerwitowb;utehipdcoswfiohdiuutehnn.dgththehaneniggihntg would if this happened in the clinical environment. The scenario starts as the ttsdohtiusetcdhnheeuanrbrtgsepeedlitsaseiydadiecnihrgaeinncthdtgeedbfroeotrgolieangoof (1) fcgroeotnmtthintehupeehbtyhesedicsciioadnnevateowrsaaytion; patient who is waiting to go (2) use conﬂict management isccdphhwntoaiaoauoarntnamudelifnodelerrendgdlone.eutnltiAiatefastihtansteaupehtddtahpiesogtysbyithanetoseuiewitangcaalabeiitabndvdreineeooidsirﬀrnusiaecbneitcodaartmttseleehhn.dteeehTtstehoye ((34)) ifssscugcnoiikooepttvlitnnuulslooltetaadshliwtttvuntiieaeoouocubdctnnperhoas;eitwuaf;nshrotsyieg.itlthenvpueenhtachtytuehiesroseisscneaiaryn was clinical environment. 4 Scenario Objectives (1) Medication safety (1) students will demonstrate the correct response to a medication error; (2) students will use appropriate communication skills when delivering peer feedback; (3) students will demonstrate leadership skills in diﬃcult situations. (1) students will recognize inappropriate communication; (2) Interprofessional (2) students will use communication appropriate conﬂict management skills; (3) students will use resources appropriately. scenario required the students to use a similar skill set (patient safety, leadership, communication with health- care providers, feedback to colleagues, appropriate use of resources and followup, and delegation). The scenarios were developed and beta tested using second career nursing students and faculty prior to use in this study [16]. Students in this study were given an overview of SL during the didactic portion of their fall course. Each student was also given a Power Point handout that described the basics of SL such as how to set up an account, create an avatar, move your avatar, and use the chat function. Students were encouraged to develop their own avatars and explore the world prior to the simulations. For each simulation, students who played a role in the scenario (e.g., role of RN, unlicensed assistive personnel, patient) went to the school computer lab and logged into SL, while the remaining students were in another classroom watching the virtual interaction via LCD projector through one of the facilitator’s avatars. The students used avatars that were already created and were present in the training environment. The students needed to use the directional keys on the keyboard to move their avatar and a texting function called chat to “speak” to each other. These were the only skills necessary to participate in the virtual simulations. Prior to each simulation the students who played a role in the virtual environment using an avatar were once again given a brief overview of SL and how to manipulate their avatars. They had an opportunity to practice for a few minutes moving their avatars and using the chat function before the simulation began. A facilitator was present during the entire simulation to answer questions or troubleshoot any problems the students had during the simulation. Five groups of approximately 15 students participated in the two scenarios at two diﬀerent points in time (in Scenario 2 two of the ﬁve groups participated at the same time). It is important to note that not all students were actually able to play a role in the scenarios. Most students were observers watching the simulation scenario. This is consistent with mannequin-based simulation in which students may play roles in the simulation or observe the simulation. All students, however, do participate in the debrieﬁng of the scenario and are exposed to key learning points. Scenario