1. Branching Simulation Designs for Virtual Patients
4/22/2018
Branching Simulation Designs for Virtual Patients
Kira King, PhD
Decision Simulation
Rosalyn P. Scott, MD, MSHA
Dayton Veterans Affairs Medical Center
Wright State University
Mary Davidson, MSN APRN CHPN
Veterans Affairs Healthcare System of Ohio
Edward Bope, MD
Chief of Primary Care/Palliative Care Physician
Columbus Veterans Affairs Ambulatory Care Center
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2. Alternate Learning Paths Personalized Feedback
Types of Branching
Alternate Learning Paths
Gaming
Personalized Feedback

3. Branching: Examples & Non-Examples
Concept: Triangle
Conceptual knowledge “kinds of”
Explore examples of what is and what is not the concept
Reflection highlights the distinguishing criteria of the concept
Works with a variety of media
Decision
Reflection
Reflection
Example: Non-Example:
Triangle Circle
(Merrill, 2009)

4. Branching: Delayed Consequences
Demonstrates the consequences as the simulation flashes forward
Drama supports engagement and retention
Promotes insightful learning
Provides autonomy
Decision
Consequences
Consequences
Reflection
Reflection

5. Branching: Second Chance
Decision
Provides preliminary results of decisions
Go back and add choices for a better outcome
Models problem solving approach
Encourages self-reflection
Initial Results
Initial Results
Initial Results
Poor Outcome
Optimal
Outcome
Sub-Optimal
Outcome

6. Branching: Interrupter
Patient Interview
Interrupt learners if they make a dangerous decision
Create an alternate path or remediate via a mentor
Models the real world
Uses drama to portray dire consequences
Patient Deteriorates
Order
Lab Tests
Stabilize Patient
Results
Too Many Essential
Questions Questions Only

7. Branching: Personalized Feedback
Decision
Assesses learners
Provides a second chance with support
Remediates learners who select both optimal and sub-optimal choices
Ensures mastery
Allows skilled learners to advance quickly
Try Again w/Hints
Mastery
Remediation
Continue

8. Branching: Personalized Feedback
Remediation: You identified the 3 clinically significant findings. However, you also selected symptoms that are not clinically significant: rigidity, mood swings and difficulty sleeping.

9. Branching: Gaming Earn points
High scorers progress to harder challenges
Lower scorers can repeat Level 1
Motivates learners
Mastery learning
Challenge 4
Challenge 5
Challenge 6
Level Two
Score
Challenge 1
Challenge 2
Challenge 3
Level One

10. Branching: Gaming 10

11. Branching: Gaming 11

12. Types of Branching Branching Type Purpose Matched Examples &
Non-Examples
Teaches concepts by showing what is and what is not the concept
Delayed Consequences
Promotes insight, provides autonomy, creates drama to support learning
Second Chance
Models problem solving by doubling back to search for solutions
Interrupter
Redirects learners who make egregious choices to demonstrate dire consequences
Personalized Feedback
Ensures mastery by tailoring feedback to learner’s comprehension level
Gaming
Provides motivating challenges and ensures mastery

13. Questions?