Visually Enhanced Mental Simulation, also known as VEMS, is a type of serious game played on a tabletop for healthcare simulation team to talk through. Somewhat like board g ames for healthcare professionals, the VEMS educational experience allows teams to have conversations and complete tasks in a low fidelity clinical simulation. This article by Erin Carn-Bennett, RN, MSN will share three online resources and programs for clinical simulationists to use to deliver VEMS tabletop serious game clinical scenarios.
The clinical simulation patient and equipment in a VEMS clinical simulation scenario are made out of paper cutouts. The use of muscle memory by clinical simulation participants physically placing equipment and team members around the paper patient allows clinical teams to work through clinical scenarios together and then debrief. VEMS style of clinical simulation suits scenarios which focus on teamwork, communication, organizational systems, processes, crisis resource management principles, and clinical reasoning. VEMS is not appropriate for the process of practicing clinical procedural skills and will not meet these learning objectives.
The Children’s Health Queensland Hospital and Health Services
The Children’s Health Queensland Hospital and Health services have a free open access PDF resource for VEMS serious games. This open access resource contains VEMS printable images and many resources for facilitators in order to run a successful VEMS tabletop healthcare simulation scenario or course. The PDF document contains facilitator guidance, a video demonstration of how to use an Optimus Prime VEMS course as well as the printable resources to laminate and use in pediatric resuscitation VEMS scenarios described above.
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Children’s Health Queensland recommends printing the appropriate pages of relevance for the clinical environment in color A3 size and then laminating the paper and cutting the paper into the individual pieces of equipment. The VEMS packs can be stored in an A3 size document case or folder.
How to run a VEMS course as advised by Children’s Health Queensland
- Orientate the VEMS clinical team to the scenario environment and the use of VEMS
- Demonstrate how to use the laminated clinical equipment through application to the patient silhouette
- Demonstrate how to write up requested medications on the ‘infusion’ or ‘drug’ paper
- Encourage team engagement through suspension of disbelief and communicate aspects of the clinical simulation as team members would in real life
- In the VEMS scenario, the facilitator should provide verbal feedback on what the paper patient appears like, and other relevant patient observations or use a virtual observation machine as an adjunct in order to provide auditory and visual cues to VEMS participants
- To assist with VEMS buy in and suspension of disbelief there is use to give VEMS participants clinical information that would be seen as if this was a real patient
- A VEMS clinical simulation debrief can be run in a similar way to other healthcare simulation scenarios in different healthcare simulation modalities
- Create time gaps between the order and administration of medications to assist to simulate closed loop communication and enhance realism
Virtual Resus Room Tabletop Resus Room
Tabletop Resus Room is run in a similar manner that has been described by Children’s Health Queensland. They also encourage teams to divide into their standard team roles. Tabletop Resus Room encourages VEMS clinical simulation participants to find VEMS medications in a drug binder and administer the medication to the VEMS patient. Tabletop Resus Room also encourages a deliberate time delay built into medication administration. This assists to force closed loop communication, situational awareness and prioritization of orders.
Tabletop Resus Room also provides a number of free resources, scenarios and silhouettes in order to run a successful VEMS clinical simulation course and scenarios. The silhouette files have been appropriately sized and scaled to the equipment. Tabletop Resus Room use and recommend the SimMon app. Tabletop Resus Room has no affiliation with the SimMon app and recommends this product due to affordability and usefulness. Observations can also be displayed on whiteboards, cue cards, google slides or any other monitor app.
The Advantage of Tabletop Resus Room is the low cost. The only cost is to print out the handouts for the VEMS clinical simulation scenario to occur. There is a low-time investment required and takes less than 5 min to set up and less than 5 min to pack down. Only a small space is required to deliver a VEMS course and only needs a hard surface to deliver the education on. VEMS is a fun, interactive and team-based approach which requires no technology or internet.
Retain Neonatal Resuscitation Tabletop Simulator
Retain is the very first and currently only Neonatal Resuscitation Board Game. The RETAIN tabletop simulator is a broad team centered neonatal resuscitation education game that focuses on communication skills that can be translated into improved clinical care. RETAIN is a quick and impactful alternative to be able to train nontechnical skills to neonatal resuscitation teams.
There is the ability for RETAIN to be completed as a self-directed activity or run by a facilitator. There is access to 50 evidence-based scenarios. Some of the included cases are: term infants, preterm infants, surgical cases, hydrops, and congenital heart diseases. In comparison to other healthcare simulation solutions RETAIN is low cost and accessible in any location.
1 million newborn babies who require resuscitation are reported to die each year around the world. 66% of these newborn baby deaths are reported to be related to deficiencies in healthcare staff clinical knowledge, non technical skills and communication (660,000 babies).
RETAIN the tabletop healthcare simulation activity has been demonstrated to show improvements in clinical staff skills to safely and correctly provide newborn resuscitation care by 36% and improves knowledge retention improvement by 100%. RETAIN has the capabilities to save the lives of over 230,000 newborn
babies each year through translated skills acquired in the table top healthcare simulation game.
This article has discussed VEMS (Virtually Enhanced Mental Simulation) through the lens of sharing three online programs and resources from Queensland Children’s Health, Virtual Resus Room: Tabletop Resus Room and RETAIN the Neonatal Resuscitation tabletop game. VEMS is an incredibly versatile and useful low cost modality of healthcare simulation. Just because a clinical simulation is low fidelity, does not mean that learning does not occur. VEMS offers a useful mode of clinical simulation in any environment for clinical teams.
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