Success Story

University of Arizona nursing program uses entire SLS to ensure a comprehensive clinical experience

Nurses and doctors reviewing

At-A-Glance Facts

Established in 1957, the University of Arizona College of Nursing offers a traditional Bachelor of Science in Nursing (BSN) program, an accelerated second-degree program for students who already have a bachelor’s degree in a field other than nursing, two graduate certificate nurse practitioner specialty programs, (family nurse practitioner and adult acute care nurse practitioner), and two online doctoral programs.

After determining that developing their own simulation scenarios was too cumbersome, the University of Arizona College of Nursing began using Elsevier’s Simulation Learning System. They are currently using the pre-simulation learning resources, the simulation scenarios, the post-simulation learning resources, and the electronic medical record.


The University of Arizona College of Nursing began using Elsevier’s Simulation Learning System (SLS) in September of 2009. “Before we bought the system, we created our own simulations,” says Yvette Mathesen, B.S.N., R.N., assistant coordinator, Steele Innovative Learning Center, University of Arizona College of Nursing, Tucson. “It could take up to 40 hours to create just one scenario. It eventually became too much because we were in the process of revamping our curriculum and were really working on increasing the number of simulation scenarios available to students. We didn’t have time to develop enough of the same level of quality scenarios that we get with the SLS.”

The Simulation Experience

Prior to a student simulation experience, the faculty member allows students to access the pre-simulation learning resources. “Students prepare for simulation like they would for clinicals,” says Mathesen. “They review the pre-simulation materials, may take the pre-simulation quiz, and look at the patient’s chart to familiarize themselves with the patient’s history. When they get to the simulation lab, if they come prepared, they’ll know how to react during the simulation experience. For example, if the patient has a history of heart problems, the student shouldn’t be surprised if the patient shows symptoms of CHF [congestive heart failure] during the simulation. So if the student hears crackles while listening to the patient’s lungs, he or she should be able to ascertain that the crackles may be related to the heart problems and know to call someone.”

Following the simulation experience, the students go to the SLS electronic medical record and enter their documentation. Then they go to a debriefing and may take the post quiz. “We sometimes make changes to the simulation scenarios, in which case we may also need to make changes to the post quiz,” Mathesen says. “For example, there’s one scenario where a patient has a reaction to a pain medication, but the students may not yet be at a level where they know what to do when that happens. So instead of having them go through the whole scenario, we may have them assess the patient for pain, see if the patient has a standing order for pain medication, then give the medication. Instead of the patient having a reaction to the medication, the simulation would stop there. Then the next week, after they’ve learned what to do when a patient has a reaction to pain medication, we may bring them back to the simulation lab to complete the entire scenario.”

Staff Education

Mathesen recommends that prior to implementing SLS, all staff attend one live course. “We originally had one person do a presentation for a small group of people and others were learning how to use it on their own,” she says. “It wasn’t very organized. We later had someone from Elsevier come out and lead the training. This time we had a large group in the room. It was very effective. We found that if you have structured classes, SLS is easier to implement.”


According to Mathesen, when SLS is used as it is intended, the feedback from students has been positive. “They really like the electronic chart,” she says. “In a hospital setting, you don’t have the luxury of putting a whole group of students in a room and examining a patient’s chart.”

Mathesen says that with the SLS, the students at the University of Arizona College of Nursing are now able to do a lot more simulations than they would have in the past. “Before, we had about 25 scenarios with varying degrees of detail to choose from,” she says. “Now that our curriculum has changed, we have brand new courses for which we do a larger number of simulations.”