• Jacqueline McCallum, Valerie Ness, and Theresa Price.
• School of Nursing Midwifery & Community Health, Govan Mbeki Building, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, United Kingdom. jacqueline.mccallum@gcal.ac.uk
• Nurse Educ Today. 2011 Oct 1; 31 (7): 699-704.

AimTo explore nursing students' decision-making skills through the use of a 3D virtual environment such as Second Life.MethodAn exploratory qualitative evaluation of the students' experience of learning decision-making skills whilst in a Second Life clinical simulation laboratory. A convenience sample of five third year student nurses entered a simulated world environment where they cared for six patients over 1h. The written communication text from the Second Life scenario was saved into a Microsoft Word document. Additionally a semi-structured tape-recorded one to one interview was conducted immediately after the Second Life simulation in order to explore the students' decision-making skills.ResultsThe communication text illustrated that the majority of decisions (n=21) were made in response to a situation or a patient request, therefore 'reactive' rather than proactive (n=9). Only one student carried out a vital signs assessment on a newly admitted patient (Willie). The interviews produced two themes, performing decision-making and improving learning. The absence of 'visual cues' such as pre-operative checklists, vital sign observation charts and 'Nil by Mouth' signs may offer a rationale for why students were more reactive.ConclusionFurther work is required for students to practice decision-making skills. With further development the innovative 3D virtual worlds such as Second Life could provide this experience.Copyright © 2010 Elsevier Ltd. All rights reserved.

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