🏥 Caring Off Duty

A virtual simulation focused on the initial management of a polytraumatised child

Caring Off Duty is the second Virtual Gaming Simulation (VGS) developed within the framework of the European Envision project. It builds upon the foundations laid by “Hello, you must be Flo?”, the first VGS designed for undergraduate nursing education. This new simulation represents a second-generation approach, both pedagogically and technically.

✌️Two versions available

The simulation is offered in two distinct formats:

  • A version without scoring, focused on formative learning
  • A version with a built-in scoring mechanism. Participants receive a score based on their first choice at each decision point. A total score is calculated at the end.

Educators are advised to select the version that aligns most closely with their intended learning objectives—whether the emphasis lies on structured evaluation or reflective skill development.

Key Innovations

Several functionalities have been developed and integrated during the project’s lifecycle, and are now standard in the H5P Branching Scenario tool:

  • Randomisation of decision branches, enhancing replayability and reducing predictability
  • Scoring mechanisms at each decision point, with cumulative grading
  • Gamification elements to increase engagement
  • Individualised reporting and tracking in case of Learning Management System (LMS) integration

These features provide educators with enhanced options for flexible implementation and assessment. Facilitators are encouraged to inform participants whether the simulation will be graded and, if applicable, to clarify the assessment criteria in advance.

🎯Learning Objectives

The simulation enables learners to apply knowledge and skills related to paediatric emergency care. The following learning outcomes are addressed:

  • Accurate application of the PAT/ABCDEF framework in acute paediatric situations
  • Use of the SBAR communication protocol in interprofessional contexts
  • Leadership and communication under pressure
  • Development of an individualised care plan, adapted to the patient and family
  • Recognition and appropriate response to the emotional needs of family members


🧩Simulation Structure

The simulation consists of four clearly delineated modules:

📘 Prebriefing

The simulation is preceded by a structured prebriefing session. This aims to prepare learners for the virtual environment and ensure psychological safety. The prebriefing includes:

  • An overview of learning objectives and the simulation structure
  • Ground rules related to confidentiality, safety, and fictional context (“fiction contract”)
  • A case file providing essential clinical context

Recommended prior knowledge includes PAT, ABCDEF, SBAR, Glasgow Coma Scale, and the fundamentals of paediatric emergency care.

🎬 Online Simulation Scenario

The simulation begins with a video introduction: Sara Smith, a paediatric nurse, is heading home after a long shift when she encounters a medical emergency on the street.

  • The simulation contains 11 decision points
  • Each choice affects how the scenario unfolds
  • Correct choices trigger immediate positive feedback
  • Suboptimal choices provide constructive feedback (video or text), followed by a chance to choose again

🧭 Debriefing

Upon completion, students are invited to engage with a self-debriefing tool, based on structured reflective questioning.

  • Encourages critical thinking aligned with learning objectives
  • Offers a consistent method for individual reflection
  • Can be complemented by a group debrief for deeper discussion

💡 Knowledge Corner

Not an online course, but a supportive element of the simulation. It is not a mandatory part of the online experience but offers a valuable tool for assessing prior knowledge and exploring the clinical reasoning behind the decision points. Learners can review it either before or after the simulation.

🎓For Educators


Caring Off Duty can be used in online, blended, or classroom settings. A full implementation guide is available in the “Guides” section of this website. Educators can choose between the two simulation modes – with or without scoring – depending on the desired learning outcomes. Whether your priority is graded assessment, safe exploration, or self-reflection, this flexibility ensures the simulation can be aligned with your curriculum and teaching strategy.

Educators are supported across all three simulation phases:

  • Prebriefing: ready-to-use materials ensure a clear, safe learning start
  • Simulation: learners make autonomous decisions, supported by in-scenario feedback
  • Debriefing: the self-debriefing tool enables reflective learning, also in asynchronous formats
  • Knowledge Corner: to assess prior knowledge or to explore the clinical reasoning behind the decision points.

Tip: Clearly communicate in advance whether the simulation will be assessed, and how.