Accessible Requires Authentication Published by De Gruyter June 8, 2020

Gett’n on the bus: evaluation of Sentinel City®3.0 virtual simulation in community/population health clinical placement

Andrea Chircop and Shelley Cobbett



The purpose of this project was to implement and evaluate the integration of a computer-based virtual simulation program into a community clinical course as an alternative or complement to conventional clinical with agencies or neighbourhoods. Securing quality community health clinical opportunities for undergraduate nursing students remains challenging. In addition, evidence of a theory-practice gap in community clinical education, particularly in non-traditional settings, suggests that nurse educators need to adopt different pedagogies to ensure that students will gain competencies necessary to practice community/population health nursing. In response, we piloted the use of Sentinel City®3.0, a virtual reality simulation program.


A 5-point Likert-style questionnaire was administered to students randomly assigned to different clinical placements.


Results indicated that there were no learning outcomes in which students in Sentinel City®3.0 reported percentages lower than students in agencies or geographical neighbourhoods. When there were statistically significant differences, students engaged in Sentinel City®3.0 performed better than students in other experiences.


We recommend further exploration of multi-contextual pedagogies for community clinical.

Corresponding author: Andrea Chircop, PhD, RN, School of Nursing, Dalhousie University, Halifax, NS, Canada, E-mail:


Babenko-Mould, Y., Ferguson, K., & Atthill, S. (2016). Neighbourhood as community: A qualitative descriptive study of nursing students’ experiences of community health nursing. Nurse Education in Practice, 17, 223–228. Search in Google Scholar

Babenko-Mould, Y., Ferguson, K., Riddell, T, Hancock, M., & Atthill, S. (2014). Influence of simulated and actual community vaccination clinics on student empowerment and self- efficacy for public health nursing competencies. Public Health Nursing, 32(3), 277–283. Search in Google Scholar

Carlson-Sabelli, L. L., Giddens, J. F., Fogg, L., & Fiedler, R. A. (2011). Challenges and benefits of using a virtual community to explore nursing concepts among baccalaureate nursing students. International Journal of Nursing Education Scholarship, 8(1), 1548–923X. Search in Google Scholar

Canadian Association of Schools of Nursing (CASN). (2018). Curricular guidelines for integrating community health in baccalaureate programs of nursing, Author, Ottawa. Search in Google Scholar

CASN. (2010). Guidelines for quality community health nursing clinical placements for baccalaureate nursing students. Retrieved from: Search in Google Scholar

CASN. (2014). Entry-to-practice public health nursing competencies for undergraduate nursing education. Retrieved from: Search in Google Scholar

Cohen, B. E., & Gregory, D. (2009). Community health clinical education in Canada: Part 1 “state of the art”. International Journal of Nursing Education Scholarship, 6(1), 1–17. Search in Google Scholar

Diem, L. & Moyer, A. (2016). Community and public health nursing. Learning to make a difference through team work. (2nd Ed.). Toronto, ON: Canadian Scholars Press. Search in Google Scholar

Fogg, L., Carlson-Sabelli, L., Carlson, K., & Giddens, J. (2013). The perceived benefits of a virtual community: Effects of learning style, race, ethnicity, and frequency of use on nursing students. Nursing Education Perspectives, 34(6), 390–394. Search in Google Scholar

Giddens, J., Fogg, L., & Carlson-Sabelli, L. (2010). Learning and engagement with a virtual community by undergraduate nursing students. Nursing Outlook, 58(5), 261–267. Search in Google Scholar

Giddens, J. F., North, S., Carlson-Sabelli, L., Rogers, E., & Fogg, L. (2012). Using a virtual community to enhance cultural awareness. Journal of Transcultural Nursing, 23(2), 198–204. Search in Google Scholar

Leh, S. K. (2011). Nursing students’ preconceptions of the community health clinical experience: Implications for nursing education. Journal of Nursing Education, 50(11), 620–627. Search in Google Scholar

Liaw, S. Y., Carpio, G. A. C., Lau, Y., Tan, S. C., Lim, W. S., & Goh, P. S. (2018). Multiuser virtual worlds in healthcare education: A systematic review. Nurse Education Today, 65, 136–149. Search in Google Scholar

Pijl-Zieber, E. M., Barton, S., Awosoga, O., & Konkin, J. (2015a). Disconnects in pedagogy and practice in community health nursing clinical experiences: Qualitative findings of a mixed method study. Nurse Education Today, 35, e43–e48. Search in Google Scholar

Pijl-Zieber, E. M., Barton, S., Awosoga, O., & Konkin, J. (2015b). Nursing students achieving community health competencies through undergraduate clinical experiences: A gap analysis. International Journal of Nursing Education Scholarship, 12(1), 143–154. Search in Google Scholar

Pijl-Zieber, E. M., & Kalischuk, R. G. (2011). Community health nursing practice education: Preparing the next generation. International Journal of Nursing Education Scholarship, 8(1), 15. Search in Google Scholar

Poikela, P., & Teräs, M. (2015). A scoping review: Conceptualizations and pedagogical models of learning in nursing simulation. Educational Research and Reviews, 10(8), 1023–1033. Search in Google Scholar

Sentinel City® Urban Community. (2018). Aurora: Healthcare learning innovations. Retrieved from: Search in Google Scholar

TCPS 2. (2018). Tri-Council Policy Statement, Ethical Conduct of Research Involving Humans, Article 2.5-. Retrieved from: Search in Google Scholar

Tilton, k. J., Tiffany, J., & Hoglund, B. A. (2015). Non-acute-care virtual simulation: Preparing students to provide chronic illness care. Nursing Education Perspectives, 36(6), 394–395. Search in Google Scholar

Thomas, E. C. (2017). Teaching RN-BSN students community health using an immersive virtual environment. International Journal of Innovations in Online Education, 1(1), 1–12. Search in Google Scholar

Verkuyl, M. A., & Mastrilli, P. (2017). Virtual simulations in nursing education: A scoping review. Journal of Nursing and Health Sciences, 3(2), 39–47. Search in Google Scholar

Williams, J. R., Halstead, V., & McKim Mitchell, E. (2016). Two models of public health nursing clinical education. Public Health Nursing, 33(3), 249–255. Search in Google Scholar

Received: 2019-09-25
Accepted: 2020-04-30
Published Online: 2020-06-08

© 2020 Walter de Gruyter GmbH, Berlin/Boston