The use of simulation in curriculum affords students with the opportunity to enhance clinical skills in a safe environment. However, certain aspects of patient assessment are difficult to reproduce in current simulators, such as changes in facial expressions. Facial expressions are of particular importance when assessing for the presence and severity of pain in the pediatric population. Inconsistencies found in accurate identification of pain suggest the necessity of improved pain assessment training. This study evaluated nursing student’s perceptions of a virtual patient designed to realistically display varying levels of pain in the pediatric patient. Additional purposes of this study were to evaluate the student’s ability to accurately rate pediatric pain using a virtual patient with and without other indicators of pain, explore the students experience learning pediatric pain in nursing school, and explore the use of simulation in curriculum to teach pain. A total of N=11 nursing students participated in this study. Students were presented with a series of virtual patient faces and asked to provide a pain rating from 0-10 utilizing a pediatric pain assessment tool, and to numerically list the facial features used to identify the pain rating they chose. A questionnaire was then completed which included questions regarding the realism of the virtual patient, pain and curriculum, and simulation. Results of the study showed students rated pain lower than the expected rating when presented with virtual patient faces only, and rated pain closer to the expected rating when presented with virtual patient faces and other indicators of pain such as vital signs and verbal cues. A noticeable range of reported pain rating levels existed for all virtual faces in which students rated the pain lower or higher than the true pain rating. The majority of students reported the virtual patient was moderately to extremely realistic, and 90.9% (n=10) reported they would like to have the technology implemented into a simulation scenario.

Thesis Completion




Thesis Chair/Advisor

Anderson, Mindi


Bachelor of Science in Nursing (B.S.N.)


College of Nursing




Orlando (Main) Campus



Access Status

Open Access

Length of Campus-only Access

1 year

Release Date


Included in

Nursing Commons