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Firsthand XR

Clinical judgment practice for US nursing programs

Scenarios scored against AHA guidelines, with a patient who gets better or worse depending on what students do. US drug names, units and 911.

Close look panel showing both pupils equal and reacting to light beside the patient

The clinical judgment model, in the headset

The NCSBN Clinical Judgment Measurement Model describes six steps. In a scenario, students move through all six, in real time.

Read: the clinical judgment model in simulation
  1. 1

    Recognize cues

    Notice the changing observations, the patient’s words and what the monitor shows.

  2. 2

    Analyze cues

    Work out what the cues mean together, and what does not fit.

  3. 3

    Prioritize hypotheses

    Decide what is most likely and what is most dangerous.

  4. 4

    Generate solutions

    Choose what to do first, and what to escalate.

  5. 5

    Take action

    Do it in the headset: oxygen, a call for help, a shock, a drug.

  6. 6

    Evaluate outcomes

    Watch the patient respond, then review it in the scored debrief.

For nursing schools

Practice mode with guides for first exposure, assessed mode for check-offs, and a scored debrief every time. Students can repeat a scenario until the sequence is automatic, without booking the sim lab.

Team sessions put a group of students in one scenario with roles, on your campus network.

Nursing education in detail

For hospitals

ACLS refreshers on the ward, recognition of the deteriorating patient, and maternity emergencies, scored against AHA guidance.

It runs offline on standalone headsets, so it fits a unit’s education room or a break between shifts.

Hospitals in detail

CJMM curriculum map

A map of every clinical scenario against the six CJMM steps is being finalised with our clinical and training advisers.

Questions people ask

Do your scenarios follow AHA guidelines?

Yes. With the USA pack, resuscitation scenarios are scored against AHA guidance, with US drug names, units and 911.

Can virtual simulation count toward clinical hours?

That depends on your state board of nursing and your program’s approval. Check their current rules. We can give you what you need to describe the scenarios to them.

How does it relate to the Next Generation NCLEX?

The NGN is built on the NCSBN Clinical Judgment Measurement Model. Our scenarios give students practice making those judgments with a patient who reacts. It is not an NCLEX preparation product.

Are you a US company?

No. We are based in Australia and build regional packs for the USA, Australia and Indonesia.

See it in a headset

Book a 30-minute demo. We will run a scenario live, talk through your training units and scope a pilot that fits your team.

Trainee view of a patient sitting up in the ICU bed with the cardiac arrest panel open and a nurse at the bedside