When Simpler Feels Better: What This Study on VEMS and Mannequins Raises for Simulation Educators

A published conference abstract by Burcu Dogan, Natalie Pattison, and Guillaume Alinier adds an important—and intriguing—piece to the growing conversation about simulation modality choice. Using the Simulation Effectiveness Tool–Modified (SET-M), the authors compared nursing students’ experiences of the same clinical scenarios delivered using Visually Enhanced Mental Simulation (VEMS) versus full-scale mannequin-based simulation. Their findings are worth paying close attention to.

In a study involving over 100 third-year nursing students, learners who participated in VEMS reported higher overall SET-M scores than those who undertook the same scenarios using mannequins. Most notably, the differences were concentrated in the learning and confidence subscales related to the in-scenario experience itself, rather than the pre-brief or debrief. In other words, students felt that they learned more, and felt more confident during the scenario when the modality was VEMS.

Celebrating the Work Behind VEMS

This study builds on at the early scholarship about VEMS led by Dogan, Pattison, and Alinier, who have been instrumental in articulating it as more than a low-fidelity substitute. Their earlier work has consistently highlighted the power of mental simulation, think-aloud strategies, and visual cues to support non-technical skills, teamwork, and engagement. This comparative study builds on that work.  

Just as importantly, the authors resist oversimplified conclusions. Rather than claiming that one modality is universally “better,” they show that VEMS can offer a learning experience that is at least comparable—and in some dimensions superior—to mannequin-based simulation.

More Questions Than Answers (and That’s a Good Thing)

For educators thoughtfully trying to match modality to objectives, these findings raise some fascinating questions.

Why might learners feel more confident and engaged during VEMS scenarios? Does the reduced cognitive load of managing technology free up attention for clinical reasoning and team interaction? Does the explicit verbalisation and shared visual field enhance shared mental models in ways that mannequins sometimes obscure? Or does VEMS create a psychologically safer space that allows learners to take risks, speak up, and fully inhabit the scenario?

The SET-M scores point toward something important happening inside the scenario—but this study doesn't yet tell us why. That gap is an opportunity.

In this conference abstract the authors state that this was a mixed methods study so it is possible when they publish their final work we will have some of this qualitative data to round out understanding!

What We’d Love to Explore Next

We would love to hear more directly from learners about what these experiences feel like. What aspects of VEMS made the scenario more engaging? Where did confidence come from? How did the experience compare emotionally, cognitively, and socially to mannequin-based simulation? For what scenarios does VEMS make the most sense?

This study doesn’t settle the modality debate—and it shouldn’t! Instead, it invites us to move beyond assumptions that “more tech equals better learning” and to pay closer attention to how learners experience simulation in real time.

For teams focused on building confidence, engagement, and shared understanding—particularly around non-technical skills—this work suggests that simpler may sometimes be better.

And thanks to researchers like Dogan, Pattison, and Alinier, we’re starting to have the data to ask those questions properly.

If you want to get started with VEMS to explore its impact with your own learning group, check out our SimSimple Kits here.