E-learning and simulation in healthcare

We develop knowledge that examines the effect of digital learning resources and simulation on quality and competence in health education and clinical practice.

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Research area

E-learning and simulation in healthcare (ELOS)

Research leader

Kristin H. Urstad



Doctoral fellows






Use of digital tools in nursing education (Video: NETTOP).

Healthcare professionals must handle the complexity of health services and ensure knowledge-based practice. At the same time, the need for interaction between different professions and the ability to adapt to changes is becoming increasingly important in the healthcare sector.

Digital and simulation-based learning methods facilitate efficient and relevant teaching. They expose students to realistic academic and clinical challenges, and increase practical management abilities. The use of more simulation in healthcare also provides training in interprofessional communication. It is therefore a useful tool in the education of healthcare workers and an important skill for quality improvement in the health services.

The research group has worked systematically to gain knowledge and competence in e-learning and simulation in health education. The University of Stavanger is a national leader in the development of digital learning methods for nursing education, and has, in recent years, been particularly active in implementing digital learning tools in collaboration with NETTOP and national and international partners.

News and activities


Simulation training using 360 ° video

360ViSi is an international collaborative project with the aim of developing innovative learning methodologies in health education using VR and 360 ° video technology.

Sykepleiestudent med VR-briller
The project will offer new tools for use in simulation training in health education (Photo: Cathrine Sneberg).

Europe has an an increasing need for health workers, partly due to an ageing population requiring long term care. The education of health workers, particularly nurses, includes a substantial amount of practical training. This poses challenges in terms of access to training facilities, cost and quality of the training.

The project aims to develop an innovative learning methodology where 360-video and interactivity are combined to create engaging simulation training and stimulate the flow and exchange of knowledge between higher education and enterprises.

The method will give teachers increased competence in the production of digital tools, as well as increase and make more digital learning tools available across national borders. Furthermore, the project wants to give new ideas to companies that develop services, products and technology towards teaching.

At UiS the project is a collaboration between the Faculty of Health Sciences and the
e-learning development unit NETTOP.

Find more information about the project at 360visi.eu

Project managers: Atle Løkken, NETTOP
Funding: EUR 963.566 from Erasmus+ Knowledge Alliences
Project period: 2020 - 2022
Collaboration partners: University of Stavanger, University of Nottingham (England), Catholic University of Valencia (Spain), Turku University of Applied Sciences (Finland), Screen Story (Norway), Quasar Dynamics (Spain) og ADE Animations Designs & Effects (Finland).



The SAFETY project will develop an innovative training course in emergency medicine using e-learning and simulation training.

Paramedisinstudent i ferdighetstrening
Photo: Hilde Garlid, Validè

The SAFETY project, led by the Università degli Studi di Foggia in Italy, is an Erasmus + Knowledge Alliance project with 10 partners from 7 European countries. The project brings together several European universities and companies that develop simulation tools to develop a new course in emergency medicine that will consist of both practical and theoretical modules. Students will have access to a course based on best practice from all educational institutions in Europe that offer such education.

By standardizing the education, health professionals can work at different hospitals in Europe with the certainty that they possess the same skills as their colleagues, regardless of geographical location. The course will include two new modules; one that addresses situations where a key person in the team is missing (for example, a doctor or nurse) and a module that addresses situations where the relatives of a patient panic. All the theoretical modules in the course will be offered using an e-learning tool, while the practical modules will be completed using simulation equipment.

As a partner in the project, UiS will be part of a European training network that enables the sharing of best practices. The course will build on existing best practice, but also include training needs that are identified through literature study and interviews of students and academic staff. UiS will have a special responsibility for leading the work of conducting a literature study where the goal is to identify how to put together an optimal team for training using simulation equipment. UiS will also lead the work of developing material that will be used to simulate situations where relatives of patients panic. Such situations can have a negative impact on the team working with the patient and, in the worst case, reduce the possibility of survival in an acute situation.

Contact person: Thor Ole Gulsrud

Phd Project

Newborn resuscitation in rural Tanzania

The project aims to investigate the impact of implementation of simulation-based training on clinical management and perinatal outcome in newborn resuscitation at a district hospital in Tanzania.

Simuleringstrening med NeoNatalie Live (Foto: Laerdal Global Health)
Use of NeoNatalie Live during simulation training (Photo: Laerdal Global Health)

The PhD project focuses on simulation-based training in newborn resuscitation. The project is part of Safer Births, a research, development and implementation project to improve fetal heart rate monitoring, newborn resuscitation and perinatal outcomes worldwide.

Helping Babies Breathe is a program developed to train birth attendants in low resource areas, using a newborn simulator called NeoNatalie, developed by Laerdal Global Health, to facilitate effective learning of standard newborn care and resuscitation. Since 2009, the Helping Babies Breathe program has had a significant positive impact on early neonatal outcomes in several low-resource countries.

Over the last years, Laerdal Global Health has further developed the newborn simulator to enable a more realistic training of bag-mask ventilation, with the aim to significantly improve mastery of real newborn ventilation. This new simulator, NeoNatalie Live, also provides automatic immediate feedback to the provider to enhance motivation for training and improve training performance.  

Haydom Lutheran Hospital, in rural Tanzania, implemented NeoNatalie Live in 2016 as part of their quality improvement efforts in newborn resuscitation. The overall aim of this PhD project is to study the impact of frequent in-situ skills and simulation-based team training, using the NeoNatalie Live innovation, on acquired skills, clinical management and perinatal outcome in newborn resuscitation from 2015 through 2020.

Contact person: May Sissel Vadla


Training app for nursing procedures

In the DIGISIM project, a digital app has been developed for use in skills training in European nursing education

Lærere i DIGISIM-prosjektet
International partnership: Venche Hvidsten (UiS), Esther Navarro (UCV), Kristin Hjorthaug Urstad (UiS), Katharine Whittingham og Heather Wharrad (UoN) (Photo: Leiv Gunnar Lie).

Nursing students must master procedures such as injections, care of surgical wounds and measurement of blood sugar and blood pressure. By repeating and practicing on their own, they can perfect the execution of practical procedures in a safe environment.

Through the project DIGISIM (Development and implementation of a digital Skills Simulation App for European Nursing Education), a training app that students can use in skills training has been developed. The app, which was launched in 2020, will make it possible for students to increase their competence through a student-active learning method. In this way, the app can help increase self-confidence and reduce nervousness before students have to put their knowledge into practice.

The app contains a total of ten different procedures and includes functions such as films, equipment lists and checklists. There is also a "voice guide" that explains step-by-step how the procedure should be carried out. A proximity/light sensor also ensures that students easily can move on to the next step. Without having to touch the screen, students remain sterile while practicing the procedure.

DIGISM is developed in collaboration between students and teachers at the University of Stavanger, University of Nottingham (England), and Universidad Católica de Valencia (Spain). The app is available in Norwegian, English and Spanish, and is customized to the national nursing procedures of each country.

Available at Appstore and Google play.

Project managers: Kristin H. Urstad and Atle Løkken
Funding: 3 millions from Erasmus+ Strategic partnerships
Project period: 2018 - 2020


Simulation-based education in nursing education programmes

The aim is to explore, develop and implement simulation as a pedagogic method in two low-income nurse educational programmes.

Sykepleiestudenter fra Madagskar i simulering
Nursing students from Madagaskar (Photo: Ingrid Tjoflåt).

Global knowledge exchange is important and we especially find it meaningful to share knowledge to nursing education in low-income countries.

Researchers have an ongoing project with the aim to explore, develop and implement simulation as a teaching method within emergency medicine in nursing educational programs in two low-income countries.

By strengthening teachers' knowledge and skills in simulation as a pedagogic method, and conducting simulation sessions with nursing students at the Haydom School of Nursing in Tanzania and the Malagasy Lutheran Institute of Nursing Education in Madagascar, the research team examined both students' and teachers' experiences with simulation as method. The simulation program was adapted to the different professional and cultural contexts in both countries.

See our report from Tanzania for more information.

Project managers: Ingrid Tjoflåt and Bodil Bø
Collaboration partners: University of Stavanger, Stavanger University Hospital, Haydom School of Nursing and the Ministry of Health in Tanzania, and Malagasy Lutheran Institute of Nursing Education in Madagascar.

This is a shared project between ELOS and SHARE - Centre for Resilience in Healthcare


Use of virtual simulation as a learning tool

vSim® is a web-based platform developed to simulate nursing scenarios. Teachers at the university have tested the use of vSim in preparation for clinical practice.

Studenter bruker Vsim
The aim of the project is to explore how nursing students develop clinical judgment by using vSim® for nursing.

By using the platform, students have opportunities to interact with virtual patients and receive direct feedback on their performance. The nursing scenarios can help the students to apply knowledge, make decisions, complete interventions, get feedback on their actions and repeat activities and content at their own pace. 

Virtual clinical simulation is a new technology that is suggested to be effective in nursing education. In order to expand the knowledge base about the benefits of vSim® as a learning tool among Norwegian nursing students, the use of the virtual simulation tool was evaluated from the students' perspective.

The project was carried out among 65 second-year nursing students at UiS preparing for clinical practice at a surgical department in the specialist health service. The simulation session and the evaluation was carried out as part of the students' preparation, the week before the start of their clinical practice.

The majority of students considered the use of vSim® in surgical nursing to be useful, realistic and educational - especially in connection with preparations for surgical practice. However, a small proportion of students had difficulty understanding and navigating the program. The introduction of virtual simulation tools in nursing education must therefore include preparation, guidance during the simulation session and support for students who find it difficult to use the simulation program.

Read more about the students' evaluation

vSim for Nursing is an American simulation tool, which was developed through a collaboration between Wolters Kluwer Health (Lippincott), Laerdal Medical and the National League for Nursing.

Contact person: Ingrid Tjoflåt og Tone Knudsen Brandeggen


Digital storytelling in clinical practice

In collaboration with OsloMet, the project seeks to gain increased knowledge about digital tools that can contribute to reflection in clinical practice.

Sykepleiestudenter i lab
Digital storytelling will promote learning and reflection in students in clinical studies (Photo: Siv Sivertsen).

Storytelling is described to promote deep learning by encouraging reflection on practice and it is widely recognized in the literature as a powerful educational tool in higher education. The digital development has provided storytelling with increased possibilities as it can provide authentic learning experiences and thus enhance professional identity development and critical thinking.

Digital storytelling is the idea of telling a story, often with strong emotional content, by using a variety of digital multimedia, such as images, audio, music, video and the voice of the narrator. 

Experiences from students reflection through shared digital storytelling practice showed how the students narratives could promote reflection among nurses in clinical practice. Critical awareness and reflection is essential to maintain qualitative nursing care in busy hospitals wards. Little is known about how students digital stories can support nurses reflections in busy hospital wards.

The aim of the project is to implement the digital learning tool "digital storytelling" in clinical practice. The educational materials are intended to promote learning and reflection in students in clinical studies.

Contact person: Kristin Glenna Bodsberg


Development of interactive e-learning apps

DIMEANE is an ERASMUS+ project in cooperation with the University of Nottingham (UK) and Universidad Católica de Valencia (Spain), in which UiS is the leading partner.

Person med nettbrett
The purpose is to develop and implement an interactive mobile e-learning app for e-compendia.

Development and Implementation of Interactive Mobil E-learning Apps for European Nursing Education (DIMEANE)

The purpose of the DIMEANE project was to develop and implement an interactive mobile e-learning app for e-compendia in order to improve learning and flexibility for British, Norwegian and Spanish nursing students.

In connection with the project, qualitative and quantitative data is gathered with the intention of understanding how teachers and students experience use of these tools and how such tools are implemented in the course and the learning process.

Capturing the user perspective is ensured through student representatives from each of the three countries that are active contributors to the project. A scientific comparative study between the three countries has commenced. 

Explore the e-learning compendia on erasmusnursing.net or download the app on Google Play or App Store 

Project manager: Kristin Hjorthaug Urstad



The overall aim was to explore nursing students’ experiences with training holistic nursing care, using simulation-based scenarios in large groups.

Ferdighetstrening for sykepleiestudenter
Simulation-based scenarios in large groups (Photo: Siv Sivertsen)

A descriptive design including a quantitative approach with input of findings from a qualitative study has been used in this project, the last aimed to deepen the results from the quantitative part. The research study will be carried out using two different research methods, which comprise: 1) A questionnaire (Reed, 2010; Tosterud et al. 2015), 2) Focus group Interviews (Malterud, 2003). Data collection started September 2018.

The Norwegian Social Sciences Data Services approved the study.

Project Group: Dagrunn Nåden Dyrstad, Kristin Glenna Bodsberg, Malene Søiland, Grethe Bjerga, Turid Anita JaastadÅse Undersrud Bergesen, Kristin Hjorthaug Urstad



The DiaWeb research project is related to e-learning and supervision in clinical practice. Its purpose is to identify and explore diabetes nurses’ experiences with e-guidance for adults with type-2 diabetes in general practice.

Sykepleiestudent i uniform
DiaWeb will identify and explore diabetes nurses’ experiences with e-guidance for adults with type-2 diabetes. (Photo: Siv Sivertsen)

It is the first time that diabetes nurses will try out the guidance via secure messages in general practice in Norway. The study will, therefore, generate new knowledge within e-guidance methodology and thus form the basis for building e-guidance expertise that should benefit both persons with type-2 diabetes and professionals within diabetes care.

DiaWeb project is part of a larger research project DiaHealth which includes several national and international partners. The project is mainly funded by the Norwegian Research Council to a total of NOK 15.9 million.

Project manager: Bjørg Oftedal


MOOC in higher education

MOOC in medical calculation is applied in teaching of nursing students at the University of Stavanger

Photo: Siv Sivertsen

Based on this e-learning course, which was developed by Brynjar Foss in 2014, the pattern of nursing students’ use of "on-demand lectures" in the relevant MOOC in medical calculation has been studied.

The digital lectures consisted of 22 teaching blocks and included 14 relevant topics for the course. Data was collected via the students’ log on the media site (N=48). The result exhibits heterogeneous use. This means that there was great variation in which lectures were used in the learning process. In addition, the study reveals that students did not watch whole lectures, but fast forwarded to parts of them. This may signal that "on-demand lectures" provide students with the opportunity for repetition of difficult material, based on their individual needs (Urstad et al., 2016).

The research group’s members are currently developing a MOOC linked to how nursing students integrate the scientific subjects (anatomy, physiology and diseases) in their execution of practical nursing skills. The purpose of the project is to create a new digital multi-disciplinary multimedia workshop that connects the various technical disciplines mentioned above, using video lectures, skills instruction videos and MC (multiple-choice questions). Half of first-year nursing students have been given access to this MOOC through "It's Learning" in their preparation for practical oral exams. Interim evaluation of the MOOC project includes focus group interviews about students' experiences. There is an intention to compare exam results between the student group that has had access and the student group that has not had access to this MOOC. A scientific publication is planned based on the interim evaluation.

Contact person: Bodil Bø


Faculty of Health Sciences
Department of Public Health
Vice-Rector for Education
Division of Education
3. etg Kitty Kiellands hus
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Department of Quality and Health Technology
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