Nursing Simulation Decisions: Manikin Programming vs. VR Custom Scenarios

For years, manikins have been the cornerstone of nursing simulation, offering tactile practice and foundational skill-building. But as healthcare becomes more complex and demands cultural competence, nuanced communication, and adaptability, educators face a pivotal question: Is it time to expand our toolkit?

Here’s how the two approaches compare—and why more institutions are turning to platforms like UbiSim to give students an immersive simulation experience that more closely mirrors real clinical practice.

Scenario Design & Customization

Manikin-Based Simulation:

Customizing manikin scenarios often requires working within rigid, preprogrammed parameters. Adjusting vital signs, patient responses, and clinical conditions may involve complicated programming or reliance on technical teams.

VR with UbiSim:

UbiSim’s intuitive editor empowers nurse educators regardless of their technical background to build or modify immersive simulations with just a few clicks. From editing prebrief and debrief content to customizing the patient’s demographics, medications, and equipment, educators have full creative control. Scenarios can be built to reflect diverse clinical environments, from acute care to long-term care settings, and aligned with INACSL and NGN standards.

“I created a whole scenario in less than an hour and a half with the UbiSim Editor… And I’m not a gamer – I still have a flip phone. But it was so easy!” — Gregg Schroeder, MSN, APRN-CNS, Director of Nursing Education, Hesston College

Technical Requirements

Manikin-Based Simulation:

Programming typically demands advanced knowledge of simulation software, and troubleshooting often requires support from dedicated IT or simulation technologists.

VR with UbiSim:

No coding is needed. The editor functions more like a guided menu, allowing educators to drag and drop elements such as lab results, X-rays, EKGs, and even conversational dialogue into the scenario.

“UbiSim was easier than programming simulations for our manikin-based simulators. It's kind of like a menu. You go through and pick what you want in the room.” — Dr. Kelly Foltz-Ramos, Director of Simulation and Innovation, University at Buffalo School of Nursing

Realism & Relevance

Manikin-Based Simulation:‍

Manikins offer physical realism and hands-on skill practice but can fall short in representing diverse patients or complex emotional interactions. Role-playing and standard patients are often needed to fill these gaps, and even then, learners don’t feel fully immersed.

VR with UbiSim:‍

Scenarios can include nuanced social dynamics, such as abuse disclosures or end-of-life conversations. Patient characteristics, including age, race, gender identity, and language, can be adjusted to better represent real-world populations. Educators can also choose whether the patient is alone or accompanied by a family member, adding complexity to therapeutic communication in scenarios.

Cost & Efficiency

Manikin-Based Simulation:

Purchasing, maintaining (servicing), and upgrading high-fidelity manikins is a major investment. Scenario programming is often time-consuming and may require repeated trial and error.

VR with UbiSim:

Once educators are familiar with the editor, scenario development is fast and cost-effective. Institutions can adapt existing library scenarios or build new ones without external support.

Scope of Practice & Flexibility

Manikin-Based Simulation:

Scenarios may be limited in how easily they can be adapted for different levels of learners or scopes of practice. Rewriting them to match a new curriculum often takes significant effort.

VR with UbiSim:

Scenarios can be quickly tailored for learners across programs, whether pre-licensure nursing students or nurse residents. This ensures that simulations always reflect the actual scope of practice.

“Being able to customize the scenarios is extremely important to me as a simulation educator. Our student population has a different scope of practice... With UbiSim, being able to easily go in, edit, and customize or develop my own scenarios means that what we're asking the students to do really reflects what their scope of practice will be in real life.” - Clare Howland, MSN, RN, CHSE, Director of Simulation, Bow Valley College

Final Thoughts

Virtual reality isn’t here to replace manikins; it’s here to amplify their impact. With platforms like UbiSim, educators can craft immersive scenarios that challenge students to navigate the physical and social determinants of healthcare—all within a safe, customizable digital space. The future of simulation isn’t about choosing between old and new; it’s about bridging them to prepare nurses for a world where every patient interaction is unique.