Virtual patients are helping student nurses in Birmingham practise their skills without the risk of making life-threatening decisions, as health reporter Emma Brady discovers.

Meet Martha, Mohammed and Jack. They each suffer from common conditions such as asthma, angina, diabetes and intestinal problems, and are hooked up to monitors, intravenous drips and oxygen masks.

But they are not being treated on medical wards at City, Selly Oak or Queen Elizabeth hospitals.

Instead these twodimensional characters are convalescing in a virtual ward created by software engineering students at University of Central England.

The Virtual Case Creator (VCC) presents a series of different medical cases, as a charge nurse briefs the next nursing shift of the patients' progress but it is up to the students to continue their assessment and decide what action needs to be taken.

Each patient has between 30 and 40 different options - diagnostic tests, chart readings and scans - but students can only select 15 to assess their condition.

At the end of the session, VCC confirms how many choices were appropriate to the patient's care, but does not identify those which are incorrect to discourage trainee nurses from memorising the 'correct answers.'

Student nurses have up to 12 sessions on the VCC prior to work placements in local NHS trusts.

Alan Davies, aged 26, of Sutton Coldfield, admitted working with these simulated patients has helped him in real-life situations while on placements around the city.

The third-year nursing degree student said: "This has helped me build up a picture of how patients may present themselves in hospital and how to treat them appropriately in line with their condition or symptoms.

"A simulated situation can't be fully mirrored in reality but this enables you to learn from your mistakes, because in practise there's no room for trial and error.

"Recently I had a diabetic who also suffered from angina, similar to Mohammed's condition in the programme, and I was able to tackle that more effectively dealing with his low blood sugar count first and make better sense of his needs.

"It may have taken a little longer to assess his condition if I had not seen a similar patient, albeit a virtual one, beforehand."

The programme, which cost £60,000 to develop, is set to be rolled out to 73 other universities, hospitals and NHS organisations following its success at UCE.

Nigel Wynne, senior academic in learning and teaching at UCE's learning partnership development unit, said the idea was to get student nurses used to being 'overloaded' with information on the wards.

He said: "When nurses do a hand-over at the start and end of a shift, they can be overloaded with information on up to 32 patients and they could be personally responsible for up to 16 of them. It's a lot to take in.

"They will also have to deal with angry or anxious relatives on the phone, doctors, specialists, physios and occupational therapists as well as other members of their own team.

"By looking at patients' charts, medical records and monitoring readings, they must assess their condition and what, if any, further treatment is needed."

Each patient, such as Martha - a 44-year-old asthmatic with respiratory problems - is surrounded by monitors and medical equipment, which give readings once the student clicks on the relevant icon.

The virtual charts and records are designed to look like existing NHS forms, so nurses learn to interpret them accurately.

Mr Wynne hopes to create a virtual community where students can consult specialists, senior medics and other students online as part of the programme.

He added: "The beauty of VCC is that it can't be learnt by rote, as we can change the readings and situations so students can't just memorise previous actions and decisions.

"In their first year students are taught all the core skills and they tend not to be revisited, but are reinforced by their experience in practice and this programme helps revise that knowledge.

"We're currently developing 15 other scenarios on VCC including mental health, paediatric intensive care, and the Royal College of Defence Medicine are also interested in tailoring it to their needs.

"There's a bit of gaming theory involved here, people do get more competitive, and we're looking at making the situations harder as scores improve."