CONSTRUCTION OF HIGH-FIDELITY CLINICAL SIMULATION SCENARIOS IN TEACHING THE DIFFERENTIAL ASSESSMENT AND MANAGEMENT OF VENOUS AND ARTERIAL ULCERS

Abstract

Vascular ulcers, particularly venous and arterial ulcers, constitute a major public health problem and require from the nurse technical competence and refined clinical reasoning for differential assessment and the conduction of safe therapeutic plans. In this context, high-fidelity clinical simulation, associated with the use of a simulated patient and the moulage technique, stands out as a powerful pedagogical strategy, as it enables realistic, reproducible, and pedagogically structured scenarios. This study aims to describe the process of design, implementation, and evaluation of two high-fidelity clinical simulation scenarios focused on the care of patients with venous and arterial ulcers, with emphasis on the technical construction of the clinical cases, on the application of moulage to simulated patients, and on the pedagogical contributions perceived by participants during debriefing. This is a primary, cross-sectional, and prospective study, with a qualitative approach, descriptive nature, and evaluative purpose, configured as an experience report. It was conducted at the Clinical Simulation Laboratory of the Undergraduate Nursing Program of the Federal University of Mato Grosso, Sinop University Campus (UFMT/CUS), and affiliated with the Research and Study Group on Wounds and Dressings (GEPFeC). Participants comprised 24 subjects, undergraduate nursing students and health professionals from the Municipal Health Secretariat of Sinop (MT), in training sessions held in 2022 and 2025. Qualitative data collection took place during the debriefing conducted immediately after each scenario, with systematic recording of participants' statements by a previously trained observer, using a structured protocol. The records were organized descriptively, revealing perceptions regarding realism, clinical reasoning, and the strengthening of self-confidence. As a result, a detailed description was produced of the design of two clinical scenarios — one focused on the assessment and management of venous ulcer (VU) and another focused on the assessment and management of arterial ulcer (AU), accompanied by pedagogical templates, evaluative checklists, and debriefing structured according to the Promoting Excellence and Reflective Learning in Simulation (PEARLS) model. The application of moulage with accessible materials provided a high level of physical and sensory realism, fostering clinical reasoning, participants' immersion, and emotional engagement in the scenario. Participants' reports on clinical simulation highlighted the realism of the scenarios and their contribution to clinical reasoning and to the development of skills and professional competencies essential for the differentiation between venous and arterial ulcers and for sound clinical decision-making. It is concluded that the systematization of the scenario construction stages and of the moulage technique applied to the simulated patient provides replicable methodological grounds for the qualification of teaching in the health field, strengthening the role of clinical simulation as a student-centered formative resource oriented toward the comprehensive care of people with vascular ulcers.