Clinical Simulation Library
Instructor-ready telehealth & SDOH simulation packs built on verified Delaware data
Two clinical simulation scenarios integrating population health data, social determinants of health, and telehealth delivery models into hands-on nursing education — structured according to INACSL Healthcare Simulation Standards of Best Practice. Designed for faculty at UD, Delaware Tech, and DSU; each pack can be adapted for programs without a full simulation lab.
Every community-level statistic is cited to its public source. Data reviewed September 2026.
Read first: how this data is used
- All patient characters (Marcus Vance, Elena Gomez) are fictional composites created for teaching. They do not describe real individuals, and no real patient data is used anywhere in these scenarios.
- Every community-level statistic shown is drawn from the cited public source and is labeled with its data year. Where a more granular figure does not publicly exist, we say so rather than estimate.
- Not publicly available in Delaware: county-level diabetes amputation rates and ZIP-level maternal readmission rates. This scenario set deliberately does not invent substitutes for those figures — it uses the closest verified metrics instead.
- These scenarios are educational tools aligned with the INACSL Healthcare Simulation Standards of Best Practice. They are not clinical protocols. Instructors should verify current clinical guidelines against their own institution's policies before use.
Patient profile — fictional teaching case
Marcus Vance (fictional), age 58
Type 2 diabetes and hypertension. Enrolled in a rural telehealth RPM program after two missed primary care visits.
- Lives alone in a rural Sussex County community on a fixed income
- Limited digital literacy — uses a program-issued tablet
- Relies on public transit; rural micro-transit does not run on weekends
- Primary pharmacy is not within walking distance
Simulated RPM alert (simulation parameter — not a statistic)
Blood glucose 312 mg/dL · BP 158/94 mmHg
Marcus joins the video call appearing fatigued. He reports he skipped his insulin because his pharmacy delivery was delayed and he had no way to reach the pharmacy before the weekend.
Learning objectives
- Conduct a structured telehealth physical and SDOH assessment via video interface
- Differentiate acute clinical decompensation (e.g., DKA/HHS symptoms) from barriers driven by social determinants
- Formulate a multi-disciplinary care plan leveraging community resources and mail-order/mobile health options
Verified Delaware data behind this scenario
Each figure is cited to its public source. Where Delaware does not publish a figure, that gap is disclosed rather than estimated.
14.2%
Adult diabetes prevalence, Sussex County — the highest of Delaware's three counties
Delaware Chronic Disease Coalition (BRFSS) · 202213.9%
Adult diabetes prevalence statewide — double the 4.9% rate recorded in 1991
Delaware DHSS, Behavioral Risk Factor Surveillance System · 202220%
Share of Delaware census tracts classified as food deserts
Peer-reviewed Delaware food-access study (PMC) · 202111,000+
Rural southwestern Delaware homes and businesses without wired high-speed internet; $110M state expansion underway
WHYY / Delaware Broadband Office · 2023Mon–Fri
DART Connect rural micro-transit operates weekdays only (approx. 5:45am–8pm) — no weekend service in much of rural Sussex
DART First State · 2024~4.6 / 1,000
National benchmark: diabetes-related amputations per 1,000 adults with diabetes, up ~50% between 2009–2015. Delaware-specific county amputation rates are not published — this national figure is shown instead, clearly labeled.
AJMC · 2009–2015 dataScenario flow & critical decision points
Phase 1 — Assessment
Guide Marcus through self-checking for foot ulcers, assessing hydration status, and evaluating cognitive orientation over video.
Phase 2 — Intervention & Triage
Validate the barrier he reports while systematically ruling out acute decompensation.
If the student focuses only on medication compliance without addressing the missing supply, Marcus disengages. If the student validates the barrier and checks acute symptoms, he engages in the plan.
Phase 3 — Resource Navigation
Coordinate emergency insulin supply, walk through local mobile health options, and simplify RPM equipment to match his connectivity and literacy level.
Guided debriefing framework (NLN / INACSL aligned)
| Phase | Facilitator debriefing prompt |
|---|---|
| Reactions / Defuse | How did delivering care through a screen alter your clinical intuition compared to an in-person assessment? |
| Analysis (Data Integration) | How did knowing the community-level health data (food deserts, transit gaps, broadband access) change the way you prioritized Marcus's care? |
| Application & Equity | What structural barriers did you encounter, and what health-system changes are needed to eliminate those gaps in rural Delaware? |
Pull the underlying datasets from our repository
Patient profile — fictional teaching case
Elena Gomez (fictional), age 32
One week postpartum following delivery complicated by severe preeclampsia. Scheduled for a mandatory 7-day post-discharge blood pressure check via telehealth.
- Primary Spanish speaker — joined through a certified medical interpreter
- Limited home broadband — connecting by smartphone hotspot while caring for a newborn and a toddler alone
- Home BP log shows readings averaging 152/98 mmHg over the past 48 hours (simulation parameter)
- Lives in an urban New Castle County neighborhood with documented high poverty and elevated health risk
Simulated home BP log (simulation parameter — not a statistic)
Average 152/98 mmHg over 48 hours · baby crying · connection flickering
Elena speaks through the interpreter. The connection flickers, the baby is crying, and her manually logged readings have averaged 152/98 mmHg since discharge.
Learning objectives
- Manage a complex telehealth encounter utilizing a medical interpreter while navigating technical disruptions
- Identify early clinical indicators of postpartum preeclampsia vs. acute stress
- Utilize regional public health equity data to advocate for home-visiting nursing services or cellular-enabled remote monitoring tools
Verified Delaware data behind this scenario
Each figure is cited to its public source. Where Delaware does not publish a figure, that gap is disclosed rather than estimated.
10.8%
Hypertension in pregnancy among Delaware live births (US: 10.4%)
March of Dimes 2025 Report Card — Delaware · 2024108.9 / 10,000
Severe maternal morbidity per 10,000 delivery hospitalizations (US: 93.1) — Delaware ranks 39th of 47 states and is worsening
March of Dimes / HCUP Fast Stats · 2025 report1.7x
Inadequate prenatal care among babies born to Hispanic moms (26.0%) vs. the state rate (15.1%)
March of Dimes 2025 Report Card — Delaware · 2022–20243.5x
Hispanic women in high-poverty areas are 3.5 times more likely to receive inadequate prenatal care than those in low-poverty areas
March of Dimes — Maternity Care in Delaware · 202442.2%
Delaware births covered by Medicaid (4,430 births in 2024); Delaware has extended Medicaid coverage to one full year postpartum
March of Dimes 2025 Report Card — Delaware · 202444% → 58%
Timely treatment of severe maternal hypertension improved across participating Delaware hospitals, with 95% AIM-bundle engagement
Delaware Perinatal Quality Collaborative (PQC4ME) · 2022–2024Not published
ZIP-level maternal readmission rates. Delaware does not publish readmission rates by ZIP code — this scenario anchors risk in the verified inadequate-care and severe-morbidity figures above instead of estimating one.
Disclosure — Delaware Health Data Vault data review · Reviewed Sept 2026Scenario flow & critical decision points
Phase 1 — Communication
Maintain direct eye contact with the patient (not the interpreter), speak in short clear sentences, and confirm understanding using the teach-back method.
Phase 2 — Clinical Judgment
Recognize that severe-range blood pressures require urgent evaluation.
If the student simply tells Elena to go to the ED, she refuses because she is alone with two children. The student must navigate local emergency transportation options that accommodate her social barriers.
Phase 3 — Policy & System Action
Flag the record for a cellular-enabled BP cuff (removing the Wi-Fi barrier) and place a direct referral to bilingual public health home-visiting services.
Guided debriefing framework (NLN / INACSL aligned)
| Phase | Facilitator debriefing prompt |
|---|---|
| Reactions / Defuse | How did the interpreter-mediated, technically disrupted format change your assessment confidence and rapport-building? |
| Analysis (Data Integration) | How did the maternal health equity data (inadequate prenatal care, severe maternal morbidity rates) shape your urgency and your advocacy during the visit? |
| Application & Equity | Which structural barriers (language access, broadband, childcare, transportation) did your plan actually resolve — and which require system-level change you can advocate for as an APRN? |
Pull the underlying datasets from our repository
Real Delaware community resources
Use these verified organizations in Phase 3 resource-navigation segments — they are the real counterparts to the referrals students practice making.
La Red Health Center (Sussex County)
Federally qualified health center providing bilingual primary and prenatal care to Sussex County residents.
La Esperanza (Georgetown, DE)
Bilingual community services, family support, and health navigation for Latino families in Sussex County.
DART Connect
On-demand rural micro-transit in Kent and Sussex counties — weekday service; book via app or 1-800-652-DART.
Delaware Thrives / DPH Home Visiting
State public health home-visiting and community resource programs for expecting and postpartum families.
These packs pair with our curriculum and graduate guides — everything a program needs to bring Delaware health data into the classroom.
Educational content compiled from publicly available sources. Patient characters are fictional. Verify current clinical guidelines with your institution before instructional use.