Original Publication
Open Access

NERVE- 2: A Three Dimensional Patient Simulation of Oculomotor Nerve Palsy

Published: December 6, 2010 | 10.15766/mep_2374-8265.8383

Included in this publication:

  • NERVE-2.exe
  • Immersive Virtual Patient Left Oculomotor Palsy.pdf
  • Instructor's Guide Nerve 2.docx
  • NERVE 2 Patient Presentation.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This module portrays a simulated patient who presents to a clinic or emergency room with a complaint of double vision. The purpose of this simulation is to promote effective history taking and evaluation in order to identify a potentially life threatening cranial nerve disorder. A significant limitation of live standardized patient interaction is the difficulty in reproducing clinical findings in various conditions. Therefore, medical students are often taught diagnostic skills for evaluation of cranial nerve injuries in a low fidelity manner, mainly where the injury is described, and the student is able to visualize still images of the anticipated clinical findings. The current simulation incorporates not only an accurate depiction of the clinical findings, but an opportunity to dialogue with the patient to ascertain important history information. Once the user has completed their evaluation, they view a brief lesson plan that reinforces the pertinent history bullets and examination findings related to the pathology. Further, the plan goes on to briefly discuss the appropriate management of the patient. By the completion of this lesson, users should be comfortable identifying an oculomotor palsy and should consider the possibility of a life threatening condition such as a cerebral aneurysm.

The module has been packaged to include all necessary resource files and materials. The learner should take approximately 30 minutes to complete the interaction and lesson plan. The program does have basic hardware and software requirements. This program was developed at the University of Florida, in conjunction with collaborators at both the University of Central Florida and the University of Georgia. It was implemented in the Florida curriculum for second-year medical students. The concept was to design a realistic patient interaction experience utilizing a virtual patient. The benefits of virtual patient interactions are numerous, and include standardization, opportunity for repeat interactions, and presentations of clinical findings that may be readily reproducible in human actors. By integrating the ability to perform a history and evaluate a realistic representation of the clinical examination findings, we anticipate a significant enhancement in medical student learning of various pathologies.

Educational Objectives

By the end of this module, the learner will be able to:

  1. Obtain an effective, focused patient history and review of systems related to the presenting complaint.
  2. Perform a focused/relevant cranial nerve exam.
  3. Recognize presence of cranial nerve pathology.
  4. Understand clinical exam findings of an oculomotor nerve palsy.
  5. Identify potential causes of an oculomotor nerve palsy.
  6. Formulate appropriate plan of management for an oculomotor nerve palsy.

Author Information

  • Marc Peden, MD: University of Florida College of Medicine
  • Joon Hao Chuah: University of Florida
  • Aaron Kotranza, PhD: University of Florida
  • Kyle Johnsen, PhD: University of Georgia
  • Benjamin Lok, PhD: University of Florida
  • Juan Cendan, MD: University of Central Florida

None to report.

None to report.


Peden M, Chuah J, Kotranza A, Johnsen K, Lok B, Cendan J. NERVE- 2: a three dimensional patient simulation of oculomotor nerve palsy. MedEdPORTAL. 2010;6:8383. https://doi.org/10.15766/mep_2374-8265.8383