CLINICAL SCENARIOS
we can build any scenario for you
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we can build any scenario for you **
Essential Collection
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LEARNING OBJECTIVES :
Collect and evaluate pertinent health assessment data through application of clinical knowledge, skills, and experience.
Apply the diagnostic reasoning process during a simulated patient health assessment encounter.
Formulate diagnostic hypotheses through the application of one’s clinical experience, knowledge of pathophysiology, and obtained health history assessment data.
Evaluate obtained health history information to formulate relevant differential diagnoses.
REFERENCES :
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2020). Bates’ pocket guide to physical examination and history taking. Lippincott Williams & Wilkins.
Dunphy, L. M., Winland-Brown, J., Porter, B., & Thomas, D. (2022). Primary care: Art and science of advanced practice nursing. FA Davis.
Swartz, M. H. (2020). Textbook of physical diagnosis E-book: history and examination. Elsevier Health Sciences.
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LEARNING OBJECTIVES :
"Practice explaining the procedure to a virtual patient
Gathering the required material for the procedure
Examining nostrils as preparation for insertion
Performing the insertion procedure
Using pH testing to confirm NG tube position"
REFERENCES :
"Hodin, R. A., & Bordeiznou, L. Nasogastric and Nasoenteric Tubes. (2015). In: UpToDate, Sanfey, H., & Collins, K. A. (Eds.).
Wiegand, D. L. (2017). AACN Procedure Manual for High Acuity, Progressive, and Critical Care (7th ed.). St. Louis: Elsevier."
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LEARNING OBJECTIVES :
"Perform Glascow Coma Score assessment
Perform pupil and eye movement assessment
Perform motor function assessment
Perform reflex assessment
Perform sensory function assessment"
REFERENCES :
"The Joint Commission. (2019). Standard NPSG.07.01.01. Comprehensive accreditation manual for hospitals. Oakbrook Terrace, IL: The Joint Commission. (Level VII)
Thompson, H. J. (2009). “Neurologic assessment of the older adult: A guide for nurses”"
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LEARNING OBJECTIVES :
"Performing sterile cap change
Communicating with the patient and family
Maintaining sterile field
Removing old dressing and skin-prep
Performing sterile dressing change
Using Povidone-Iodine for dressing"
REFERENCES :
Developed in partnership with Texas Children’s Hospital.
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LEARNING OBJECTIVES :
"Demonstrating the steps of PIV assessment using the acronym ACT
Modelling the use of vein finding technology
Performing PIV insertion and securement
Demonstrating the steps required to address PIV extravasation"
REFERENCES :
Developed in partnership with Texas Children’s Hospital.
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LEARNING OBJECTIVES :
"Preparing the patient for the procedure by confirming identity and selecting the ideal vein for insertion
Palpating the vein for clear visibility
Performing the insertion in a smooth and painless manner
Removing the IV carefully
Applying a gauze over the insertion site after removal"
REFERENCES :
"Developed in alignment with CDC Guidelines.
Standard 26. Vascular Access Device (VAD) planning. Infusion therapy standards of practice. (2016). Journal of Infusion Nursing.
Infusion Nurses Society. (2016). Policies and Procedures for Infusion Therapy (5th ed.). Boston, MA: Infusion Nurses Society."
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LEARNING OBJECTIVES :
"Interacting and informing patients of the care procedure
Deflating and inflating the cuff to ensure proper placement
Practice performing an open suctioning to clear airway of secretions
Practice performing closed suctioning in critical care patients "
REFERENCES :
"Intensive Care Society. (2014). “Standards for the care of adult patients with a temporary tracheostomy; Standards and guidelines”.
Morris, L. L., et al. (2013). Tracheostomy care and complications in the intensive care unit. Critical Care Nurse, 33(5), 18–30."
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LEARNING OBJECTIVES :
"Gathering required material
Performing hand hygiene
Detaching catheter from the securing device
Removing the catheter and applying a fresh dressing"
REFERENCES :
"Developed in alignment with NCBI, Percutaneous Central Catheter by Gonzalez R, Cassaro S.
Vascular Access Device (VAD) planning. Infusion therapy standards of practice. (2016). Journal of Infusion Nursing.
Centers for Disease Control and Prevention. (2011). “Guidelines for the prevention of intravascular catheter–related infections”"
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COMING SOON
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COMING SOON
Don't see your required scenario , we can build it for you
**
Don't see your required scenario , we can build it for you **
Emergency Collection
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LEARNING OBJECTIVES :
"Providing specific treatment for severe hyperkalemia
Prioritizing initial investigations and therapies
Maintaining situation awareness of an unstable patient
Communicating the clinical situation clearly to consultants "
REFERENCES :
"Mount DB. Disorders of potassium balance. In: Brenner and Rector’s The Kidney, 11th ed, Yu A, Chertow G, Luyckx V, et al (Eds), W.B. Saunders & Company, Philadelphia 2020. p.537.
Winkler AW, Hoff HE, Smith PK. Factors affecting the toxicity of potassium. Am J Physiol 1939; 127:430."
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LEARNING OBJECTIVES :
"Perform a focused history/physical exam in an acutely unwell patient
Effectively lead/manage a team to provide appropriate care for an acutely unwell patient
Recognize risk for PE and initiate the appropriate workup
Demonstrate clear leadership and effective team communication
Appropriately ask for help and communicate concerns over the phone
Urgently mobilize appropriate consultant services "
REFERENCES :
"Josh Farkus. 2019. Submassive and Massive PE. Internet Book of Critical Care. https://emcrit.org/ibcc/pe/
Amit Shah. 2018. PE Thrombolysis. Emergency Medicine Cases. https://emergencymedicinecases.com /video/emu-365-pe-thrombolysis-in-2018/
Peter Reardon et al. 2018. Contemporary Management of the High-Risk Pulmonary Embolism: The Clot Thickens. Journal of Intensive Care Medicine. 34(8):603-608"
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LEARNING OBJECTIVES :
"Demonstrate organized approach to initial evaluation of a seizing patient
Call for help in a timely manner
Begin pharmacologic management of the seizure with benzodiazepines
Consider possible etiologies of the seizure
Communicate the clinical situation clearly to consultants
Initiate a transfer to a higher level of care"
REFERENCES :
Developed in alignment with American College of Emergency Physicians guidelines.
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LEARNING OBJECTIVES :
"Conducting initial assessment of patient
Early recognition of sepsis and identifying a likely source of infection
Timely implementation of broad-spectrum antibiotics and source control
Eliminate other differential diagnoses of shock "
REFERENCES :
"Tintinalli’s Emergency Medicine. Chapters 50, 56, and 89
EM Cases. “Episode 122 Sepsis & Septic Shock – What Matters Live from EM Cases Course”, with Dr. Sara Gray
Kane SP and Benken ST. “Vasopressor Selection in Septic Shock”, Society of Critical Care Medicine
Farkas J. “Vasopressors”, The Internal Book of Critical Care"
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LEARNING OBJECTIVES :
"Review an approach to the unstable ward patient
Prioritize the initial investigations and therapies, including ventilatory support
Review the initial management of the patient with pneumonia "
REFERENCES :
"Surviving Sepsis Campaign: http://www.survivingsepsis.org/ Guidelines/Pages/default.aspx
Rosen’s Emergency Medicine: Chpts 2, 6, 66, 130 "
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LEARNING OBJECTIVES :
"Use a focused history to elicit a patient history
Identify the rhythm displayed on the monitor
Perform cardiac pacing
Assess patient using SAMPLE and OPQRST methods
Initiate appropriate ACLS management"
REFERENCES :
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O’Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://doi.org/10.1161/ CIR.0000000000000916
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LEARNING OBJECTIVES :
"Interpret focused history to elicit a patient history
Assess patient using SAMPLE and OPQRST methods
Recognize VT on an ECG
Perform synchronized cardioversion
Administer correct interventions based on the patient condition"
REFERENCES :
"Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O’Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://doi.org/10.1161/ CIR.000000000000091
"
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LEARNING OBJECTIVES :
"Read and identify rhythm displayed on the monitor
Administer correct interventions based on the patient condition
Communicate effectively with team members
Perform efficiently as a team
Identify and make effective use of emergency equipment "
REFERENCES :
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O’Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://doi.org/10.1161/ CIR.0000000000000916
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LEARNING OBJECTIVES :"Interpret focused history to elicit a patient history
Read and identify rhythm displayed on the monitor
Assess patient using SAMPLE and OPQRST methods
Administer correct interventions based on the patient condition
Perform close-to-real conversation with virtual patient based on verbal communication enabled by natural language processing"
REFERENCES :
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O’Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://doi.org/10.1161/ CIR.0000000000000916
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COMING SOON
Critical Care Collection
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LEARNING OBJECTIVES :
"Explaining the procedure to a virtual patient.
Gathering the required material for the procedure.
Setting up a sterile field.
Performing the chest tube insertion procedure.
Suturing the wound.
Applying the dressing.
Connecting the chest to drainage and suction."
REFERENCES :
"Lippincott Nursing Procedures. 8th edition. 2019. Pages 747 – 759
https://merckmanuals.com/professional/pulmonary-disorders/how-to-do-pulmonary-procedures/how-to-do-tube-and-catheter-thoracostomy. Merck Manual. How To Do Tube and Catheter Thoracostomy. Rebecca Dezube, Johns Hopkins University. 07/2022.
https://www.uptodate.com /contents/thoracostomy-tubes-and-catheters-placement-techniques-and-complications Thoracostomy tubes and catheters: Placement techniques and complications. John T Huggins, MD, Shamus R Carr, MD, FACS, George A Woodward, MD. 01/2023. "
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LEARNING OBJECTIVES :
"Prepare patient and check equipment
Demonstrate correct steps when starting a central line
Identify common complications when starting a central line
Demonstrate correct steps towards performing a central line insertion"
REFERENCES :
"Developed under the guidance of MedVR Education advisory team.
Standard 26. Vascular access device (VAD) planning. Infusion therapy standards of practice. (2016). Journal of Infusion Nursing, 39, S51–S54. (Level
VII)
Infusion Nurses Society. (2017). Policies and procedures for infusion therapy of the older adult (3rd ed.). Boston, MA: Infusion Nurses Society."
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LEARNING OBJECTIVES :
"Plan for delivery of ostomy care through selection and organization of necessary equipment
Apply proper technique for the removal of a pouch and cleansing the stoma
Determine, prepare, and apply the correct size barrier ring and pouch "
REFERENCES :
"Wound, Ostomy, and Continence Nurses Society. (2010). Management of the patient with a fecal ostomy: Best practice guideline for clinicians. Journal of Wound, Ostomy and Continence Nursing, 37(6), 596–598. (Level VII)
Developed under the guidance of the MedVR Education advisory team."
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LEARNING OBJECTIVES :
"Setting the posture of the patient, pre-oxygenation and pre-medicating the patient
Inserting the laryngoscope and endotracheal tube correctly
Confirming the placement of the ET tube"
REFERENCES :
"Wiegand, D. (2017). AACN Procedure Manual for High Acuity, Progressive, and Critical Care (7th ed.). St. Louis, MO: Elsevier.
American Association for Respiratory Care (AARC). AARC Practice Guideline: Removal of the Endotracheal Tube – revision & update. Respiratory Care, 52(1), 81–93."
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LEARNING OBJECTIVES :
"Confirming the identity of the patient
Gathering the required equipment and preparing a sterile field
Preparing the lidocaine syringe, pre-flush lumens and applying USG gel to the probe
Inserting the catheter and attaching the Sherlock 3cg connector
Flushing the lumens and applying a Tegaderm dressing"
REFERENCES :
"Developed in alignment with NCBI, Percutaneous Central Catheter by Gonzalez R, Cassaro S.
Vascular access device (VAD) planning. Infusion therapy standards of practice. (2016). Journal of Infusion Nursing.
Centers for Disease Control and Prevention. (2011). “Guidelines for the prevention of intravascular catheter–related infections”"
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LEARNING OBJECTIVES :
"Locating and cleaning the insertion site
Numbing the insertion site
Making an insertion and collecting aspirate
Drawing aspirate using a Jamshidi needle and stylet"
REFERENCES :
"Wiegand, D. L. (2017). AACN procedure manual for high acuity, progressive, and critical care (7th ed.). St: Louis, MO: Elsevier.
The New England Journal of Medicine (NEJM), Bone Marrow Aspiration and Biopsy by Suman Malempati, M.D., Sarita Joshi, M.D., Susanna Lai, M.P.H., Dana A.V. Braner, M.D., and Ken Tegtmeyer, M.D."
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LEARNING OBJECTIVES :
"Preparing the patient for the procedure by confirming identity
Gathering required equipment and creating a sterile field
Performing the insertion procedure
Confirming the correct placement of the catheter and inflating the balloon to secure it in place"
REFERENCES :
Developed in alignment with Agency for Healthcare Research and Quality (AHRQ) Appendix G. Indwelling Urinary Catheter Insertion Checklist.
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LEARNING OBJECTIVES :
"Preparing the single transducer hemodynamic pressure monitoring system
Positioning the patient in the Trendelenburg position
Cleansing the insertion site and preparing the ultrasound device
Flushing of lumens and connecting the catheter to the hemodynamic pressure monitoring system
Labeling all tubing and observing external centimeter marking of catheter"
REFERENCES :
Adapted from Wiegand, D.L. (Ed.). (2017). AACN procedure manual for high acuity, progressive, and critical care (7th ed.). St. Louis: Elsevier.
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LEARNING OBJECTIVES :
"Removing the old dressing while taking care of all hygiene precautions
Washing and cleaning the wound with utmost care
Applying ointment and fresh dressing on the cleaned wound"
REFERENCES :
Developed in alignment with AACN Procedure Manual for High Acuity, Progressive, and Critical care (7th ed.) Wiegand, D.L. (Ed.). St. Louis: Elsevier (2017).
Mental Health Treatment
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LEARNING OBJECTIVES :
"Learn about the Stages of Change
Assess current level of engagement to identify personal stage of change
Acquire beginner’s knowledge of “Barriers” to treatment
Learn about the criteria associated with addictive use of alcohol and/or other drugs
Acquire working knowledge of the neuropsychology of “Habits”"
REFERENCES :
"Prochaska, J. O., Norcross, J. C., & DiClemente, C. C. (2013). Applying the stages of change. Psychotherapy in Australia, 19(2), 10–15. https://search.informit.org/doi/10.3316/informit.254435778545597
American Addiction Centers (2022). CAGE Questionnaire (4 Questions to Screen for Alcoholism), Information obtained from https://americanaddictioncenters.org/alcoholism-treatment/cage-questionnaire-assessment.
National Institute on Alcohol Abuse and Alcoholism, (2003). Assessing Alcohol Problems: A Guide for Clinicians and Researchers, 2d ed. NIH Pub. No. 03–3745, Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service. http://pubs.niaaa.nih.gov/publications/AssessingAlcohol/index.htm.)
Tsamitros, N., Sebold, M., Gutwinski, S., & Beck, A. (2021). Virtual Reality-Based Treatment Approaches in the Field of Substance Use Disorders. Current Addiction Reports, 8(3), 399-407.
Bohil CJ, Alicea B, Biocca FA (2011) Virtual reality in neuroscience research and therapy. Nat Rev Neurosci 12:752–762. doi:10.1038/nrn3122"
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COMING SOON
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COMING SOON
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COMING SOON
Pediatric Collection
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LEARNING OBJECTIVES :
"Identify respiratory distress in an infant.
Review the diagnosis of bronchiolitis.
Initiate supportive care with supplemental oxygen and fluids.
Recognize treatment failure and intubate an infant."
REFERENCES :
Friedman J, Rieder M, Walton J. Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age [Internet]. Canadian Pediatric Society; 2021. Available from: https://cps.ca/en/documents/position /bronchiolitis
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LEARNING OBJECTIVES :
"Display leadership by maintaining calm demeanor during crisis and acting decisively
Employ good communication skills by using closed loop, listen to the input of others, and address concerned family members
Implement the basic ED treatment of asthma
Recognize refractory/severe asthma and institute appropriate treatments"
REFERENCES :
"Ortiz-Alvarez, A Mikrogianakis; Managing the Patient with an acute asthma exacerbation. Canadian Paediatric Society, Paediatric Child Health 2012;17(5):251-5
Allen JY, Macia CG. The efficacy of ketamine in pediatric emergency department patients who present with acute severe asthma. Ann Emerg Med. 2005;46(1):43-50
Management of Life-Threatening asthma in the ED First 10 in EM https://first10em.com/2015/08/18/asthma/
Management of Acute Pediatric Asthma Exacerbations EMCases https://emergencymedicinecases.com/pediatric-asthma/ "
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COMING SOON
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COMING SOON
LET US BUILD ANY SCENARIO THAT YOU WANT
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LET US BUILD ANY SCENARIO THAT YOU WANT **
Perinatal Collection
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LEARNING OBJECTIVES :
"Effectively lead a team through a neonatal resuscitation
Demonstrate high quality closed-loop communication during resuscitation
Recognize flat baby and initiate warming and drying
Start PPV and initiate MRSOPA
Intubate, obtain IV and give appropriate medications"
REFERENCES :
"Textbook of Neonatal Resuscitation
Edited by: Gary M. Weiner, MD, FAAP, Jeanette Zaichkin, RN, MN, NNP-BC DOI: https://doi.org/10.1542/9781610025256
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LEARNING OBJECTIVES :
"Recognize an emergency
Demonstrate appropriate clinical management of the patient with hemorrhage
Measure QBL (Quantitative Blood Loss)
Display appropriate teamwork and communication
Conduct appropriate communication with patient and family"
REFERENCES :
Developed in accordance with California Quality Care Collaborative, Association of Obstetrics and Gynecology and Joint commission.
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COMING SOON
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COMING SOON
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COMING SOON
Paramedic Collection
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LEARNING OBJECTIVES :
"Interpret focused history to elicit a patient history
Read and identify rhythm displayed on the monitor
Administer correct interventions based on the patient condition
Perform close-to-real conversation with virtual patient based on verbal communication enabled by natural language processing "
REFERENCES :
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O’Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://doi.org/10.1161/ CIR.0000000000000916
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LEARNING OBJECTIVES :
"Display leadership by maintaining calm demeanor during crisis and acting decisively
Employ good communication skills by using closed loop, listen to the input of others, and address concerned family members
Implement the basic ED treatment of asthma
Recognize refractory/severe asthma and institute appropriate treatments"
REFERENCES :
"Ortiz-Alvarez, A Mikrogianakis; Managing the Patient with an acute asthma exacerbation. Canadian Paediatric Society, Paediatric Child Health 2012;17(5):251-5
Allen JY, Macia CG. The efficacy of ketamine in pediatric emergency department patients who present with acute severe asthma. Ann Emerg Med. 2005;46(1):43-50
Management of Life-Threatening asthma in the ED First 10 in EM https://first10em.com/2015/08/18/asthma/
Management of Acute Pediatric Asthma Exacerbations EMCases https://emergencymedicinecases.com/pediatric-asthma/ "
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COMING SOON
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COMING SOON
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COMING SOON
WE CAN BUILD ANY SCENARIO THAT YOU WANT
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WE CAN BUILD ANY SCENARIO THAT YOU WANT **
Enviromental Services
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LEARNING OBJECTIVES :
"Introduce learners to the cleaning area and the procedure to be followed
Introduce learners to the cleaning cart and high-touch points
Familiarize learners with the AIDET procedure
Provide practice in conversing with patients and caregivers
Practice the cleaning procedure by following a defined set of steps"
REFERENCES :
Developed in alignment with AHE (Association for the Health Care Environment) guidelines.
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LEARNING OBJECTIVES :
"Identify high-touch areas in an operating room that require disinfecting every time
Practice cleaning sequences high to low and clockwise/counter-clockwise
Learn trash segregation and sequencing
Practice OR suite floor mopping
Learn restocking and room preparation for next case"
REFERENCES :
Developed in alignment with AHE (Association for the Health Care Environment) guidelines.
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COMING SOON
Allied Healthcare
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LEARNING OBJECTIVES :
"Performing sterilization procedures of decontamination, disinfection, sterilization, and packaging
Practicing the Flat Simultaneous Envelope packaging method
Appropriate use of PPE kits depending upon the location and nature of work
Sorting items for different stages of sterile processing "
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LEARNING OBJECTIVES :
"Wearing PPE before surgical scrubbing
Cleaning nails and fingers following defined steps
Scrubbing hands and arms systematically
Rinsing and dripping without allowing contamination"
REFERENCES :
This module has been developed in accordance with Association of Surgical Technologists (AST) guidelines.
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LEARNING OBJECTIVES :
Positioning and Turning a Patient
Assisting with a Patient Transfer
Assisting a Patient with Crutches
Performing Range-of-Motion Exercises
Ascending the Wheelchair
Descending the wheelchair
REFERENCES :
Developed in alignment with the book Physical Therapy Aide - A Worktext by Roberta C. Weiss, 3rd Edition
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LEARNING OBJECTIVES :
"Identifying and placing leads correctly on a virtual patient
Understanding the controls of an ECG machine and steps to generate a report
Mastering the five-step process of gathering and interpreting ECG data
Identifying sinus rhythms and analyzing rhythm strips
Identifying inverted P morphology formations, P wavelengths and their relation to QRS complexes"
REFERENCES :
Developed in alignment with Electrocardiography for Healthcare Professionals (Fifth Edition) by Kathryn Booth and Thomas E. O’Brien.
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LEARNING OBJECTIVES :
"Routine venipuncture with a syringe
Venipuncture using an Evacuated Tube System (ETS)
Venipuncture with a winged infusion set
Capillary collection of blood sample"
REFERENCES :
Developed in alignment with Phlebotomy: Worktext and Procedures Manual (Fourth Edition) by Robin Warekois and Richard Robinson.
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COMING SOON