Pain is a complex and multi-dimensional phenomenon. Nurses play a vital role in assessing and managing pain and must use sound clinical reasoning to accurately make clinical judgments to notice, interpret and respond to patients’ pain.

Exploratory research on the impact of a newly developed AV simulation on nursing students' Noticing and Interpreting skills in assessing pain of culturally diverse patients. Data were collected via self-administered pre and post–intervention surveys.

The majority of participants were able to identify that the patient was in greater pain than reported, however some participants were unable to notice and interpret the impact of culture during pain assessment. Participants were more aware of the subjectivity of pain (cultural knowledge), and that the strategies learnt would improve their future clinical practice (cultural desire).

Findings support the need to include AV simulations in the nursing curriculum to enhance student nurses’ cultural awareness, knowledge, and skills regarding pain, all complex factors for making the best clinical judgments to respond to pain.