Talking with the patient

How to explain a direct oral anticoagulant

Other platforms explain it with text and video. In VMS you practice it on the patient.

MD / DOPANursing (NCLEX)
Practice it in VR with Blocky

Direct oral anticoagulants are simpler than warfarin, with no routine INR tests. Patients still need to know how to take them safely.

Step by step

  1. Explain why

    The medicine lowers the risk of stroke or of new clots in the legs and lungs. [1]

  2. Explain the dose and timing

    Apixaban and dabigatran are taken twice a day; rivaroxaban and edoxaban usually once a day. Higher doses of rivaroxaban are taken with food. [2]

  3. Stress not missing doses

    The effect wears off within a day, so missed doses quickly raise clot risk. Follow the missed-dose rule for that drug. [2]

  4. Teach bleeding signs

    Black stools, blood in the urine, vomiting blood or a sudden severe headache need urgent care. [3]

  5. Warn about interactions

    Avoid NSAIDs and aspirin unless prescribed. Some seizure, HIV and antifungal drugs also interact. [2]

  6. Plan for procedures

    Tell every dentist and surgeon. The drug may need to be paused before a procedure. [1]

  7. Check kidney function and cost

    Doses depend on kidney function, so blood tests are repeated. Make sure the patient can afford refills. [4]

  8. Use teach-back

    Ask the patient to tell you when they take each dose and what they will do if they miss one. [5]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

Sources

  1. AAMC Core Entrustable Professional Activities (Core EPAs)
  2. Open RN, Nursing Pharmacology 2e (CC BY 4.0)
  3. The Joint Commission, National Patient Safety Goals
  4. NCCPA PANCE Content Blueprint
  5. AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back)

Facts and steps follow AAMC Core Entrustable Professional Activities (Core EPAs); AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back). VMS is not affiliated with these organizations. Updated: 2026-10-11.