Simulation in Schools of Nursing:
Teaching with Pre-Programmed
Scenarios
Darren P. Lacroix
Educational Services
Laerdal Medical America’s
Statement of Disclosure
Participants must attend the entire session in order to earn contact hour credit.
Verification of participation will be noted by learner initial/signature on the roster.
Planners and presenters have declared the absence or presence of any real or perceived conflict
of interest which might influence the planning of this activity.
Darren Lacroix has identified the following real or perceived conflicts of interest:
Darren Lacroix is an employee of Laerdal.
No commercial support has influenced the planning of the educational objectives or the
content of this activity.
If there were any commercial support provided for this activity, it would be used for events
that are not related to continuing education.
There is no endorsement of any product by the provider or NCNA associated with this activity.
It is expected that no presentation will relate to products governed by the Food and Drug
Administration. But, during the course of this activity, if there is discussion related to such
products, FDA-approved and non-approved uses will be disclosed to participants.
Course Objectives
• Identify components of Pre-programmed
Scenarios
• Discuss preparation requirements for a simulation
to increase the simulation's psychological fidelity.
• Using a Pre-programmed scenario handout, locate
and review the scenario's learning objectives,
proposed correct treatment and debriefing
content.
• Discuss the instructor’s role in planning,
facilitating, and debriefing simulations.
• Demonstrate planning, facilitation, and debriefing
of a clinical simulation.
So where do I get a pre-programmed scenario?
From your colleague or
through networking
Purchased Scenario Packages
Begin With An End In Mind
• Assess curriculum and determine most appropriate
scenario for your needs
– Objectives and content in alignment with the
course goals and objectives
– Appropriate level for learners
• Know when to end your simulation
– Objectives met?
– Time constraints
• Time for debrief
– Instructor prepared to facilitate
• Instructors, learners, and facility are available
Review learning Objectives
•
Verify that objectives match the
program’s learning goals and the
learner’s current skill level.
•
When learning objectives are
revised, update the content areas
that are inter-dependent such the
scenario file, props and other cues,
and debriefing points
Review Correct Treatment
•
Review the correct treatment
guidelines – determine what behavior
the learner should demonstrate
during the simulation.
•
Remember, any changes made to
this area must also be addressed in
the learning objectives and other
interdependent content areas.
Review Debriefing Points
•
Debriefing topics are usually
anchored to the scenario’s
learning objectives and
educational content.
•
Instructors are encouraged to
remain flexible when formulating
debriefing topics. Unexpected
events may occur during a case
that warrants exploration during
the debriefing.
Review Scenario Files
Open then Scenario Editor
Review Scenario File
•
The scenario file contains frames,
actions, and event triggers.
•
View using scenario editor.
•
Frames are like storyboards.
•
Key Terms:
–
Actions
–
Events
–
Trends
–
Handlers
Anatomy of a Scenario File
 Patient information and patient monitor.
 Actions: control simulator.
 Handler: link learner’s performance and
actions (optional).
 Event Output: trigger movement between
frames.
 Trend: physiological change over time.
Review Event Menu
•
Electronic checklist of
customizable events.
•
Events appear in Event
Log when clicked by
operator.
•
Event may drive a
change in simulator
behavior
Review Physiological Trend
•
Trends enable changes to
vital signs over time.
•
Trends may be altered to
meet specific learning
objectives.
•
Saved trends may be
inserted into any scenario
Review Event Handler
•
Handlers link events to
actions to create an
automated response.
•
Handlers may be
customized and
inserted into any
scenario.
Prepare the Environment and Simulator
•
According to evidence within the
simulation literature, the psychological
fidelity (realism) of a simulation is
important to learners.
•
Learner prefer cases that feel real
•
“Simulated” simulation is not
recommended!
Use Realistic Materials
Prepare Environment & Simulator
•
•
•
Assemble Equipment and Medications
– ECG monitor
– Stethoscope and BP cuff
– Crash cart
– Chart
– Medications
Prepare the Environment
– Examination room
– Sounds (phones ringing, etc.)
– People (assistants, physician, and technicians)
Prepare the Simulator
– Dress appropriately
– Moulage as needed (blood, emesis, etc.)
– Provide Props (pill bottles, inhaler, prayer beads, etc.)
Prepare the Learners
•
Learners are more likely to
succeed when they know what is
expected of them
•
Examine the simulator prior to the
simulation. Review features and
capabilities (voice, pulse points,
drug administration, etc.)
•
Permit the learners to acclimate to
the new learning environment
•
Review learning objectives.
•
Discuss roles
•
Report to student
Guidelines for the Lab
•
•
•
•
•
•
Confidentiality is critical.
Set Expectations.
Treat the simulator as you would treat a real patient.
Act like you would in a real clinical situation.
– No food and drinks
– No cell phones or text messaging
– Dress appropriately
Most labs require students to sign confidentiality agreements.
Develop Fiction Contract
Instructor’s Role during Simulation
•
Behavioral guidelines for facilitating a healthcare simulation
– Welcome the learners and communicate your expectations about
their clinical performance, affective behavior and professionalism.
For example:
• “Welcome – You are about to participate in a simulated patient
case. The patient has a chief complaint – I expect you to
assess the patient and manage her to the best of your ability.
Treat the simulated patient as an actual human patient. This
case lasts approximately 10 minutes. We’ll debrief as a team
following the case.”
– Emphasize the simulator’s features. For example:
• “I expect that you will ask the patient questions and actually
assess their vital signs – please do not ask me for this
information.”
– Permit the learners to ask questions prior to the simulation.
Instructor’s Role during Simulation
•
•
•
•
Begin the case when the learners are ready
Observe the learners performance
Register events using the Graphic User Interface (optional)
The instructor must decide under what conditions they would
interrupt the simulation.
–
For example, safety-related violations that may injure a
learner warrant intervention while a learner’s deviation from
the learning objectives is an opportunity for all parties to
learn and may not warrant interruption
Let’s simulate!
1. Central Simulation, need volunteers to role play
1. Primary Instructor (work with students)
2. Secondary Instructor/Tech (work with computer)
3. Primary Student Nurse
4. Secondary Student Nurse
5. Crowd: Observers
2. Divide into groups and replicate same central simulation
1. Laerdal Representative at each table
2. Prep/Run session ~10-15 min
3. Debrief as a group to share learning/discovery
Questions or Comments
Next Steps
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•
•
•
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Practice….
Set realistic goals
Develop an action plan
Faculty enrichment/Continuing Education/Staff Development
Budget for formal training
– Time: Hands-on time with Simulator
– Financially: Custom training with Simulation Experts
Networking
Set time lines and realistic goals
Simulation User Network
http://simulation.laerdal.com
Please give us feedback…