Welcome

Pediatric Simulation usingPreprogrammed Scenarios

Lori Kurtz RN, BSN, MA Ed.Educational Services Specialist

Course Agenda

• Welcome and Introductions• Discuss Teaching with Pre-Programmed Scenarios• Review Scenario Materials/Contents• Preparations for Simulation Sessions• Scenario session, facilitation, & debriefing • Wrap-up

Next Actions Resources Evaluation

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?So where do I get a pre-programmed scenario?

• Self program

• Shared from a colleague

• Purchase from SimStore

• DESCRIBE SIMSTORE HERE

• Objectives meet program’s learning goals and the learner’s current skill level.

• Be flexible, many scenarios may be tailored to meet specific needs. Eg: This case can have L.O. adjusted to have student provide treatment to practice level/ability and not play in entirety as originally designed.

Review Learning Objectives and Product Details

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

Start 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.

Test run scenario prior to use with learners

• Click learner events – watch events register in Session Log

– IMPORTANT: Click each event and observe the simulator’s response – this is an important step that should be completed before actually facilitating a simulation with learners in a teaching or evaluation session.

• Watch the events register in the debrief log and in some cases, trigger actions or movement to additional frames. Observe trends – if applicable.

• Switch to Scenario Editor if questions arise about scenario flow.

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

Use Realistic Materials

Medication Administration Record Provider Orders

Patient Information Card A Favorite Toy!

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. This section provides tips on how to prepare learners for a simulation.

– 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.– Report to Student– Discuss roles.

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. Typically, when in a testing situation, the instruction would not offer cues and advice to the learner. When teaching, it is not uncommon to pause a simulation to offer assistance to the learner.

Suggested Roles & Responsibilities

• Remember, every lab is different but roles remain consistent• Below are roles based on a typical scenario

– Primary Instructor (Position 1)– Secondary/Assistant Instructor (Position 2)– Lab Technician (Position 3)– Primary Learner “Hot Seat” (Position 4)– Secondary Learner (Position 5)– Assistant Learner/aid (Position 6)– Assistant Learner/family (Position 7)– Observer (Position 8)

Suggested Roles & Responsibilities

Primary Instructor

2nd Instructor

Lab Tech

Primary Learner

2nd Learner

Learner/aid

Learner/family

Observers

Let’s simulate!

1. Central Simulation, need volunteers to role play1. Primary Instructor (work with students)2. Secondary Instructor/Tech (work with computer)3. Primary Student Nurse4. Secondary Student Nurse5. Crowd: Observers

2. Divide into groups and replicate same central simulation1. Laerdal Representative at each table2. Prep/Run session ~10-15 min

3. Debrief as a group to share learning/discovery

Questions or Comments

Next Steps

• 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 Networkhttp://simulation.laerdal.com

• Meetings

• Forums

• Downloads

• Research

• Free to join!

Laerdal Services

Sales and Supportcustomerservice@laerdal.com

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877-LAERDAL (523-7325)Fax: 1-800-227-1143

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