Scenario design in high fidelity simulation
The scenario being designed needs to address specific learning objectives (while not preventing other learning points to emerge).
Defining a scenario – A patient case with a main story having the aim of bringing out specific learning objectives (usually 1-4, depending on the duration of the scenario). Can range from human factors (calling for help, dealing with a difficult patient) to more specific medical issues (management of acute cases)
A degree of flexibility must be built into the scenarios as they have to adapt to the participant’s actions – making patients deteriorate more rapidly or using a member of staff to steer the scenario back on track by helping the participant without teaching
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Rehearsing scenarios – Piloting a scenario with colleagues prior to using real participants to ensure no element has been forgotten, all resources are available, and that it runs smoothly and realistically.
Pre-programmed scenario vs. on the fly scenarios Pre-programmed scenarios require a lot of preparation and dry runs to debug the scenarios and ensure they run smoothly and that the physiological parameters change realistically – participants most likely actions need to be anticipated and built into the scenario as different pathways. (More demanding in initial programming but allows more time for the simulation operator to observe the participants.
On-the-fly simulations require less preparation beforehand but is more demanding for the simulation operator. This method requires a second pair of eyes in the control room to make sure all participants’ actions and communications have been taken into consideration to progress the scenario accordingly and to inform on debriefing issues that may otherwise be missed.
A mix of the 2 strategies is also possible – program the deterioration and use on-the-fly depending on what treatment strategy is