Designing Effective Simulation Scenarios for Health Educators

Tez Brown-Cotterell

Marilyn Simard

Aubrey Sozer

Submitted in INTAPT 2019-2020

                 Submitted to Dr. A. Ghavam-Rassoul and Dr. J. Peranson

                                                    March 4, 2020

Workshop Abstract

Title of Workshop: Designing Effective Simulation Scenarios for Health Educators 

Name of presenters: Tez Brown-Cotterell, Marilyn Simard and Aubrey Sozer

Topic Area: Simulation Based Teaching

Goal of the workshop: For the audience to learn how to create and apply a simulation scenario.

Intended Audience: For this presentation the audience for this workshop are the INTAPT students, but could also be applied to any professional who is looking to improve their competency to build simulation based teaching.

Objectives of workshop:

1. Recognise three situation when simulation learning can be applied in your workplace
2. Name five benefits of using simulation learning in your role as a teacher
3. Describe the six steps needed to create a clinical scenario based on Bambini’s model
4. Apply the knowledge gained during this workshop to create a clinical scenario independently

Overview of the workshop design:

This is a three hour interactive workshop in building a simulation scenario. We take the learner through the six steps of building a scenario based Deborah Bambini’s “Writing a Simulation Scenario: A Step-By-Step Guide”. In this workshop participants will be divided into two working groups to each create a simulation scenario. As the presenters describe each step the learners will be involved in applying these steps to build and complete a final scenario. Once both scenarios are complete, the groups will each take turns facilitating their own scenario and participating in the other group’s scenario. At the end both groups will receive a debriefing and evaluation on the scenarios they have created.

Workshop Summary

Introduction

Simulation-based learning allows learner to experience real situations in a controlled environment and without being subjected to the stress of real life. In the medical field, simulations are used since the early 1960s to teach cardiorespiratory resuscitation with medical manikin.

Application of Simulation (some examples):

• Routine learning and repetition of clinical and communication skills
• Practice of complex clinical situations
• Design and testing of new clinical equipment
• Performance assessment

Simulation Types:

• Part-task trainers
• Computer-based systems
• Complex manipulation
• Integrated simulators

Benefits and Challenges of Simulation:

Benefits	Challenges
Risks are avoided	Cost
Undesired interference is reduced	Administrative challenges
Tasks/scenarios can be created to demand	Need time to create and run scenarios
Skills can be practised repeatedly	To make the situation real
Training can be tailored to individuals	Identify competencies/abilities to be assessed
Retention and accuracy are increased	To establish instruments/metrics to conduct the assessment
Transfer of learning to real situation is enhanced	Technical/programming difficulties
Diagnosis of educational needs	Attitude of learners

Recapitulation of Pendleton’s Model (INTAPT 2019-2020)

1. The learner says what they thought was done well
2. The teacher says what they thought was done well
3. The learner says what was not done well and could be improved upon
4. The teacher says what was not done so well and makes suggestions for improvement

Six steps to create a clinical scenario based on Bambini’s model

Writing the simulation scenario can be challenging but rewarding.  Following a step by step approach can makes the task less daunting and the end result equally fulfilling. In this workshop we use a six step framework to building a simulation scenario. This starts with a determination of the outcome of the simulation experience. That is the knowledge and skills you intend for the learners to acquire having gone through the experience. It is important that one ensures that this is aligned the organisation’s policy or in keeping with recommended standards. After which the context of the scenario is determined. This is what provides the realism of the experience and includes the physical environment, actors/players, location to name a few. All of this to approximate the real-life context as closely as possible. Creating the objectives of the scenario is the step that follows. Objectives should be congruent with the intended outcome(s) and are the action arm to the outcome. That is, what does the learner have to do for the outcome to be achieved? The objectives therefore will contain a verb from the order level in keeping with the stage of the learner. Once these are done then comes the script of Flow of the scenario. This is how the story unfolds and includes the beginning phase which lays the scene. The middle phase follows which is where the challenge of the scenario unfolds after which comes the End phase which closes the script. Once this is done we now review and refine the scenario to ensure it unfolds logically. Lastly we add complexities according to the level of the learner involved and the specific points of emphasis. We will not be exploring debriefing in this workshop but this is an important element and should be done at the end of all such encounters.

References

Allan Waters Family Simulation Centre ( AWFSC) : Simulation Workbook

Bambini, D. (2016). Writing a Simulation Scenario: A Step-By-Step Guide. AACN Advanced Critical Care, 27(1), 62-70. doi: 10.4037/aacnacc2016986

Batty, H., Ghavam-Rassoul, A., Peranson, J. (2019). Theories and Principles of Adults as Learners [PDF.] 

Batty, H., Ghavam-Rassoul, A., Peranson, J. (2019). Reflection, Feedback and Self-Assessment [PDF.] 

Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education, 40(3), 254-262. doi: 10.1111/j.1365-2929.2006.02394.x

Colorado Hospital Association. (2019). How to Write a Simulation Scenario How to Write a Simulation Scenario. Retrieved from https://cha.com/wp-content/uploads/2019/04/2.2-How-to-Write-a-Simulation-Scenario.

Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS). Simulation In Healthcare: The Journal Of The Society For Simulation In Healthcare, 10(2), 106-115. doi: 10.1097/sih.0000000000000072

INACSL Standards Committee (2016). INACSL Standards of Best Practice: Simulation Outcomes and objectives. Clinical Simulation in Nursing, 12(S), S13-S15. http://dx.doi.org/ 10.1016/j.ecns.2016.09.006.

INACSL Standards Committee (2016). INACSL standards of best practice: Simulation Simulation design. Clinical Simulation in Nursing, 12(S), S5-S12. http://dx.doi.org/10.1016/ j.ecns.2016.09.005.

INACSL Standards Committee (2016). INACSL standards of best practice: SimulationSM Participant evaluation. Clinical Simulation in Nursing, 12(S), S26-S29. http://dx.doi.org/10.1016/ j.ecns.2016.09.009. 4) https://cha.com/wp-content/uploads/2019/04/2.2-How-to-Write-a-Simulation-Scenario.pdf

Kneebone, R. (2003). Simulation in surgical training: educational issues and practical implications. Medical Education, 37(3), 267-277. doi: 10.1046/j.1365-2923.2003.01440.x

Krishnan G, D., Vasu Keloth, A., & Ubedulla, S. (2017). Pros and cons of simulation in medical education: A review. International Journal Of Medical And Health Research, 3(6), 84-87.

Lioce, L., Reed, C. C., Lemon, D., King, M. A., Martinez, P. A., Franklin, A. E., Borum, J. C. (2013). Standards of Best Practice: Simulation Standard III: Participant Objectives. Clinical Simulation in Nursing, 9(6). doi: 10.1016/j.ecns.2013.04.00 

Lopreiato, J., & Sawyer, T. (2015). Simulation-Based Medical Education in Pediatrics. Academic Pediatrics, 15(2), 134-142. doi: 10.1016/j.acap.2014.10.010

Sick Kids Learning Institute. (2014). Simulation Program Scenario [PDF.] .