Healthcare Simulation Scenarios: Why Preparation is Essential for Learners

Before a healthcare simulation experience, learners may ask, “What are we doing today?” The unknown, coupled with the desire to succeed, may cause stress or anxiety among these learners. Additionally, the use of simulators can be overwhelming to those who are unfamiliar with healthcare simulation technologies and how they work – putting them at an immediate disadvantage. This HealthySimulation.com article, written by Kathy Sokol, shares why relaying a clinical simulation lesson plan and all expectations prior to the experience helps better prepare learners for what they’ll need to know to perform each medical simulation to the best of their ability. Most commonly, this process is refereed to as the “prebrief” or a clinical simulation prebriefing.

Ultimately, learners depend on their facilitators to elevate them to successful outcomes during a healthcare simulation scenario. For those who experience challenges, like regulating an IV pump or listening to lung sounds on new equipment, an unsatisfactory mark for the healthcare simulation experience does little but deter them from wanting to proceed with the clinical simulation experience.

There can also exist a strong learning curve for individuals who have never been exposed to healthcare simulation. They must be presented with the necessary tools for success before each clinical simulation encounter. If a healthcare simulation educator is unsure of how to proceed with an orientation to the sim lab experience, they should allow the learners to guide the process through feedback following each scenario. There are also several resources on healthcare simulation lab, including prebriefing, in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation best practices.

Often, post-simulation surveys will reveal the negative effects of inadequate preparation for the scenario. Learners may also express the desire for a more thorough introduction to the simulator and other equipment. Understanding how clinical simulation tools and equipment work improves the chance for better performance. Otherwise, learners may feel misled by the facilitator, especially if they do not ensure that all learners are properly introduced to the clinical simulation experience from the onset. This can lead to both disengagement and disinterest on the part of the learner.

When providing instruction to those newly introduced to the realm of healthcare simulation, some facilitators and sim techs may forget the hours spent working with these manikins and all the training they received themselves. Depending on the university or training facility, learners may only come in contact with such simulators for a couple of hours each semester. This unpreparedness can result in fear of unknown results, poor learner experience, and poor overall satisfaction with the sim. By contrast, low anxiety levels make for a more positive learner outcome.

For these reasons, the question “What are we doing today?” should never have to be asked by learners. Facilitators and learners must clearly understand what is to be expected of each clinical simulation scenario. If a learner is confused by the manikin setup or another piece of equipment, instead of approaching the situation with critical thinking, they may inherently feel the panic associated with being unsure of how to proceed.

Thus, valuable clinical simulation time will be wasted, lessening the effectiveness of the learning opportunity for both the learner and facilitator. Proper preparation can help ensure that all parties how knowledge of how to use the necessary equipment to improve the flow of the medical simulation scenario, as well as learner confidence. Facilitators must take the time to write a healthcare simulation scenario that includes a thorough introduction to the sim lab.

That being said, learners also need a chance to become familiar with all components of the healthcare simulation scenario before the lab begins. As the simulator requires an operator to initiate all built-in features, understanding how the manikins are machines work will eliminate the potential for uneasiness in use. For example, a healthcare simulation scenario that requires dim lighting can be the recipe for disaster if the learner is not adequately prepared. Addressing these possible concerns before they are encountered will reduce anxiety, confusion, and the fear of failure.

To help introduce a new set of manikins purchased for the nursing program, sim specialists can create healthcare simulation scenarios on how to safely operate and interact with each one. An example can be four stations being set up to accommodate the four new simulators, with each control room being manned by a sim tech and a facilitator to make sure things run smoothly.

Here’s a possible healthcare simulation scenario that can be used to introduce a birthing simulator. Learners will assist in a normal delivery without complications, and the manikin will be able to talk and answer questions and could be turned and repositioned as required during the sim. No medications or treatments are included in the scenario. The learner’s goal should simply be to get experience working with a birthing simulator.

A brief orientation to the cubicle was done to show the learners equipment needed during the simulation. If new equipment is added to a scenario, the facilitator should always demonstrate the operation during prebrief. A set of orders is available on the computer in the room and should consist of the following:

• Introduce each team member to the manikin patient (to become familiar with how the voice sounds)
• Touch the telemetry screen to start recording vital signs (students can waste time during a scenario trying to figure out how to get a blood pressure)
• Lock the bed, lower the bottom side rails and raise the head of the bed (especially important if the mannikin uses a different bed than the learners are familiar with)
• Find the pulses on the patient and record the heart rate (there will be times the facilitator doesn’t want the bedside monitor turned on)
• Initiate the birth (some mannikins can be controlled at the bedside, others are controlled by a tech in the control room)
• Learners can see what happens as the cervix opens and the baby descends
• Learners can touch the perineum and get a sense of what the cervix feels like
• Learners become familiar with the rate of speed the baby will be delivered
• Finish the birthing scenario with the delivery of the placenta (learners may find seeing what a placenta looks and feels like helpful)
• Place the newborn into the warmer set to the proper temperature (depending on the warmer being used, some are more complicated to use than others)
• Call the provider for a diet order (learners need to know how to use the phone and intercom in the sim room to communicate with the facilitator and tech)

Orders are personalized to anticipate problems that might be encountered by learners during the healthcare simulation. Remember, this type of clinical simulation scenario helps learners gain confidence and decrease anxiety to prepare for future healthcare simulations.

Overall, the goal of healthcare simulation is to provide a safe environment for the learner to practice what is learned in class and test knowledge. Becoming familiar with manikins helps bring out the best performance in learners by improving confidence and comfort levels in the healthcare simulation lab. Taking the time to develop a clinical simulation to orient learners to the sim lab will undoubtedly yield a positive return on investment.

9 Key Considerations When Designing a Sim Lab

About the Author: Kathy Sokol

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Kathy Sokol lived most of her adult life in Florida before “retiring” to Las Vegas. She has been a registered nurse for over 30 years and a nurse educator since 2005. Kathy has a masters degree in nursing education and earned Master Instruction certification from Chamberlain University College of Nursing.

She set up and managed simulation labs on several campuses throughout the country. Kathy  collaborated on a course called Sim 101 to educate faculty on how to enrich student learning through simulation. In 2016, Kathy and her team did a presentation at IMSH on how to efficiently open a sim lab while saving time and money.

Kathy was initiated into Sigma Theta Tau International Honor Society. She was a nominee for the Daisy Faculty Nurse Award. She has been published in RN Magazine, is a regular contributor on LinkedIn and has an adult learning page on Facebook. She is currently working on a book about change.

Kathy lives in Las Vegas with her husband. She is a visiting professor at Chamberlain University College of Nursing.