Evan Stiger

    Incorporating simulation into curriculum is a new concept for many healthcare educators. Every year, educators across America, from physical therapy (PT) to nursing to EMS, will write their first scenarios. This can seem like a daunting task for a novice, but there’s no reason for concern. Scenario-building is a simple and rewarding task.

    Here are five questions to ask when developing a scenario, appropriate for any healthcare discipline.

    1. What should students know before the scenario?

    The goal of simulation is to provide a low-risk environment in which students can effectively learn. Although no one can be hurt in a simulation, students are still anxious about their performance prior to a scenario. In order to ensure the effectiveness of the simulation, educators should prepare students prior to the start of the scenario in what’s called a prebrief.

    A prebrief can vary from instructors giving students extremely detailed information to providing a broader outline of the scenario. Some educators provide a lot of details to ensure students are comfortable and focused on developing psychomotor skills. Others share little to force students to think on their feet.

    Prebrief information can also be shared in a variety of ways, such as via handouts for students to review as homework or as a brief presentation at the start of class.

    Preference and teaching style will largely shape prebrief, but educators should put plenty of time and thought into how they’ll provide context prior to a scenario.

    2. What are the learning objectives?

    Learning objectives drive every simulation. They focus on what students are expected to know by the end of the scenario. It’s important to have concrete objectives defined early in the planning process as they’ll influence the rest of the scenario.

    3. What are the circumstances of the scenario?

    The circumstances of a scenario will drive the learning process, and determine what students learn as the scenario unfolds. Plan how the scenario starts with the patient’s condition or presenting complaint. As the scenario progresses and students make decisions about treatment, determine how the patient’s condition changes, and how the change is communicated to the participants.

    Advanced scenarios may include additional challenges, such as distractions from family members, uncooperative patients, or healthcare professionals who are underperforming in their roles as caregivers.

    It’s very important to keep in mind the learning objectives defined in the previous step when developing the circumstances of the scenario.

    BL-CTA-scenario building_11-2019

    4. How will students be assessed?

    At the end of the scenario, students will need to receive a grade. Instructors need to know what to base their grades on, and communicate that to the students. Learning objectives, patient outcome, participation, preparation, and even bedside manner can all be weighed.

    Educators should define here what are appropriate responses to the circumstances of the scenario.

    5. How long will the scenario last?

    As any experienced instructor will say, there’s never enough time to cover everything. To ensure class time is used effectively, determine how long everything will take. If class is an hour, perhaps prebrief is homework, the scenario is 30 minutes, debriefing is 20 minutes, and students can ask questions for the rest of the time. More class time gives an instructor more flexibility.

    Planning is important, but it can’t account for everything. Something unexpected is bound to happen. Be sure to note any challenges, evaluate progress, and plan improvements for future classes.

    Did we miss anything? How do you plan scenarios?

    Fu, Wing and Stavrolakes, Kimberly. “Creating an Effective and Low-Cost Complex Patient Simulation Course: The Recipe from Soup to Nuts.” American Physical Therapy Association Educational Leadership Conference, 18 October 2019, Bellevue, WA.