Immersive scenarios

Definition: In this form of scenario, the team manages a case, and debriefs it, retrospectively. The scene is contextualized, meaning that the clinical events are managed in a realistic environment. The script is multifaceted with several clinical events occurring simultaneously, along with situations that influence the behaviours of the participants toward the patient, their colleagues and their performance.
Suitable for the following competencies: This format is useful for non-technical skills and teamwork and complex clinical case management including decision-making.

Format: Up to 12 participants. Best achieved with separate rooms for simulator and discussion with real time audio-visual transmission, however this is not critical.

How its run: A team is briefed prior to the scenario with relevant information about a case. Subsequently they enter the simulation training room and manage the case in full (approximately 20 -30 minutes). Remaining participants watch in realtime via a video link. Afterwards they participate in a detailed reflective and retrospective discussion, or debrief (approximately 20-30 mins).

The scenarios

  • Each scenario will involve a team of up to 6 doctors and nurses
  • Prior to the beginning of the scenario, the team will be allocated. Depending on the course, the team members may allocate their team roles among themselves, or a faculty member may allocate roles
  • The team will be briefed immediately prior to the scenario in respect to the nature of the case
  • The team will receive a hand-over from a faculty member and then manage the case as presented. The other participants will observe the scenario from the seminar room.
  • A computer operator will be in the next room controlling the patient simulator’s behaviour and recording events
  • A video recording may made during the scenario and will be reviewed during the debriefing and tutorial that follows. Whilst this may sound alarming, it is our experience that participants feel that the scenario reviews are one of the highlights of the course. As you will discover on the day, these recordings are made for your benefit and are fully confidential

The simulated patients

  • Actors or robotic patient simulators will be used as the patient(s) in the scenarios. They will be highly realistic in some respects and less realistic in others
  • Additional clinical information will be available from the control room (via the voice of Big Brother)

The environment

  • You will be working in a simulated clinical environment enacting the types of wards relevant to your course. The patient may be attached to monitors and infusion sets. The equipment in use is real, and all safety precautions must be taken (e.g. defibrillation)
  • The environment is designed to enable typical clinical tasks to be carried out. As in the real clinical setting, these may malfunction and require trouble shooting. If something doesn't work you will be expected to fix it or find an alternative solution
  • The environment will be realistic although is unlikely to exactly replicate your individual workplace. A faculty member will also be in the training room acting (usually as a nurse) if you require assistance locating equipment. If something is missing, ask for it and we will get it for you if we can

The debriefing - A debriefing occurs immediately after each scenario. This part of the day will be an opportunity to sit down in another room and discuss the scenario which has just been presented. Both the participants and the observers within the group will be asked to comment on how they felt things went. The instructors will facilitate the discussion. The scenarios will address specific issues from clinical (using a structured approach) and behavioural (teamwork and error minimisation) aspects