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Teaching With Simulation:

A Simulation Facilitators Course.

Developing Your Scenario

Patricia Toth, MSN, RN, CHSE
Gregory Motuk, MSN, RN
Scenario Development
 Scenario Title:      
 Reason for Development (Needs Assessment):  Identify
unit strengths and limitations to determine where simulation might make an
improvement. What is the reason for the education? Is simulation the best way to
teach this concept?  
 Level of Learner:      
 Target Duration:      
 Learning Objectives: tie your objectives to your needs assessment.
These focus your teaching. Remember to include an evaluation of the objectives and
an assessment strategy to determine if the objectives were met.
 Objective 1:    remember to make the objectives measurable and craft them so
your staff can be successful in the scenario   
 Objective 2:  match your technology to your objectives.  Address the
participant’s knowledge level and experience
Standards for Best Practice
The Standards for Best Practice were developed and updated by
the Best practice Committee within the International Nurses Association
for Clinical Simulation and Learning (INACSL). The Standards include:
Needs Assessment
Measurable Objectives
Format of Simulation-Based Experience (SBE) - The format of an SBE provides the
structure and process and allows the designer to identify expected outcomes of the
Clinical Scenario or Case - The designer should use a process that ensures quality and
validity of the content and maintains the reliability and standardization of objectives. The
clinical scenario or case story may include a situation and backstory, clinical progression
and cues, time frames, script, and identification of critical actions. Make it evidence based.
Facilitator Approach - The specific facilitation method selected should be participant
centered and driven by the objectives, participant's knowledge/level of experience, and the
expected outcomes. The level of facilitator involvement is inversely proportional to the
participant's knowledge and experience. 
Standards for Best Practice
7. Briefing -  Briefing sets the stage for the SBE by identifying participants'
expectations and may differ depending on the level of experience of the
participant(s) and theoretical framework. Briefing is structured, planned for
consistency, and completed immediately before the scenario/case.
8. Debriefing and/or Feedback - I n the design phase of the SBE, a debriefing or
feedback method is identified. Debriefing and feedback are different, but both are
critical elements that should be structured using best practices.
9. Evaluation - In the design phase, evaluation processes are determined to ensure
quality and effectiveness.
10. Participant Preparation –In the design phase, inclusion of participant preparation
should be determined once all the elements of the SBE have been identified.
Preparation is designed to promote the best possible opportunity for participants
to successfully address the simulation objectives. The designer and facilitator are
responsible for ensuring that preparatory activities address the knowledge, skills,
attitudes, and behaviors that will be expected of the participants during the SBE.
Preparation activities should support the participant(s) ability to achieve the
objectives of the SBE and are completed in advance of the SBE briefing.
11. Piloting Testing - On completion of the design, the entire SBE should be pilot
tested to ensure it accomplishes what is intended, meets objectives, and is
effective when used with participants
Scenario Development
 Confederate Roles and Names – important to include exactly what you
want them to do to move the scenario along in the right direction
 Facilitator Roles and Name

 Link curricular objectives to:

 Organization Mission
 Core Competencies
 Patient Safety
Scenario Development
 Setting:
 Date:
 Time:
 Location: sim lab or in-situ?
 Role of the participant:
What do you expect the staff to do…are they being tested, are they in learning mode?
How will you facilitate the scenario so that the staff can be successful and feel safe
throughout the scenario? Let them know that this is a safe environment, it is OK to
Scenario Development
 Patient Information: make the scenario realistic
  Name:
 DOB:
 Medical Record Number:
 Allergies:
 Height:
 Weight:
Scenario Development
 Gloves____________ Sterile Gloves
 IV Pole (quantity)_______ Mask (type)_______
 IV channels (quantity)________ Gowns #____________
 Hand Sanitizer Goggles
 Patient Chart Booties
 Patient Identification Band

 Type of simulator: high vs low fidelity simulation. Not everything needs Sim Man!
 Be specific (ie Laerdal intubation head vs Sim Man 3G)
  Type of bed (i.e.: OR table/ Hill Rom bed/
 Furniture (Bedside table/chairs/couch)___________
Scenario Development
 Systems (for manikin set-up and facilitator use)
 Initial Scene (only include abnormalities)
 Neuro:
 Respiratory:
 Cardiac:
 GI
 GU

 Make sure that you have a list of ALL of the supplies that you will need.
This is difficult the first scenario.
Scenario Development
 Meds:
 Name
 Drug concentration
 Dose to be given
 How supplied (ie: tablet, solution etc)
 Do this for every medication that you will want them to use.
Scenario Development
 Moulage (i.e.: secretions, urine, blood, simulated
 Supplemental Media (i.e. photos or videos of skin appearance,
EHR, X-rays, ECG, Echocardiogram, Endoscopy video):
 Supplemental References(pediatric formulary, educational

 Confederate Roles: very important to rehearse the role with the

confederate. They keep the scenario on track and are used to introduce different
concepts throughout the scenario. They can assist the staff, if needed, or put
them back on track or in a different direction altogether. You must discuss
everything with the confederate before the scenario has begun.
Scenario Script
Scenari Patient Simulator Expected Simulator Scripted
o Stage Condition/ Paramete Interventio response Participant/
Information rs ns/ to Actor
Actions interventio Response (if
n (indicate used)
if response
is over
assessment Gen:       Vitals: List List List and
and decision  Airway:       ECG:       everything everything rehearse
 Breathing:       HR:       you expect you expect everything
 Circulation:       RR:       staff to the that you want
Disability:       BP:       perform simulator to your
 Exposure:       SpO2:       do with each Confederate
ETCO2:       intervention. to do and say.

Stage 2 Change in Repeat Repeat Repeat Repeat

condition: above above above above
  X-Rays and