Content guide

Simulation Directors: Neel Naik MD & Chris Reisig MD – chr2019@med.cornell.edu. Please contact Chris if you have any questions about your case or plan for the day.

KEY ELEMENTS

The information below is intended to be a guide for the format we would like you to follow to provide learners consistency in how the cases are run. Please take a moment to review the details below, so that you can come prepared for leading your simulation.

TEAM

• You will be working with a simulation specialist who will be running the mannequin and will follow the narrative of the case as written
• Some cases may have actors or support players. Please include them in the team and make them feel welcome.

THE PRE-BRIEF

• The is NO PRE-BRIEF. General instructions for simulations will be given to participants in the morning orientation.
• Teams are expected to arrive 15 minutes before the case to meet their team, assign roles and review the learning objectives.
• They should jump right into the case the moment you open the door. (see below)

REALISM

• KEEP A GAME FACE
• The case should start the moment the door opens. They have been told to prepare to jump in immediately.
• Some cases will have actors to facilitate the realism; others will require you to play the role of EMS or other clinician engaging the team.
• Certain vital signs and other exam findings are able to be created. Please ask the sim specialist the capabilities of the mannequin.
• DO NOT give extraneous information. Only exam details that they could not elicit because of limitations of the mannequin.
• Nothing happens unless the team does it. Examples include:
  • No monitor on vital signs unless leads attached
  • No fluid or IV meds unless IV is placed
• Equipment & Carts – have all the equipment needed for the case
• Pharmacy –
• Labs & Imaging – Relevant labs and imaging can be provided to team by you if requested.
• Consultants – Are usually “not available” You can simply say they are, “on their way” or “with another sick patient”

THE DEBRIEF

• When the case has reached its conclusion, you will notify the team and end the case.
• As faculty you will lead the debrief
• De-briefs should continue for the allowed time (usually 15min)

THE DEBRIEF STRUCTURE

For a quick review of an effective debriefing structure please review the material here.

• Reaction phase
  • check for initial reactions to allow emotions to be defused before proceeding  (“emotion before cognition”) and identify learner-generated learning objectives
  • “What are your initial reactions?”, “what is at the forefront of your minds?”
• Description phase
  • outline the key events of the simulation using either a learner-centered (i.e. a participant provides the description) or instructor-centered approach (the facilitator provides the description) to develop a shared mental model of the events that took place
  • Learner-centered approach is more likely appropriate if:
    • More time
    • Learner willingness/ expectation
    • Knowledge of learner’s skill to synthesise
    • Simpler scenario
• Analysis phase
  • explore what happened, why, and what can be learned
  • Any of the conversational techniques and educational strategies described previously may be used according to:
    • Time
    • Domain
    • Rationale
    • Experience
• Summary phase
  • Highlight key learning points form the discussion using either a learner-centered (i.e. learners share their “take home” points) or instructor-centered approach (the facilitator summarises the discussion and emphasises key learning points)
  • Useful to allow time for questions before summarising so that the debrief finishes on appropriate points of emphasis

Provided by: Simulation Debriefing – Life in the Fast Line

• Written by: Chris Nickson
• May 10, 2022