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Session 2
Objectives


Describe the essential components of
scenario design



Develop learning objectives that are
suitable for simulation



Build a basic scenario to address those
objectives
Anatomy of a Simulation
Learning
Objectives/Competencies

Task analysis data

Event sets/Scenario

Skill inventory/ historical
performance date

Synthetic/ immersive
environment

Performance
measures/dynamic
assessment

Feedback/ instructional
strategy

Performance diagnosis

Adapted from Jan Cannon-Bowers 2005
Anatomy of a Simulation
Learning
Objectives/Competencies

Task analysis data

Skill inventory/ historical
performance date

Event sets/Scenario

Scenario
Design

Synthetic/ immersive
environment

Performance
measures/dynamic
assessment

Feedback/ instructional
strategy

Performance diagnosis

Adapted from Jan Cannon-Bowers 2005
Scenario design

The design and implementation of a
partially scripted situation in which the
learner is challenged to (and has the
opportunity to) demonstrate the defined
objectives.
Tip #1
Tip #2
Learning objectives
Hint: use strong action verbs
 SMART objectives
 Specific, measurable, appropriate, realistic, t



imebound
Centered around desired
observable behaviors
Achievable for the learner
Example Objectives
By the end of this simulation
training, learners will be able to:







demonstrate effective teamwork behaviors (ie.
communication, information exchange, mutual
support, leadership),
diagnose and manage a clinical condition,
correctly perform a skill (ie.insertion of central
venous catheter, correct placement of an
advanced airway) ,
effectively counsel a “standardized patient”
about his or her prognosis, etc
Tip #3
Who are your learners?


Identify who and how many learners will
be involved in the simulation
 Impacts complexity of scenario

 Influences debriefing and assessment plans
What are the Elements of
Scenario Design ?
Tools
 Environment
 Script (Story)


 Patient “states”

 Learner actions
 Trigger events

Confederate roles and instructions
 Facilitator instructions

Types (tools) of simulation


high fidelity (computerized full body
manikin)



task trainer for skills performance
mastery
“standardized patient” (learner
interacting with a trained actor)
hybrid (combination of these)



Environmental considerations
setting
 medical equipment
 clinical forms
 Props (moulage?)

The story…..








Credible
Beware of medical controversy unless this
is the purpose of the scenario
Don’t try to trick the learner
Who is your patient? What has happened
to him/her? When does the scenario start
and end?
What drives the story forward?
What distractions do you want to build in?
Important definitions
“State”
 “Triggers”
 “Learner Actions”
 “Confederate”

Trigger events
Effective building of a scenario requires trigger
events.
A trigger event is a condition, action or event
within the scenario that
move the “patient” into a different state
This should push the learner toward a specific
action, decision or thought process
Confederate roles /instructions
Confederates should have a specific
purpose within the scenario
 Confederates should keep learners on
track
 Confederates should challenge learners
in areas relevant to learning objectives
 Confederates don’t lie unless that’s the
objective (and why would it be?)

Facilitator instructions
Information necessary for another
instructor to run your scenario without
you
 FAQs
 Good questions for debriefing
 Content that should be covered in
debriefing

Tip #4
Dry Run Objectives







Ensure that scenario progresses in a
credible way
Ensure that learner actions move the
scenario in the desired direction
Ensure that learner can achieve desired
objectives in the scenario
Try to identify possible deviations from
anticipated learner actions, and build in
ways to redirect learners
Refine scenario as necessary based on dry
run
Tip #5
Prebrief
Establish learning climate
 Describe relevant features of simulator
 Describe learning objectives or
expectations
 The Basic Assumption
 The Fiction Contract
 The Promise (Vegas)
 Any information about the patient for the
learner(s) before the scenario begins

Tip #6
Sample case scenario
Title: Cardiac Arrest / PEA
Learning Objectives:
1.
Demonstrate effective teamwork behaviors in a code
situation
2.
Provide effective treatment to the patient in a cardiac
arrest
3.
Demonstrate the ability to do a critical analysis of the
underlying causes of the patients arrest
Case backround: 52 yo man with schizophrenia admitted from to
general medicine from inpatient psych for evaluation of
shortness of breath. Nurse was going in to take
vitals, thought pt looked strange - called for help

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Scenario design 2 11 14

  • 2. Objectives  Describe the essential components of scenario design  Develop learning objectives that are suitable for simulation  Build a basic scenario to address those objectives
  • 3. Anatomy of a Simulation Learning Objectives/Competencies Task analysis data Event sets/Scenario Skill inventory/ historical performance date Synthetic/ immersive environment Performance measures/dynamic assessment Feedback/ instructional strategy Performance diagnosis Adapted from Jan Cannon-Bowers 2005
  • 4. Anatomy of a Simulation Learning Objectives/Competencies Task analysis data Skill inventory/ historical performance date Event sets/Scenario Scenario Design Synthetic/ immersive environment Performance measures/dynamic assessment Feedback/ instructional strategy Performance diagnosis Adapted from Jan Cannon-Bowers 2005
  • 5. Scenario design The design and implementation of a partially scripted situation in which the learner is challenged to (and has the opportunity to) demonstrate the defined objectives.
  • 8. Learning objectives Hint: use strong action verbs  SMART objectives  Specific, measurable, appropriate, realistic, t   imebound Centered around desired observable behaviors Achievable for the learner
  • 9. Example Objectives By the end of this simulation training, learners will be able to:     demonstrate effective teamwork behaviors (ie. communication, information exchange, mutual support, leadership), diagnose and manage a clinical condition, correctly perform a skill (ie.insertion of central venous catheter, correct placement of an advanced airway) , effectively counsel a “standardized patient” about his or her prognosis, etc
  • 11. Who are your learners?  Identify who and how many learners will be involved in the simulation  Impacts complexity of scenario  Influences debriefing and assessment plans
  • 12. What are the Elements of Scenario Design ? Tools  Environment  Script (Story)   Patient “states”  Learner actions  Trigger events Confederate roles and instructions  Facilitator instructions 
  • 13. Types (tools) of simulation  high fidelity (computerized full body manikin)  task trainer for skills performance mastery “standardized patient” (learner interacting with a trained actor) hybrid (combination of these)  
  • 14. Environmental considerations setting  medical equipment  clinical forms  Props (moulage?) 
  • 15. The story…..       Credible Beware of medical controversy unless this is the purpose of the scenario Don’t try to trick the learner Who is your patient? What has happened to him/her? When does the scenario start and end? What drives the story forward? What distractions do you want to build in?
  • 16. Important definitions “State”  “Triggers”  “Learner Actions”  “Confederate” 
  • 17. Trigger events Effective building of a scenario requires trigger events. A trigger event is a condition, action or event within the scenario that move the “patient” into a different state This should push the learner toward a specific action, decision or thought process
  • 18. Confederate roles /instructions Confederates should have a specific purpose within the scenario  Confederates should keep learners on track  Confederates should challenge learners in areas relevant to learning objectives  Confederates don’t lie unless that’s the objective (and why would it be?) 
  • 19. Facilitator instructions Information necessary for another instructor to run your scenario without you  FAQs  Good questions for debriefing  Content that should be covered in debriefing 
  • 21. Dry Run Objectives      Ensure that scenario progresses in a credible way Ensure that learner actions move the scenario in the desired direction Ensure that learner can achieve desired objectives in the scenario Try to identify possible deviations from anticipated learner actions, and build in ways to redirect learners Refine scenario as necessary based on dry run
  • 23. Prebrief Establish learning climate  Describe relevant features of simulator  Describe learning objectives or expectations  The Basic Assumption  The Fiction Contract  The Promise (Vegas)  Any information about the patient for the learner(s) before the scenario begins 
  • 25. Sample case scenario Title: Cardiac Arrest / PEA Learning Objectives: 1. Demonstrate effective teamwork behaviors in a code situation 2. Provide effective treatment to the patient in a cardiac arrest 3. Demonstrate the ability to do a critical analysis of the underlying causes of the patients arrest Case backround: 52 yo man with schizophrenia admitted from to general medicine from inpatient psych for evaluation of shortness of breath. Nurse was going in to take vitals, thought pt looked strange - called for help

Editor's Notes

  1. Elements are units of design, term is referenced on the syllabus. They may or may not be essential depending on the type of scenario chosen.