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Struggling to bring ideas to life? Marjorie Miller and Colleen O’Leary-Kelley seek brilliancy in coffee cafes, where they can often be found jotting ideas on the shop’s napkins. They then consider their learners, topics, and examples to come up with great scenarios to write. Evaluating their goals and objectives helps to maximize learners’ clinical simulation experience, and, to think, it all started with simple free-flowing concepts. Marjorie and Colleen have a look at fidelity when creating their scenarios. They try to make their simulations as realistic as possible with the manikins they have. Their term for this is practicing realism – making the learners feel that they are absolutely practicing true-to-life during medical simulation training. How do they get the scenario examples that they want to use? We’re going to revisit their brilliancy. They look at many examples from communication, cultural diversity, and teamwork collaboration to ethic issues, priority settings, and decision making. They don’t focus on a specific clinical simulation, but rather a broad range of topics to build their simulations around. Let’s consider a roadmap: driving from one destination to another. That’s how these two women “get there” with their scenarios. They focus on what they really want their learners to do, and coach them on getting from point A to point B in a relatively straight line. What they see is a rather convoluted way of arriving, and they strive to create scenarios that don’t create as many learner detours. In doing so, they create a storyboard for streamlining and lessening the chances of going off-course. It allows them to keep it simple, keep it focused, and keep it short. In the California Simulation Alliance, the initial process in scenario development and medical training is to come up with a standardized template of approximately twelve pages that includes everything they need to write a scenario. The template provides structure, it lists the learning objectives, it lists the evidence-based references, it gages the level of fidelity, and it gives – the very important piece – the story, the case flow, which highlights the debriefing points. Essentially, the case flow triggers the scenario development state. Marjorie and Colleen take the report they are going to be using and transfer it from their storyboard to initiation. All of these actions evoke measurable results for both learner and team skills while practicing human patient simulation. In debriefing points, you may notice where, in simulation healthcare, learners met competencies or there was a gap. Their goal is to reinforce what was done positively and help learners close their own performance gap. Many simulations end abruptly; even some with a simple “simulation over”. Those at the California Simulation Alliance like to go about it another way. They may have leaners give a hand off to an upcoming shift or have a charge nurse come in and say they are needed in another room. This helps to keep realism alive, so learners stay absorbed in realism and fidelity for as long as they can.  About the Author : The writer of the article has a generalized concept in the field of Laparoscopic Surgery Training and Simulation Healthcare.
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