#searchandrescue

My "Realism in Clinical Scenarios" Soapbox…

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As recently as in the past few months, I again observed a mock emergency response scenario, and I kid you not - they taped/wrapped IV tubing to the manikin arm saying, “IV started”.

I’m a veteran emergency nurse and educator, an inventor of wearable vascular access products, and I am “a tough stick” when it comes to IVs. That said, here we go…

That kind of limitation, the lack of realism, extends the gap between what we prepare them to do and what they will actually experience regardless of their status as soon-to-be new providers or salty old veterans.

That simple omission feels awfully close to a “pretend you started the IV” situation and we DO NOT PRETEND in clinical simulation.

“In the simulation, it is important to make a simulation experience as real as possible.  This is accomplished primarily by having the students perform the task and not just pretend to do it,” shared S. Howard, Ph.D., RN, CHSE, in “Increasing Fidelity and Realism in Simulation”, 2018, LWW.com.

C. Kroboth, NRP, CCEMT-P, LT, Fairfax County Fire and Rescue adds, “Don’t cut corners here; it’s nearly impossible for students to “imagine” or “pretend” that certain stimuli are present in the simulation when they’re not. Take advantage of all the resources at your disposal using simulated smells, moulage, and even recorded sounds, so that these sensory elements are familiar when they encounter them in the field.”

Of course, there’s always an exception, like when the provider is in a hospital/clinic setting scenario and the patients would have established IVs … but not in an external emergency or disaster situation. The percentage of the population walking around with an established IV is, I’m sure, quite small.

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To be fair - I must also include a sincere thank you to those of you who consistently try to maintain the highest level of realism in scenarios - you know who you are.

There are a variety of wearable products to increase the clinical realism of SPs (our ReaLifeSim products would be some of them), plus manikins that can be programmed to do nearly everything.

Let’s keep it real people - so we don’t do a disservice to those we’re teaching.

Emotional Resilience

Traumatic stress. Compassion stress. Physical stress. Social stress.

Regardless of their place on the responder spectrum of care, everyone from hospice nurse to combat medic can become victims, affected by the incidents to which they respond, day in and day out.

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It’s been said that people in other careers dream about retirement while First Responders just dream of surviving. The environmental stressors and trauma routinely confronted by medical professionals and emergency responders affect their emotions, decisions and actions and we are doing better to prepare the next generations of providers.

From “The Importance of Emotional Resilience for Staff and Students in the ‘Helping’ Professions: Developing an Emotional Curriculum”, L. Grant, Prof of Social Work and G. Kinman, Prof of Occupational Health Psychology, Univ of Bedfordshire, “Educators need to prepare students for the realities of caring work and encourage them to be assertive in seeking out the support they require to protect their own wellbeing, to advocate for working conditions which optimize the wellbeing of their patients and clients.”

The summer conferences are providing a variety of clinical challenges from simulated complicated childbirths to simulated mass casualty scenes taken from the headlines.

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Realism in clinical simulation practice is helping them to identify what they feel and why they are feeling it - in a safe environment, supported by facilitators, instructors, and peers.  

We must continue to provide effective learning experiences that are immersive - simulating a “real-life” situation that can engage the learners’ senses, emotions, thinking, and behavior.