Pediatric simulation scenarios can have a lot of elements to consider to ensure that an effective scenario is delivered by clinical simulation faculty. When in the process to learn about delivery of pediatric simulation scenarios, this can cause overwhelm in an inexperienced healthcare simulation faculty. This article by Erin Carn-Bennett will discuss some considerations in the delivery of pediatric simulation for those new to the delivery of pediatric simulation scenarios.
In pediatric simulation, there is not only the manikin patient to consider, but also the family and their input into the clinical simulation scenario. Pediatric simulation requires manikins as ethically and morally there are challenges around the inability to be able to use simulated patient actors as a pediatric patient. However, the use of a simulated person to be a family member within the pediatric simulation can be incredibly useful. A family member’s presence is also realistic to real life where pediatric teams also have to care for the pediatric patients’ family members.
If the parent or caregiver is not present in the clinical simulation scenario represented by a faculty member or a simulated parent then the faculty need to be prepared for questions from the clinical simulation participants about them. An easier answer which is uncomplicated may include that the parent is in the shower or is out of the clinical space to move the car. Clinical teams are used to family centered care and the inclusion of parents, so this needs to be a consideration in the plans for the clinical simulation faculty.
With the use of parents there should be careful consideration by those who write the scenarios as to not emphasize any perceived or actual stereotypes. For example: a single parent who is poor and/or a smoker. The use of employment status or the job in which a caregiver is in is usually not relevant in a clinical simulation, however if this information is used then this should be used with careful consideration and assessment for bias and stereotypes.
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Different cultural backgrounds should be represented within pediatric simulation as per the population base of different countries. However, there should always be an assessment for any perceived or actual bias and stereotypes within the scenario stem. These should be acknowledged and not reinforced in any way by faculty that deliver the clinical simulation scenario.
There should also be considerations of who will start in the room at the start of the pediatric simulation scenario. Consider if a full clinical team will be required as the scenario starts or just one team member such as the patient’s nurse. The simplicity of one nurse who starts the scenario off with the patient and then escalates to call for help can be a great way to get team members communicating with one another. This is also a great opportunity for nurses to practice handovers of critical information to a broader team with a patient who has deteriorated.
Think about whether any new information will be given to clinical simulation participants at different points throughout the scenario and how will this information be delivered. Consider if any moulage is required and what the manikin will be dressed in.These seem like minor details, however in a pediatric simulation these features and considerations can add a lot of fidelity and assist participants a lot with immersion into the clinical simulation scenario.
There should be a lot of consideration put into the pediatric simulation scenario stem or background story of the case. Make sure that the clinical simulation stem makes sense to the clinical environment that the clinical simulation is delivered in. If there are inaccuracies within the clinical simulation stem, this can affect buy-in for the clinical simulation participants and has potential to derail the scenario.
Be sure to test out any new scenarios to be sure that the case makes sense and the participants get to the learning objectives that were anticipated by faculty. However, as a faculty member there is also great importance to park personal agendas to meet all learning objectives listed. Especially in the postgraduate clinical environment ensure that the clinical simulation debrief is learner centered and also learner led where possible to maximize learning and protect psychological safety.
A lot of pediatric clinical findings on assessment can be subtle. Therefore the importance of the information delivered within the clinical simulation scenario is key. An experienced clinical simulation scenario director will also notice when teams are misled by clinical information within the scenario stem or by the manikin and will redirect them to where they should be, if required and appropriate. This may be achieved by the clinical simulation director giving the clinical simulation participants more relevant clinical information which guides the team into the direction of the pre-defined patient diagnosis.
As faculty for a pediatric simulation there should be consideration as to whether any laboratory results will be made available to the clinical teams involved in the scenario. There should be anticipations made as to what laboratory results may be required for the team’s immersion. Consideration should also be given as to what point will this information be given to the team in the pediatric simulation scenario. These results will need to be accurate to the patient’s clinical presentation and add to fidelity and immersion within the clinical simulation scenario.
This article has discussed some considerations to get started with the delivery of pediatric simulation scenarios. There are a number of considerations that need to be made by faculty such as the involvement of parents and how this will be achieved without the reinforcement of any stereotypes or bias. The stem of the scenario needs to be an accurate representation of a case within the clinical environment in which the pediatric simulation is delivered. Pediatric simulation can be a lot of fun to deliver and refine. Careful attention to details and also continuous learning by faculty can assist in the strive towards a highly effective and successful program.
