Images of the scenarios described in this paper are available from the authors.
Blurring the boundaries: scenario-based simulation in a clinical setting
Article first published online: 17 MAY 2005
Volume 39, Issue 6, pages 580–587, June 2005
How to Cite
Kneebone, R. L., Kidd, J., Nestel, D., Barnet, A., Lo, B., King, R., Yang, G. Z. and Brown, R. (2005), Blurring the boundaries: scenario-based simulation in a clinical setting. Medical Education, 39: 580–587. doi: 10.1111/j.1365-2929.2005.02110.x
- Issue published online: 17 MAY 2005
- Article first published online: 17 MAY 2005
- Received 19 April 2004; accepted for publication 19 July 2004
- clinical competence/*standards;
- patient simulation;
Context The ability to perform clinical procedures safely is a key skill for health care professionals. Performing such procedures on conscious patients is challenging and requires a combination of technical and communication skills. We have developed quasi-clinical scenarios, where inanimate models attached to simulated patients provide a convincing learning environment. Procedures are rated by expert observers and by the ‘patient’ and recorded for subsequent review. This study explores the potential of locating such scenarios within a real clinical setting, allowing participants to experience the challenges of the workplace while ensuring patient safety. An innovative portable digital recording device (the ‘Virtual Chaperone’) is evaluated for use in clinical settings.
Methods A qualitative design (observation and interview studies) investigated volunteer medical students undertaking 2 procedure scenarios (insertion of urinary catheter and wound closure with sutures) within the accident unit of a large London hospital. All procedures were observed in real time and recorded digitally (using the Virtual Chaperone). A protocol was used for structured feedback. Observational and interview data was analysed using standard qualitative techniques.
Results Seven sessions with 22 undergraduate medical students took place over 9 months within 1 centre. Data confirmed the feasibility of using a moveable, self-contained training scenario within an authentic clinical setting. Overall, the response from participants was positive.
Conclusion Scenario-based teaching within an authentic clinical environment is feasible and perceived by participants to be educationally useful. This approach blurs traditional boundaries between skills laboratory teaching and clinical practice and may offer considerable advantages in training for clinical procedures.