Author: Corey Heitz, MD
Peer Reviewer and Editor: Nikita Joshi, MD
“The best laid plans of mice and men...”
Whatever the situation, you as the facilitator need to prepare how to fix sim-case-derailment in advance. If you are like many of us, and believe in realism, then you need to know what you’re going to do to keep the scenario going, or, when you need to break realism and “fix it.”
The following are potential issues and options for how to work through or around issues that arise during simulations. Options can be separated into “adapting” the case (keeping your changes within the scenario) and “restoring” the case (fixing it, often from without).
The underlying concept to any scenario rescue or modification is to remember:
What are your objectives?
When applying any of the above corrections, or others not listed here, remember to consider your original objectives. Would letting the scenario progress naturally, albeit differently than planned keep the learner from meeting their objectives? Interrupting the case for correction or redirection may ruin the flow and result in artificiality.
Other considerations for any correction:
Videos Highlighting Correction Techniques
Below are two videos showing options for case management when unexpected events occur.
Wrong Type of Shock
Acknowledgements: adapted from “Keeping it Real When Faking it” presented at CORD AA 2010, Mike Smith MD, Thomas Noeller MD Corey Heitz, and Raymond Ten Eyck MD.
Dieckmann P, Lippert A, Glavin R, Rall M. When Things Do Not Go as Expected: Scenario Life Savers. Simul Healthc. 2010;5:219.