Form for planning and elaborating high fidelity simulation scenarios: A validation study.

Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the "snowball" sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item "It was easy to use the form to build your scenario" (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.

Realistic health care simulation scenario: what is relevant for its design?

We sought to describe the stages of scenario development with emphasis on the most relevant aspects according to the literature and guidelines of The International Nursing Association for Clinical Simulation and Learning and Best Evidence Medical Education, which are discussed and exemplified on the basis of our professional experience. The following stages were described and commented on for scenario design: planning, objectives, simulation structure and format, case description and perception of realism, pre-debriefing, debriefing, evaluation, materials and resources, and pilot test. A scenario design based on good practices involves important elements, and each stage is closely interrelated and interdependent in its creation process.

Realistic health care simulation scenario: what is relevant for its design? / Escenario en simulación realística en salud: ¿qué es relevante para su diseño? / Cenário em simulação realística em saúde: o que é relevante para a sua elaboração?*

ABSTRACT We sought to describe the stages of scenario development with emphasis on the most relevant aspects according to the literature and guidelines of The International Nursing Association for Clinical Simulation and Learning and Best Evidence Medical Education, which are discussed and exemplified on the basis of our professional experience. The following stages were described and commented on for scenario design: planning, objectives, simulation structure and format, case description and perception of realism, pre-debriefing, debriefing, evaluation, materials and resources, and pilot test. A scenario design based on good practices involves important elements, and each stage is closely interrelated and interdependent in its creation process.

RESUMEN Se buscó describir las etapas de confección de escenarios, con énfasis en los aspectos más relevantes, según la literatura y las directrices de la The International Nursing Association and Learning y de la Best Evidence Medical Education, las que se discuten y ejemplifican de acuerdo con nuestra experiencia profesional. Fueron descritas y comentadas las siguientes etapas para el diseño de escenarios: planificación, objetivos, estructura y formato de la simulación, descripción del caso y percepción del realismo, predebriefing, debriefing, evaluación, materiales y recursos y piloto. El diseño del escenario basado en buenas prácticas abarca elementos importantes, y cada etapa está íntimamente interconectada e interdependiente en su proceso de creación.

RESUMO Buscou-se descrever as etapas de elaboração de cenários, com destaque para os aspectos mais relevantes, segundo a literatura e as diretrizes da The International Nursing Association for Clinical Simulation and Learning e da Best Evidence Medical Education, as quais são discutidas e exemplificadas com base em nossa experiência profissional. Foram descritas e comentadas as seguintes etapas para elaboração de cenários: planejamento, objetivos, estrutura e formato da simulação, descrição do caso e percepção do realismo, pre-debriefing, debriefing, avaliação, materiais e recursos e piloto. A elaboração do cenário baseada em boas práticas envolve elementos importantes, e cada etapa está intimamente interligada e interdependente no seu processo de criação.

Simulação in Situ, uma Metodologia de Treinamento Multidisciplinar para Identificar Oportunidades de Melhoria na Segurança do Paciente em uma Unidade de Alto Risco / In Situ Simulation, a Multidisciplinary Training Method to Identify Opportunities to Improve Patient Safety Improvement in a High Risk Unit

Introdução A simulação é uma metodologia usada para substituir ou amplificar experiências reais por experiências guiadas que evocam ou replicam aspectos do mundo real de maneira interativa. A simulação in situ leva essa técnica diretamente aos locais onde ocorrem atendimentos, com a própria equipe de saúde atuando em seu ambiente de trabalho em cenário simulado. Objetivo Descrever experiência piloto de simulação in situ realizada em unidade de pronto atendimento, destacando oportunidades de avaliação de sistema de atendimento, trabalho em equipe e detecção de ameaças latentes à segurança (ALS). Métodos Estudo aplicado na Unidade Ibirapuera do Hospital Israelita Albert Einstein e realizado pelo Centro de Simulação Realística Albert Einstein. Foi apresentado cenário de paciente de 45 anos com síndrome coronariana aguda que evolui para parada cardiorrespiratória. Simulação híbrida de 30 minutos com uso de ator e simulador de alta fidelidade (SimMan 3G®).Utilizado checklist e filmagem para avaliar habilidades e atitudes, usados em debriefing estruturado com uma hora de duração. Resultados A experiência proporcionou avaliação técnica, comportamental e sistemas. Detectou quatro ALS e permitiu reflexão guiada sobre trabalho em equipe. Conclusão Este piloto contribuiu para o alcance dos objetivos propostos com o cenário e demonstrou oportunidades de treinamento e melhoria. A simulação in situ pode ser usada no futuro sistematicamente para treinamento contínuo de equipes, visando à melhoria da qualidade de atendimento e à segurança do paciente. .

Introduction Simulation is a method used to substitute or enhance real experiences with guided, interactive experiences that are reminiscent of or replicate aspects of the real world.In situ simulation takes this technique directly to the places where health care is rendered, with the health team acting in a simulated scenario within their work environment. Objective To describe the pilot in situ simulation experience conducted at an accident and emergency unit, highlighting the opportunities to assess the care system, teamwork and detection of latent safety threats (LSTs). Methods The study was applied at the Ibirapuera Unit of the Hospital Israelita Albert Einstein and performed by the Albert Einstein Realistic Simulation Centre.A scenario was presented wherein a 45-year old patient whose acute coronary syndrome evolves into cardiac arrest.A 30-minute hybrid simulation involving the use of an actor and high fidelity simulator (SimMan 3G®).A checklist was used and the simulation was filmed in order to evaluate skills and attitudes in a structured 1-hour long debriefing. Results The experience provided a technical, behavioural and system assessment. Four LSTs were detected and it enabled a guided reflection on teamwork. Conclusion This pilot contributed to achieving the objectives proposed with the scenario and demonstrated opportunities for training and improvement.In situ simulation may be used systemically in the future for continuous team training, aimed at improving service quality and patient safety. .