From: The impact of contextualization on immersion in healthcare simulation
Mission phase | Basic | Contextualized | Fidelity adjustments |
---|---|---|---|
(1) Dispatch, ambulance | Dispatch delivered from the instructor during introduction | Through a realistic two-way communication system | Equipment fidelity, functional task alignment |
Oral information from the instructor | Full visualization, in a driving simulator, of an actual turnout from the station to the address (4 min). Communication with the dispatch center is possible. | Equipment fidelity, environmental fidelity, functional task alignment | |
(2) On scene assessment | The instructor informs the team that they are at the scene and that they can start working. Equipment is already in place. | Crew physically relocate themselves and equipment to the patients’ apartment. | Functional task alignment |
The team enters an apartment (simulated in a lecture room) with physical props and with interiors projected on the walls—which may indicate, e.g., the lifestyle of the patient or give clues about the situation. Ambient sounds and a dog barking behind a half open door were used to further enrich the environment. | Environmental fidelity | ||
(3) Initial patient assessment | The team interacts with the manikin in a lecture room that represents the home of the patient. | The team interacts with the manikin in the apartment. | Environmental fidelity |
(4) On-scene treatment | Medicine is delivered by informing the instructor of the action. | Medicine is delivered in a realistic way using RFID tags. | Equipment fidelity |
Calls to medical control and ECG transmission are handled via the instructor. | Calls to medical control and ECG transmission are handled in a realistic way. | Equipment fidelity, functional task alignment | |
(5) Scene departure and transport | The manikin is loaded to the stretcher. The team stays in place but verbalize/report to the instructor that they load the patient into the ambulance. | The manikin is loaded to the stretcher, brought out of the apartment, and then loaded into the ambulance/driving simulator. | Equipment fidelity, environmental fidelity, functional task alignment |
Driving is not a part of the simulation but the team may discuss the case and inform the instructor of what they would have done during transport. | The simulated trip to the emergency department takes 7 min during which additional treatment is carried out in the ambulance. | Equipment fidelity, environmental fidelity, functional task alignment | |
(6) Patient handover to emergency department | The team reports to the attending emergency physician. | The team reports to the attending emergency physician. |