Any paramedic program has the critical task of developing a specific scenario library. The development process must look at many factors including: the conditions to be covered, age group of patients, psychomotor skill incorporation, teamwork development, affective domain challenges and more.
As EMS educators, our goal is to lead the development of our students from beginners to competent providers. This is accomplished through a range of educational activities in the classroom, the lab, the hospital and the field. Those activities are guided by national standards regarding content areas and learning objectives. The recent introduction of the National Registry of EMTs (NREMT) Paramedic Portfolio and IOOH Scenario Exam has placed a greater emphasis on the role of scenarios in the EMS development process.
Development of scenarios is a discipline onto itself. While the best source for scenarios is often real-life encounters, these encounters must be adapted to a format that allows consistent experience delivery for students. There are numerous professional resources available for the rigorous development of high-quality scenarios. The Society for Simulation in Healthcare is a leading interprofessional society that advances the application of simulation in healthcare through training, reference materials, and workshops.
At its simplest, a scenario plan is a blueprint that guides educators on how to conduct the simulation exercise. It should include objectives and information on setup, performance and debriefing. Beyond the basics advanced topics such as student prompts, actor roles, red herrings and more will be included. The art part of scenario design comes with building engaging recreations, packed with the tension of the street and providing the opportunity for learning demonstration.
To Develop a Scenario Library
In order to develop a scenario library, a program must do the following:
- Establish an overall content blueprint.
- Start developing individual scenarios. This is a large task requiring hundreds of hours, and assigned to many people.
- Review written scenarios for accuracy and flow.
- Scenarios must be practiced to validate they do meet the objectives of the scenario.
- Once the library is complete it must be continually updated to reflect current practice.
- Familiarizing faculty and adjuncts with the scenario resources is a critical step.
- Having scenarios easily accessible and in a secure format is also very important.
Both the National Registry and the Committee on Accreditation of Educational Programs for the Emergency Medical Service Professions (CoAEMSP) (2019 Minimum Student Competencies) have specific requirements for scenario topics broken down by conditions and age groups. This requirement sets out the minimum topics areas that a program must develop around.
For many topics and age groups a variety of topics will be developed to reflect beginner to competent levels of performance and to provide a wide range of practice opportunities. Different scenarios will be developed as formative scenarios and others as summative scenarios. The National Registry provides models of scenarios and also indicates required scenario parts.
Other Challenges and Resources
Creating a library is time consuming. Research published by the National League for Nursing indicates that scenario preparation time is often in ta 4:1 preparation to delivery ratio. Just as there are resources to assist with the development of individual scenarios sources exist for the sharing and acquisition of ready-made scenarios.
The National Registry has an extensive library of online paramedic scenarios. Many programs are willing to share scenarios with colleagues. Finally there are commercial packages available from simulator vendors and other organizations. As with any acquisition it is important to understand how the scenarios were developed and ensure a fit with your program.
In the martial arts, students have been guided for hundreds of years from novice to expert through the use of katas or ritualized forms. In many ways a scenario library is our EMS equivalent of these of katas that we will use to develop expert disease fighters for the healthcare challenges of the real world.
This is a guest post by Greg Vis (BS, EMT-P), the founder of Hudson Simulation Services and provider of simulation support to more than 100 programs across the United States and internationally. Greg completed the accreditation process of the Society for Simulation in Healthcare as a Certified Healthcare Simulation Educator (CHSE), and all training follows evidence-based methodologies. Prior to founding HSS, Greg managed a number of large medical simulation programs for the US Army’s Research Engineering and Development Command (RDECOM) at Fort Sam Houston in San Antonio, TX. Greg is adjunct faculty at Hudson Valley Community College in Troy, NY and the training officer for the Middleburgh EMS Agency.