Peer Simulation Guidelines: Maximize Authenticity and Learning in Healthcare Training

Welcome to the peer simulation program, peer patient. In this video, I will outline some guidelines to help you make

the most of your peer simulation experience. The benefits of simulation are extensively researched and widely

published across many health disciplines. Simulation is an exciting and innovative way of helping students

prepare for real life clinical interactions with patients. The aim of simulation is to enable you to practice

treating a patient and perhaps interacting with a clinical supervisor in a safe and realistic environment

before you head out into clinical placements. In some simulation experiences, a mannequin is used. In

others, trained actors actually portray the patient role. Peer simulation involves working with fellow students to

explore a clinical scenario. You will be asked to either portray a patient role, be a therapist, or perhaps take on an

observer role during peer simulation. In addition to developing your patient care skills, there is value to be gained from

portraying the patient role. This helps to develop empathy and a real feeling of what it is like to be a patient during

peer simulation. For peer simulation to be effective, it needs to be as realistic as possible, mirroring the

realities of clinical placement. Participants need to suspend disbelief and engage and immerse fully in the

process and not treat it as just another PR class. To achieve maximum authenticity and learning benefit from

simulation, we request that you adhere to the following guidelines. Number one, stay in character. This is really

important and applies to all participants, the patient, the therapist, the observer, and the

supervisor. For students to gain maximum benefit from peer simulation, they must feel like they're treating a real

patient, not a fellow student. When you are the patient, be punctual, as you will need to get yourself into

character. This may include putting on a costume and positioning yourself in the treatment space. During the interaction,

do not laugh, chat to the person on the next plinth, ask your partner for ideas, or check your phone. When you are the

therapist, remember that your interaction with the patient commences as soon as you say hello. Your peer

patient will be in character, so introduce yourself as you would with any other patient. There will be

opportunities to ask for advice during simulation. However, do not ask your peer who is playing the role of the

patient. You will not have a friend to ask during a patient interaction in clinic. Remember, this is different to a

normal Pratt class and you need to stay in character as a therapist at all times. The simulation may also include a

supervisor role or an observer role. Observers will not actually actively take part in the simulation, but may

provide feedback on the interaction. Supervisors may ask you to explain what you were doing. They might ask

questions, ask about your plan, correct your handling, or provide advice exactly as they would do in clinic. If a

supervisor is in the room, ensure that you interact with them authentically, exactly as you would with a supervisor

on a clinical placement. Number two, be prepared to ensure accurate portrayal of the scenario. You will have adequate

preparation time for both of your roles, either therapist or patient. Make sure that you use this time wisely.

As a therapist, ensure that you have a clear understanding of everything that you have read in the preparatory notes.

Make sure that you have a well-considered clear plan for your interaction.

As the patient, ensure that you have read all the supporting material and have practiced accurate movement, voice,

facial expressions, and emotions. Number three, call a timeout if you need to break character. Timeout is a tool

that all participants can use. The therapist, the patient, the supervisor, or the observer.

Timeout is used to pause the scenario and allow discussion around an event that has occurred. Timeout also allows

for a scenario to rewind so that the therapist can repeat the skill, allowing for refinement and practice of the skill

as required. You can go out of character if a timeout is called, but please don't use this as a chance to chat to others.

As a therapist, timeout is an opportunity for you to mentally step away from the interaction and consider

what you might do next. If you feel completely lost, that's fine. It happens to the best of us in clinical

situations. The learning experience is in working out how to deal with this feeling and then moving forward with the

interaction. Try to limit the number of timeouts called as a patient. Reserve calling a

timeout for those moments when you feel that the therapist has done something that might potentially have caused you

harm. If the therapist has done something that you think a patient would not like, try

to provide learning cues by changing your behavior. For example, if the therapist says something you think the

patient would be offended by, improvise and become withdrawn in the conversation or point out in character that you did

not appreciate the comment. Remember to call time in when you are all ready to resume the simulation. Number four, the

patient is not to carry notes, a computer or a phone. You will be provided with prompt notes on how to

portray the patient in the preparation session. It is up to you how you remember the key points, but in the

interest of authenticity, you are not permitted to have obvious notes or prompts that you are frequently

referring to as this adversely affects authenticity. When playing the patient, if you have

forgotten the scripted answer to an interview question, make up something that is relevant and appropriate. Try

not to interrupt the flow of the dialogue. Most students report that simulation is a great learning

experience. Despite initially feeling really nervous and finding the process quite challenging, this feeling

dissipates over time as you become more accustomed to the process. Simulation is a really valuable way to practice before

entering clinic. The more that you engage in the experience, the more that you will enjoy it. Have fun.