In the process of medical education, simulations are one of the most important and often overlooked tools available to instructors. There are many considerations that must be taken into account when leading a simulation. The process of converting theoretical knowledge into practical actions is not a simple one, especially when critical decision-making is involved. A firm guiding hand, when applied correctly, can have immense benefits in the execution of a sim. Let us begin at the beginning.

Each and every simulation is grounded in theory. Students must have an adequate understanding of the material before attempting their hand at treating a mock patient, this much is evident. However, instructors tend to take the pre-brief for granted. A simulation must have a clear goal for the students to strive for. Just telling them to “treat the patient” is often not enough. Ideally, a scene is described and then the job of the rescuers defined. “Work through the triangles, take full sets of vitals, identify (do not treat) 3rd triangle problems, and finally call into command.” Guidance such as this can instill assurance in students, all the while converting protocol into habit. Different expectations are appropriate at different times during the HEART class. The less the students know, the less complex a simulation should be. The first few simulations should be basic and deal with mastering the patient assessment system (PAS), for which something like the aforementioned pre-brief could be ideal. Sims later-on should involve treatment, creating plans for long-term management, and considering evacuation options. Such sims necessitate more involve pre-briefs that give students a sense of where they are, what environmental considerations they will face, and all of the resources available to them. An effective simulations begins with a detailed pre-brief that puts everyone on the same page as far as knowledge, expectations and goals are concerned.

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