How to Write Clinical Simulations in Nursing Education

teacher teaching students in classroom

Here are some ideas and recommended steps for writing your own simulated clinical experiences.

  1. First, determine the learning objectives for the simulated clinical experience. This is key to success and will help to direct the debriefing session.
  2. Use actual client situations that you or one of your students encountered in the clinical setting. Realism is essential to a simulation experience, and an actual client situation is as real as it gets!
  3. Write the story. Outline what happened in the actual clinical situation. It is best to do it in a storyboard format so the actions flow in a realistic sequence. You might use some butcher paper to draw it out horizontally, allowing plenty of space between each section. It is okay to embellish the story at this point. You may even want to combine two or more clients for the one scenario.
  4. Next, add in the actors — nurses, healthcare providers, family members, other healthcare professionals (social worker, chaplain, charge nurse, etc.).
  5. Final components to complete the story. These are the details that should be added to the simulated experience:
    1. Handoff report – how do you want the simulated activity to begin.
    2. History and Physical – background of the client.
    3. Initial orders – these are the orders that were written before the scenario begins.
    4. Initial assessment findings – what the simulated client should look like when the student first encounters him/her.
    5. Expected actions – actions you would expect the students to perform during the activity. These should be identified for each expected change in the client’s condition.
    6. Client’s outcomes to actions and changes in condition – these can be written in an algorithm format so the person running the simulation can easily change the condition of the client.
    7. Scripts for the actors – it is nice to include scripts so the actors know what they are expected to say. For instance, if the student is expected to call the healthcare provider, the healthcare provider should have a script that would include the orders that will need to be given. There may be scripts for family members, social workers, and other actors within the clinical simulation scenario.
  6. Find evidence to support medical orders, nursing actions, and client condition. This is probably the most time-consuming part, but it is also an essential element to ensure your students are following the latest recommendations for care.
  7. Write the inventory list for equipment and moulage. This is another essential element and takes some thought. In order to “suspend disbelief,” the scenario must be as realistic as possible. This means using appropriate equipment, medications, and moulage (clothing, makeup, and other supplies, as needed, to make things like blood, vomitus, wounds, etc.). There are some good web sites for moulage materials.
  8. Write suggested questions for debriefing.
  9. The clinical simulation scenario is now complete. Try it out. Make adjustments where needed.
  10. Assign it to your students and evaluate the effectiveness of the exercise!