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First Aid Scenarios - Why Bother?

By Josh Kirby


Why should we bother with all the effort and time it takes to use practical scenario based training in our first aid? Isn’t it all a bit distracting and takes up too much of our ever-precious time and energy?

No.

Well... I would say that... given that I’ve spent far too much of my spare time over the past year building this website for people to use because I’m so convinced in how useful they are. But a lot of people probably don’t really get my (slight) obsession with scenarios so I figured it might be useful to write something to explain – why bother?

What do I mean by a scenario?
By scenario, I’m thinking a training situation where you are role-playing with someone (or something in the case of a resuscitation doll) acting as the patient. The first aiders then need to go through the situation as if they would for real.

They’re one tool in your toolbox
Now that I’ve clarified what I’m talking about, I should probably say right up front that scenarios definitely shouldn’t be the only training tool for first aid. In fact, if it is the only tool you use, you may as well just go to the pub and have fun there. It’s important that we have some fundamental knowledge before going on to develop those skills learned in a scenario situation. If you don’t have that simple knowledge going into a scenario, no matter how well it is written, you are probably not going to get very much out of it. That being said, you only need the basics to be able to start getting more out of them (i.e. I’m not saying you need the knowledge of an experienced prehospital Doctor but rather the basics of how to recognise a heart attack or whatever condition the scenario is testing and how to deal with it at your skill level).

6 Reasons

I’ve discussed 6 reasons why I think scenarios are a great addition to first aid training below. They’re things I’ve seen from my experience rather than from research done into their effectiveness – although I would bet there would be a correlation.

1. Get it wrong in a safe environment
People make mistakes. It doesn’t matter what you are doing or you are. You could be a postman, a musician, the monarch of your own island or a rocket scientist – but you will sometimes make mistakes. Scenarios are a great place to make mistakes – because it’s so much better to make a mistake in training than on a real patient (goes without saying I hope!). Scenario training should be a safe environment. What I mean by this is that everyone should EXPECT to make mistakes and know they can use the experience to learn from it – that way they are less likely to make the same mistake again. This means that no-one takes the mick when someone makes an error, even if it’s something that they should know, otherwise no-one will want to take part and no learning will happen. There’s also the aspect that there isn’t a real patient, so you can pause the scenario to chat things through and work out what the best option is – you have more time than in a real scenario. So when you face a similar situation for real, you’ve already done half of the thinking because you did it when you had bags of time in a practice session. It’s always good to remember that those at the top of their professions are often those who have made the most mistakes...and learnt from them.

2. Pressure and your reaction
The idea of practical scenarios is to try and simulate the real situation. This includes the pressure that will inevitably be the looming cloud when you are doing it for real. It’s not possible to truly simulate this pressure but you can get somewhere close with good casualty simulation (actors and make-up) and a good attitude. You never really know how you might react to any given situation that you come across but you can start getting an idea when a little pressure is placed on you. This applies to both individual small scenarios or large scale mass-casualty scenarios. I’ve definitely seen first aiders go blank when there are loud noises everywhere, it’s dark and they’ve got a serious patient to treat. But from this situation, they now know a little of what it feels like and will hopefully be able to calm themselves better in future and go back to their basics. Evidently, if you put people under a lot of pressure, you also need to make sure that there is pastoral support for them to make sure it’s a learning experience rather than just a traumatic one!

3. Builds confidence
Treating in scenarios can build the confidence of first aiders. Confidence in their skills and that they can make a positive difference to patients and that they know when they need extra help. Learning knowledge in a classroom environment is a far cry from being faced with the signs and symptoms for real and then needing to do something about it. Even things as simple as talking to a patient –having a good patient manner – can be completely off-putting and put you on the back foot if you haven’t got used to doing it through practice scenarios. It’s worth noting that scenarios can also crush people’s confidence if you don’t run them well so you need to give them enough time and be sensitive to people’s individual learning needs.

4. Allows and encourages reflection
Anyone who knows me will know that I don’t shut up about reflecting on each patient I ever treat whether that is in a scenario or for real. You learn so much by going through what happened and looking at what went well and what can be improved. It’s a positive experience if you have the right attitude – you can do it in your head rather than writing it down all the time. Scenarios are a natural mechanism to allow and encourage people to reflect on how things went. At the end of each scenario, facilitators can guide discussion and feedback from everyone involved in the scenario. Everyone then learns together and are more likely to do it themselves in their everyday first aiding practice.

5. Test specific skills and knowledge
You can test almost any piece of skill or knowledge through a well written scenario (well ones that are first aid related anyway). By knowing what you want to get out of it in the first place, you ensure that you test the specific skills you want to. This means that those taking part don’t need to know everything there is to know about first aid – they just need to know the topic you are testing. For example, perhaps you are running a session on heart attacks and angina for new first aiders. You can get them doing some simple scenarios specifically aimed at chest pain related topics and can be incorporated into regular training sessions easily. There are also loads of variations for each scenario. Maybe you think you’ve done hundreds of resuscitation scenarios but have you ever done one in a crowd, in the dark, with an aggressive bystander or in a ridiculously small space? Or maybe you haven’t done a heart attack scenario with a patient who is deaf, has learning difficulties, is refusing treatment or has a complex medical history? If you think you’ve done every variation of a particular topic, I’m pretty sure that you are wrong!

It probably won't be as you expect for real
My final reason (yup, nearly at the end!) is that when you come across something for real, it almost certainly won’t be exactly as you’ve learnt it in the classroom. In fact, it probably won’t be exactly as you’ve practiced in a scenario either. But if you’ve done a load of scenarios and practiced your basics with variety of different complications, when you do come across it in a slightly different way for real, you will be better able to think on your feet and work well. You’ll have done the basics so many times that you can do them in your sleep...you’ll be more confident and, I’d argue, more capable of dealing with the situation.

I’d love to know what you think so do add a comment below or get in touch on the make a suggestion page.


Comments: What do you think of the article? Do you agree that scenarios are useful? If you are logged in, your usename will be assigned to the comment.
Anonymous:
Good point, so what have you got to back it up

Anonymous:
Fantastic website, thanks for the resources

Anonymous:
Running carefully designed scenarios as realistically as possible is the only way prepare participants to deal effectively with real life situations.

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