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Simulation scenario rehearsal: the key to successful and effective simulations
  1. Rami A Ahmed1,
  2. Patrick G Hughes2,
  3. Aimee K Gardner3
  1. 1 Summa Health System, Akron, Ohio, USA
  2. 2 Florida Atlantic University, Boca Raton, Florida, USA
  3. 3 Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Rami A Ahmed, Virtual Care Simulation Lab, Akron City Hospital, Akron, OH 44304, USA; ahmedr{at}

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All the real work is done in the rehearsal period.”

The late British actor, Donald Pleasence

The key to successful and effective execution of simulation cases is rehearsal. This is the distinct area where those programmes and faculty who regularly make running complex high-fidelity simulations look effortless distinguish themselves. This flawless execution is not the manifestation of expensive simulators, large fully equipped simulation labs or a huge cadre of simulation support staff. Rather, it is the ability of the simulation team to come together before the execution of the simulation scenario to ensure a unified vision, in both the creative and technical aspects of the case (see figure 1). This requires the development of an atmosphere of creativity, openness to new ideas to improve the case and the strong desire to execute outstanding simulations. This is also the area that is frequently overlooked by many as an unnecessary use of time and only essential for elaborate or special simulation cases.

Figure 1

Creative and technical aspects typically reviewed during simulation scenario rehearsal. ESP, embedded simulation participant.

Outstanding simulations require more than well-written cases. While the case serves as the script for the confederates and the technicians, it does not ensure effective execution of a case. The rehearsal, however, is not just about practising lines, it provides a forum for the confederates to develop a complementary relationship with one another to bring the scenario to life, increasing the fidelity for the learner. It allows a period of discovery and experimentation where the confederates can see what works and what does not. It provides an opportunity for the technician or faculty member, who will potentially serve as the voice of the patient (if using a simulator), to interact with the confederates in a way that fulfils the vision of the simulation director. Despite the importance of this concept, and …

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