Table 1

Description of simulated scenarios

Scenario featuresAdult scenarioInfant scenario
EducatorSenior educator in dieteticsSenior educator in speech-language therapy
Simulated patientSemiconscious unstable adult patient within 24 hours after stroke
Stroke ward setting
One-month-old infant following congenital heart surgery
Paediatric cardiac ward setting
SimulatorManikin (Laerdal SimMan 3G)Baby manikin (BabySIM, CAE Healthcare)
ConfederatesNurse at bedsideMother and nurse at bedside
Potential phasesRead clinical notes
Gain clinical information from nurse
Observation of level of consciousness
Attempt to rouse patient and clinical observations
Physical examination
Communicate findings and decisions with nurse and alert medical team
Chart nasogastric feed regime
Review clinical notes
Introduce role to nurse and mother
Gain clinical history from nurse and mother
Assess state and clinical observations
Physical examination
Make up bottle, swaddle, feed, clinical observations
Communicate findings and provide advice re: feeding
Expected procedural skillsClinical notes interpretation
Locate patient’s vital observations in medical notes and on a monitor (heart rate, respiratory rate, blood pressure, oxygen saturation)
Interpret clinical data including interpreting the data and accuracy of hospital fluid balance, food and drug charts
Interpret malnutrition screening data and information on the nutritional status of patients
Communicate your role in nutrition and swallowing to patients/whanau
Involve the family in shared decision-making
Work within a team with a patient-centred approach
Identify commonly used equipment in a ward environment
Ascertain the level of consciousness of a patient/infant
Determine readiness and safety to trial oral feeding
Enable the patient/infant to be in a safe swallowing position
Carry out an accurate cranial nerve examination on patient/infant
Make accurate clinical observations during feeding
Communicate assessment results to (1) patient/whanau, (2) nurse, (3) doctor
Communicate safe, appropriate recommendations for patient/infant and mother
Request support from supervisors when needed
Briefing instructions for educators facilitated scenarioThe key to simulated scenarios is realism and reflection
Ensure actors can remain in role at all times—close curtains around the scene while in reflection time
Educators must encourage students to feel safe to ‘think loud’ as a group
Pause the scene at designated times or if the students are struggling—at novice level, this should be error-less learning
Avoid talking too much as the educator—let the group discuss and reflect. Use curious questioning, ‘What do you think happened there?’ ‘What are your thoughts about next steps?’
Switch in 1 SLT/1 dietitian student at each pause