Real-time decision-making in chronic illness branching simulation

Abstract

The United States (US) is facing a rapidly aging population that suffers from multiple chronic illnesses. To prepare nursing students to care for this increasingly complex, aging population nurse educators must develop curricula that incorporate both current technology and cutting-edge teaching pedagogies that facilitate development of real-time decision-making skills. Branching scenarios are simulations that mimic real-life; rapidly changing patient conditions unfold based on actual student decision-making. This challenges learners to adapt the nursing process based on subjective and objective assessments and utilize current technology to analyze multiple sources of patient data. As nursing students make decisions and act, the scenario branches, presenting them with immediate feedback on the outcomes. Branching simulation scenario designs incorporate multiple different mobile technologies with decision-support software that nursing students may access, such as real-time decision-support algorithms, evidence-based guidelines, telehealth, medication information resources, and electronic medical records (EMRs). Faculty at NYU Rory Meyers College of Nursing (NYU) have successfully incorporated mobile technology with decision-support software into branching simulations as a strategy to develop real-time clinical decision-making in the care of older adults with multiple chronic illnesses.

Learning and clinical reasoning experience of second-year medical pharmacology students and teachers with virtual patients developed using OpenLabyrinth

“…An important aspect of a virtual case scenario is ability to provide multiple options for users to choose from; for example, given a set of symptoms and signs, a patient may be subjected to one or more laboratory investigations; similarly, based on the patient's response, the pharmacotherapy may remain unchanged or be altered. Branching case scenarios enable the users to choose from multiple options and these, in turn, determine the outcome of the case, with choosing of wrong options resulting in adverse outcomes [8]. Opportunities for mid-way course corrections can also be provided in branching case scenarios (Figure 1).…”

“…A branched case scenario includes one or more decision points wherein the user is presented with two or more responses to choose from; depending on the responses chosen, the case scenario may proceed in different directions. In a clinical case scenario, different responses may alter the course of the progression of illness, ultimately resulting in a favourable or adverse outcome for the patient [8]. Given the theoretical advantages of electronically delivered interactive branched case scenarios in enhancing the teaching-learning experience, current study aimed to obtain feedback from medical students and teaching faculty regarding their experience of interacting with a virtual case scenario on OpenLabyrinth platform.…”

A Staged Defragmented Simultaneous Debriefing Model As Integrated Micro-debriefing Components Inside Online Simulation for Competencies Formation

“…13. Branching technology as an effective learning strategy [ 34 , 35 ] can be used to implement multiple repetitions within individual blocks in a defragmented debriefing model to fully master competencies so that errors do not accumulate and are not transferred to the end of the simulation scenario.…”

A Mathematical Model Based on Stratifying the Severity of Medical Errors for Building Scenarios for Clinical Cases With Branching

“…These simulations mimic real-life patient encounters and can be tailored to different competency levels. As students progress, the scenarios become more complex, reflecting the challenges they will face in clinical practice [ 1 ].…”