NUR6033 Module 2 simulation scenario design example

Reviewed by Junia Fairbank, MSN, RN · American College of Education · True APA form, annotated

This page holds a complete NUR 6033 Module 2 example in true APA form: a simulation scenario design for American College of Education's Innovation in Nursing Education course. Following the decision in Module 1, the composite program's simulation coordinator designs the first standardized patient encounter: a 24-year-old man on his first day in an inpatient psychiatric unit who hears voices telling him he is being watched. The paper follows the published best-practice standards for simulation design and for prebriefing, along with the standardized patient educators' own standards, showing the objectives, the actor's case file, the prebriefing script, fidelity choices, facilitation, evaluation and pilot plan.

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Marcus, Day One: A Standardized Patient Scenario on First-Episode Psychosis and Command Hallucinations, Designed Criterion by Criterion Against Published Simulation Standards

Student Name

American College of Education

NUR6033: Innovation in Nursing Education

Module 2 Assignment

Instructor Name

July 15, 2030

What this page is doingThe title names the patient and the clinical focus, then the standards the design follows, which tells the grader the scenario is complete and standards-based. The APA 7 title page carries the course line and the module assignment as listed.
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The Standards Used

Among the simulation community's published best-practice standards, the one on design sets out the steps of designing a simulation-based experience, from a needs assessment and measurable objectives through the choice of modality, the scenario, fidelity, facilitation, prebriefing, debriefing and evaluation to pilot testing before full use (Watts et al., 2021). A companion standard addresses prebriefing, the preparation and briefing that establish psychological safety and a shared understanding before the scenario begins (McDermott et al., 2021). Because this scenario uses a standardized patient, it also follows the standards of the Association of Standardized Patient Educators, which address a safe work environment for actors and learners, case development, standardized patient training, program management and professional development (Lewis et al., 2017). The design below follows those standards in order.

What this page is doingThe governing standards are named from their published sources, including the standardized patient standards that apply to this modality, which establishes the framework the design follows.
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Needs, Objectives and Modality

The needs assessment was completed in Module 1: students lack experience of conversation with a person experiencing psychosis, and many fear it. The scenario has four measurable objectives. During a 15-minute encounter, the student will introduce themselves and explain their role in a way that the patient acknowledges; respond to the patient's description of hearing voices with at least two statements that acknowledge the experience without disputing or agreeing with its content; ask directly whether the voices tell him to harm himself or others and what he does when they speak; and, when the patient becomes more distressed, set a calm limit and offer a choice. The modality, a trained standardized patient, was chosen because each objective requires a live, responsive conversation.

What this page is doingObjectives are measurable, observable and tied to the needs assessment, and the modality is justified against the objectives, which follows the first criteria of the design standard.
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The Case and the Actor's File

Marcus Hill is 24, a delivery driver admitted yesterday through the emergency department after his sister found him awake for three nights, covering the windows of his apartment with foil. He hears two male voices that comment on what he does and tell him that his neighbors are watching him through the television. On admission he denied voices telling him to hurt anyone; this morning he told the night nurse that the voices said he should "make them stop watching." He has no prior psychiatric history, smokes cannabis most days and is guarded but not aggressive.

The actor's file describes how Marcus behaves and what changes his behavior. At the start he sits on the bed facing the door, glancing at the ceiling vent, answering briefly. If the student introduces themselves and sits at a respectful distance, he relaxes slightly. If the student says the voices are not real, he becomes more guarded and asks the student to leave. If the student asks directly about what the voices say, he hesitates, then says they tell him to make the neighbors stop, and, if asked what that means, says he does not know, he just wants them to stop. At ten minutes, regardless of the student's approach, the voices become louder, and he stands, paces and raises his voice; if the student sets a calm limit and offers a choice, such as sitting down together or going to a quieter room, he accepts. Every trigger in the file is tied to an objective, so that what the actor does tells the student, and the debriefer, what the student did.

What this page is doingThe case is written with enough detail for realism, and the actor's file specifies responses tied to each objective, including a scripted escalation, which is the core of standardized patient case development.
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Fidelity, Prebriefing and Facilitation

Fidelity is chosen for the objectives, not for its own sake. Physical fidelity will be moderate: a simulation room set as a psychiatric unit bedroom, without cords or loose objects, with the ceiling vent visible. Conceptual fidelity, meaning that the case is clinically coherent, and psychological fidelity, meaning that the encounter feels real, matter most, which is why the case was reviewed by a psychiatric nurse practitioner and a peer support specialist with lived experience.

The prebriefing will take ten minutes for each group of four students. It will state the objectives, explain the encounter's structure and the roles of the observers, set a fiction contract in which students agree to treat the encounter as real and faculty agree that the actor will portray the case consistently, and establish psychological safety: mistakes are expected, the debriefing will be confidential to the group, and any student can pause the encounter by raising a hand. Students will also be told that the scenario involves psychosis, so that any student with relevant personal experience can speak with faculty beforehand. Facilitation during the encounter will be minimal. A faculty member will observe from behind one-way glass and will intervene only if safety requires it or if a student freezes for more than a minute, in which case the student may take a time-out and consult peers.

What this page is doingFidelity choices are justified by the objectives, and the prebriefing follows the prebriefing standard with a fiction contract and explicit psychological safety, including provision for students with personal experience.
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The Second Encounter

Each student has two encounters, and the second is designed to build on the first rather than repeat it. The second encounter takes place on Marcus's third day. He has started an antipsychotic medication, the voices are quieter but still present, and he is tired and slowed. He tells the student that he does not want to take the medication any more because it makes him feel "like a zombie" and because he is not sure he was ever ill; the neighbors, he says, may just have been loud. The objectives shift from engagement and risk assessment to collaboration: the student should explore his concerns about the medication without dismissing them, provide accurate information about common side effects and what can be done about them, and involve him in planning what to tell the psychiatric prescriber. The actor's file again ties his responses to the student's approach. If the student insists that he must take the medication, he becomes silent and turns away; if the student asks what matters to him, he says he wants to go back to work, and the conversation can connect treatment to that goal. The second encounter lets students apply feedback from the first while meeting a new challenge that is just as common in practice: a patient whose acute symptoms are easing and who now questions the treatment. Scheduling both encounters two weeks apart allows debriefing of the first to shape the second.

What this page is doingA second, progressive encounter is designed with new objectives and scripted responses, which shows how the scenario supports developing skill over time rather than a single exposure.
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Evaluation and Pilot

Each encounter will be evaluated in two ways. Faculty observers will complete a checklist of the four objectives, rating each as met, partly met or not met, and the actor, trained to give feedback from Marcus's perspective, will tell the student in two or three sentences what made him feel more or less safe. The debriefing, designed in the next module, will use both. The scenario will be pilot tested in August with four volunteer students from last year's class and two faculty members, as the design standard recommends before full implementation. The pilot will check the timing of the escalation, whether the actor's responses are consistent across students, whether the checklist can be completed reliably by two observers and whether the case is portrayed respectfully, which the peer support specialist will observe and comment on. The standardized patient standards' emphasis on a safe work environment will be applied to the actor as well: breaks every hour and a short debriefing at the end of each day.

What this page is doingEvaluation combines faculty ratings tied to objectives with standardized patient feedback, and a pilot is planned with specific checks, including respectful portrayal and actor well-being, completing the design.
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References

Lewis, K. L., Bohnert, C. A., Gammon, W. L., Hölzer, H., Lyman, L., Smith, C., Thompson, T. M., Wallace, A., & Gliva-McConvey, G. (2017). The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Advances in Simulation, 2, Article 10. https://doi.org/10.1186/s41077-017-0043-4

McDermott, D. S., Ludlow, J., Horsley, E., & Meakim, C. (2021). Healthcare Simulation Standards of Best Practice: Prebriefing: Preparation and briefing. Clinical Simulation in Nursing, 58, 9-13. https://doi.org/10.1016/j.ecns.2021.08.008

Watts, P. I., McDermott, D. S., Alinier, G., Charnetski, M., Ludlow, J., Horsley, E., Meakim, C., & Nawathe, P. A. (2021). Healthcare Simulation Standards of Best Practice: Simulation design. Clinical Simulation in Nursing, 58, 14-21. https://doi.org/10.1016/j.ecns.2021.08.009

How this NUR 6033 Module 2 example is structured

NUR 6033 Module 2 often designs a simulation scenario following recognized standards of best practice; your classroom's instructions decide the standards and format. This example names the standards, follows their design criteria in order, provides the working materials a facilitator and actor would need, and ends with a pilot and evaluation plan.

NUR6033 Module 2 questions, answered

What does NUR6033 Module 2 usually ask for?

NUR6033 Module 2 often asks you to design a simulation scenario that follows recognized standards of best practice, with objectives, case details, prebriefing, debriefing and evaluation. Your classroom's instructions decide the standards and format.

Which standards should a simulation design follow?

The Healthcare Simulation Standards of Best Practice are widely used in nursing, with separate standards for design, prebriefing, facilitation and debriefing. Standardized patient scenarios also draw on the ASPE standards.

What goes in a standardized patient case file?

The patient's history and presentation, how the actor should behave, and how the behavior changes in response to what the learner does, with each trigger tied to a learning objective.

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