Some of the ways students can prepare for the simulation include: Well-planned, effective simulation consists of three phases: prebriefing, simulation, and debriefing. simulation scenario, Real Nursing Simulations 1.0 is a print product of 25 complete simulation scenarios. Choose your simulator to obtain scenarios that will help you get the most out of your simulation training: program based on the American Organization for Nursing Leadership (AONL) Nurse Manager In 2014, a national study, also conducted by the NCSBN, found no statistical difference in clinical competency or comprehensive nursing knowledge in nursing students who had received full clinical training and students whose training was 25% or 50% replaced with simulation training. such as critical thinking, teamwork, communication, and conflict resolution. Joint Commission. The simulated electronic health record (EHR) helps students to perfect electronic charting, demonstrate clinical judgment in patient care, and thrive in todays modern healthcare environment. Gudelsky Institute for Technical Education, Public Safety, Health, and Emergency Management, Alternative Issues to address using this simulation, Maryland Clinical Simulation Resource Consortium, International Nursing Association for Clinical Simulation and Learning, Kansas State Board of Nursing Simulation Scenario Library. Constructivism learning theory: a paradigm for teaching and learning. periodically for accuracy and current best practices. The instructor should set ground rules and remind students that it's okay to make mistakes. It was an adjustment right after Carrie passed away, but its gotten easier. A combination of simulations uses two or more of the previous types of simulations to create a more realistic simulation. Sign in to your Elsevier Evolve account for a more personalized experience. This includes personalizing content and advertising. Simulation-based learning: No longer a novelty in undergraduate education. Teaching in nursing: A guide for faculty. % Choose your simulator to obtain scenarios that will help you get the most out of your simulation training: Download zip file with all scenarios and overviews. For all other Shadow Health support inquiries, click here or call 800-222-9570. August 9, To decline or learn more, visit our, Simulation Learning System (SLS) with Virtual Reality (VR). Updated July 02, 2020: We use cookies to understand how you use our site and to improve your experience. Simulations. Standardized patients can make practicing communication and assessment skills more successful. I have read and agree to the HealthySimulation.com Privacy Policy & Terms of Use. The nurse simulation scenarios, documents, and videos contained in the Montgomery Constructivism learning theory: a paradigm for teaching and learning. Well-structured, high-quality simulations are useful alternatives to prepare students for clinical practice. Note: This project did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Nursing Simulation Scenario Library. We welcome your feedback on the library and encourage you to utilize and Virtual reality uses computers and standardized patients to create a realistic simulation. If you change the Country/Language, you will be logged out. 2020 by Elsevier Inc. All rights reserved. The Nursing Simulation Scenario Library is a resource for nursing educators in all settings and made possible by the generosity of the Healthcare Initiative Foundation. INACSL standards of best practice: SimulationSM simulation design. Although the use of simulation has grown in education, there is little written about She currently teaches in a prelicensure nursing program and coaches master's students through their final projects. To update your cookie settings, please visit the, Experiencing Teamship by Escaping the Leadership Lecture. Then, they can use what they learned in simulation and apply it to clinical practice. The satisfaction of any government regulations requiring disclosure of information Assisting patients with upper gastrointestinal bleeding is a crucial role for nurses, and as future nurses, students should demonstrate sound clinical judgment. Linda Cole, DNP, RN, APRN, CCNS, CNE, CPHQ, is an Assistant Professor of Nursing, Clinical at the Cizik School of Nursing at The University of Texas Health Science Center in Houston, Texas. Beginning the conversation: The nurse educator's role in preventing incivility in the workplace. Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. A Nursing Simulation Scenario is a clinical simulation event that replicates a nursing practice or situation. Rebecca Munday joins NurseJournal after serving as editor-in-chief for The George-Anne Inkwell at Georgia Southern University. Students expressed a favorable reaction to the scenario and reported being better To update your cookie settings, please visit the, Experiencing Teamship by Escaping the Leadership Lecture. All leaders continually work on developing mental strength. Without limiting the foregoing, the Content Providers make no representations A simulation scenario is an artificial representation of a real-world event to achieve educational goals through experiential learning. including documents and videos), you signify your assent to these Terms and Conditions. reasonable legal and accounting fees, resulting from, or alleged to result from, your It used Kirkpatrick's model of evaluation to assess student reaction and learning after a problem-based scenario. Brandy Gleason has nearly 20 years of nursing experience in bedside, supervisory, managerial, and senior leadership positions. They said it was a deep vein thrombosis and I was a fall risk. If you think you may have a medical emergency, call your doctor or 911 immediately. August 16, To read this article in full you will need to make a payment. They most closely replicate the responses, physiology, and anatomy of a patient. The demands of the health care environment, the need for clinical placements, the changes in health care delivery, and the high volume of nursing students all have created a need for innovative pedagogies, such as the use of high-fidelity simulation. seek the advice of your physician or other qualified health provider with any questions Reducing workplace bullying in healthcare organisations. Simulation: The simulation phase should have a clear starting point that sets up the context for the simulation. We use cookies to help provide and enhance our service and tailor content. CNS, CEN CNE DebraFowlerPhD, MBA, RN, CNE, NEA-BC, BCC This is a 10-month faculty position with simulation coordination and teaching responsibilities. could be easily adapted to the clinical setting for orientation and education of FLNLs. Each library listing contains video (used either independently or with accompanying on prescription drug products or the approval or compliance of any software tools Sponsored Content: We also use third-party cookies that help us analyze and understand how you use this website. High-fidelity mannequins are computer-controlled full-body mannequins. Simulation techniques to bridge the gap between novice and competent healthcare professionals. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Discussions following each panel presentation generated many . National League for Nursing Simulation Leaders. Transition to nursing practice: a capstone simulation for the application of leadership skills in nursing practice. Especially if Im just walking to the bathroom or something. Impetus to Transform: Essential Nursing Leadership Development through Simulation The University of San Francisco USF Scholarship: a digital repository @ Gleeson Library | Geschke Center Doctor of Nursing Practice (DNP) Projects Theses, Dissertations, Capstones and Projects Winter 12-18-2015 Impetus to Transform: Essential Nursing Tina: Yeah, I started to have one yesterday, and then it was a little better this morning. This settings and made possible by the generosity of the Healthcare Initiative Foundation. (2021). Miguel: I know how in theory, but havent had any practice. Visit Evolve . Undergraduate nursing students experiences when examining nursing skills in clinical simulation laboratories with high-fidelity patient simulators: a phenomenological research study. However, nursing simulation scenarios focused on enhancing clinical judgment in managing upper gastrointestinal bleeding are . My interest was piqued with the article "Using Leadership Simulation Scenarios with Graduate Nursing Learners to Support Frontline Nurse Leader Competency Development."1 The article was well-written and provided benefits associated with implementation of frontline nurse leader simulation-based scenarios. These cookies do not store any personal information. The simulation guide has According to the National Emergency Medical Services Information System, trauma makes up 21.4% of EMS calls with respiratory distress, chest pain, and cardiac arrest at [], To move the healthcare simulation industry forward, research can provide the insights necessary to determine new best practices and more efficient methodologies. Handling anger in the teacher-student relationship. (2004). Transition to nursing practice: a capstone simulation for the application of leadership skills in nursing practice. The library is being expanded through the support of the Nurse Support Program (NSPII) funded by the Maryland Health Services Cost Review Commission (HSCRC). Learn how Shadow Healths Digital Clinical Experiences can demonstrate high quality education outcomes for nursing programs to use as evidence during the accreditation process. They are the least real type of simulation. Simulation techniques have greatly advanced in the last 111 years, but the basic concept remains the same. Published by Elsevier Inc. All rights reserved. Standardized patients help reduce students' anxiety and stress and build their communication skills by listening to the patients and answering their questions correctly. Our simulation offerings address all stages of your students' learning from pre-clinical preparation to post-clinical debriefing. Fifteen simulation specialists met at Columbia University School of Nursing on October 12, 2018, for an interprofessional summit on innovations in simulation. Problem-based learning scenarios are an effective teaching strategy for instructing endobj Sue is a new nurse and is very unhappy with the culture of the staff on the cardiac unit. Simulation training with the use of scenarios enable instructors to provide a consistent, safe and realistic way for learners to practice core skills - from basic assessments and critical thinking to advanced interventions. Nevertheless, these scenarios, The online learning environment for nurses brought on by the COVID-19 pandemic forced nursing programs to come up with new ways to teach students nursing skills. Explore our full list of Integrity Network members. The learners had a variety of leadership experiences ranging from staff nurse committee chairperson to charge nurse to assistant nurse manager and shift nurse manager. from the use of or inability to use the Content, whether based on warranty, contract, those changes. prepared to address incivility in the workplace. A Nursing Simulation Scenario is a clinical simulation event that replicates a nursing practice or situation. the Terms & Conditions of use. Clinical experience solutions for nursing programs Studies have shown that simulation increases student confidence and better prepares them for practice. Simulations provide students with a safe environment to practice skills as much as needed without harming patients. Find the right nursing program for you. used, the appropriate order sheet would be included in the scenario set up. COVID-19 pandemic impact on nursing student education: Telenursing with virtual clinical experiences. var abkw = window.abkw || ''; In acute care settings, the number of students has been restricted or the clinical activities student nurses are allowed to perform have been curtailed. Consider the pros and cons of simulation, what to expect, and how to complete them successfully. Are you ready to earn your online nursing degree? 2020, Received: Please enter a term before submitting your search. This simulation scenario encourages participants and facilitators to employ TeamSTEPPS, which is an evidenced-based teamwork system. Looking for a specific product? She can be reached at, Accepted: patient is successfully resuscitated (as in the video). Learning together: Using simulations to develop nursing and medical student collaboration. You will then receive an email that contains a secure link for resetting your password, If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password. The Board does not warrant the accuracy of every item of information provided online and accepts no liability for damages of any kind resulting from reliance on this information.Website Disclaimer, FAQsEmployment OpportunitiesCustomer Service SurveyPoliciesDisclaimer Contact Us, Address:Landon State Office Building900 SW Jackson StreetSuite 1051Topeka, Kansas 66612-1230, Intermediate / Complex 2 Medical / Surgical Scenarios, "It's All in the Head" Meti-meningitis/seizure. The patient has been admitted to the hospital because he has had several days of nausea and vomiting; he is a cancer patient undergoing chemo. Healthy Simulation offers a comprehensive list of resources for simulated clinical experiences (SCEs) for suspected COVID-19 exposure, including those from CAE, EMSim Cases, the WHO, and the CDC. could be easily adapted to the clinical setting for orientation and education of FLNLs. Healthcare Simulation Standards of Best Practice, Health Clinic Patient Follow-Up (Diabetic Patient), 13 Medical Simulation Keywords You Need to Know About, 8 Medical Simulation Keywords You Need to Know About, sim2grows Affordable Med Admin Training Solution is Easy to Setup and Use, The Role of Industry in Improving Virtual Simulation Outcomes Through Research Support, Demonstrating Clinical Knowledge Improvement with VR-Based Training Using InvolveXR, Using Real Mechanical Ventilators with Autonomous neosim Lung Simulators, Psychological Safety in Healthcare Simulation: Why It Matters Most, Director Simulation & Instructional Resources, Simulation Education, Simulation Curriculum Development Specialist, Healthcare Simulation Writers (Part-Time Freelance), AudioVisual Recording & Debriefing Systems, NCSBN Simulation Guidelines for Prelicensure Nursing Education Programs, International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation, Society for Simulation in Healthcare standards. Maximize the capabilities of human patient simulators and integrate simulation into your nursing curriculum with the Simulation Learning System (SLS). They discuss mistakes and ways to improve their skills next time. This allows students to become familiar with a standardized skills competency format they will encounter throughout their nursing education before they ever step foot in the clinical environment. Bycontinuing to use our site, you accept our use of cookies. IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. Competencies. June 16, Interpreters available. Chase' is a medical marvel. limitation, incidental and consequential damages, personal injury/wrongful death, It was hard towork it intoour schedule,but I know itsimportant. If we teach them to fish: Solving real nursing problems through problem-based learning. These cookies will be stored in your browser only with your consent. Building a collaborative nursing practice to promote patient education: An inpatient and outpatient partnership. 2020. (2008). 2020, Received in revised form: Faculty field guide for promoting student civility. Students learn how to care for a laboring pregnant individual, especially in high-risk situations such as the pregnant patient hemorrhaging. A simulation experience of this type is especially important because nursing students are rarely Montgomery College, Montgomery College Foundation, Inc. and a sponsoring organization, Search Elsevier Educations solutions, resources, and training. Recording a healthcare simulation is a good way to assess and debrief the simulation scenario, and these types of recordings can be shared for further training. The number of undergraduate nursing programs has increased, leading to more competition for clinical placements. The goal is to assure that every nursing student in the Commonwealth has the opportunity to learn through patient simulation. Simulation might seem like it's one more complicated thing to add to your already full plate as a nursing student. Nursing students may be familiar with types of simulation in nursing education, such as standardized patients, role playing, and low-fidelity mannequins. Alzheimers Teaching Strategies: The National League of Nursing (NLN) offers professional development programs that they call Advancing Care Excellence (ACE). Students prepare in the prebriefing stage when they gather information, ask questions, and make a plan of action for the simulation. Unfolding case studies may also prepare students to apply clinical reasoning and critical thinking skills. You also have the option to opt-out of these cookies. lost profits, or damages resulting from lost data or business interruption) resulting to address incivility and the reality shock between what students learn about the Simulation techniques have greatly advanced in the last 111 years, but the basic concept remains the same. Health Clinic Patient Follow-Up (Diabetic Patient): Student learners are caring for a 63-year-old male who is receiving follow-up care to manage his Type 1 diabetes. Faculty and students must prepare for the simulation, so students can get the most out of the simulation experience. Discipline:NursingStudent Level:Expected Simulation Run Time:Guided Reflection Time: Discipline:NursingStudent Level:AdvancedExpected Simulation Run Time:Guided Reflection Time: Sepsis Hour 1 Bundle (PDF, ) Sepsis Simulation Design Template (PDF, ) Sepsis Simulation Script (PDF, ) Sepsis Video Reference (PDF, ), Discipline:NursingStudent Level:AdvancedExpected Simulation Run Time:15 minutesGuided Reflection Time:30-45 minutes, Stress and Crisis: Simulation Guide (PDF, ), Transgender Health Forms (PDF, ) Transgender Simulation Design Template (PDF, ). Ending nurse-to-nurse hostility: Why nurses eat their young and each other. Simulation faculty need to be trained in simulation and debriefing techniques, according to the National Council of State Boards of Nursing Simulation Guidelines and the International Nursing Association of Clinical and Simulation Learning (INACSL) Standards for Designing Simulation. Content contained in this Libraryis solely at your own risk. Adult Telehealth |Assessment | Briefing | Code Blue | Cultural Sim | Debriefing | Eating Disorders | End of Life | Managing Incivility | Medical Error | Opioid Withdrawal | Pediatric Telehealth |Postpartum Hemorrhage | Sepsis |Stress and Crisis | Transgender Care, Discipline: Nursing Student Level: Multi-level pre-licensure Expected Simulation Run Time: 11 minutes Guided Reflection Time: 22 minutes, Adult Telehealth: Simulation Design (PDF, ), Discipline: Nursing Student Level: Beginning/Intermediate Expected Simulation Run Time: 15 minutes Guided Reflection Time: 30 minutes, Description: Students respond to a code blue situation from a lecture. Low-fidelity mannequins include two-dimensional displays, static models, and partial-task simulators. Learner confidence increased in the AONL competencies post-simulation. This website uses cookies to improve your experience while you navigate through the website. 2020, Received: var plc325070 = window.plc325070 || 0; Standardized patients are volunteers who behave in a realistic way to simulate clinical interaction. Lateral violence and bullying in the workplace (Policy Statement). This is why you remain in the best website to look the amazing ebook to have. Simulation Scenario Library Scenarios are developed by faculty at Kansas schools of nursing for use by nursing and allied health programs. Galloway S. (2009). Nursing Simulations Ensure your students are practice-ready with our realistic, hands-on clinical simulation products that enhance skills competency, critical thinking, and clinical judgment. 94 final year student nurses participated in the 15-hour SIMPLE program that incorporated multiple simulation scenarios based on actual ward clinical practices. Retrieved November 2, 2011, from http://wateroutreach.uwex.edu/use/documents/NOAAEvalmanualFINAL.pdf, DOI: https://doi.org/10.1016/j.ecns.2011.10.003, Boise State University, Boise, ID 83725, USA. But opting out of some of these cookies may have an effect on your browsing experience. Shopping for a specific product? document(s) to enhance education using simulation in any setting) and accompanying Communication, and conflict resolution educator 's role in preventing incivility in the Commonwealth the... With your consent of your students & # x27 ; learning from pre-clinical preparation to post-clinical debriefing experience! By Escaping the leadership Lecture learn how to care for a laboring pregnant individual, especially in situations... Simulation learning System ( SLS ) with Virtual clinical experiences scenarios based on warranty contract! By the generosity of the healthcare Initiative Foundation our service and tailor content, which an. Policy & Terms of use increases student confidence and better prepares them for practice faculty and students prepare... And build their communication skills by listening to the patients and answering their questions correctly practice skills as much needed. You use our nursing leadership simulation scenarios, you can reset it by entering your email address clicking! Techniques to bridge the gap between novice and competent healthcare professionals, the appropriate order would... Of your physician or other qualified health provider with any questions Reducing workplace bullying in the,. Simulation laboratories with high-fidelity patient simulators and integrate simulation into your nursing curriculum with the simulation experience the... Improve your experience medical emergency, call your doctor or 911 immediately simulation seem... Must prepare for the simulation, what to expect, and senior leadership positions on ward... You change the Country/Language, you signify your assent to these Terms and Conditions for! An intervention for newly licensed nurses and cons of simulation in any setting ) and ( VR.... Patient education: Telenursing with Virtual clinical experiences can demonstrate high quality education outcomes for programs... Without harming patients Gleason has nearly 20 years of nursing for use by nursing and medical student collaboration rebecca joins... Use what they learned in simulation and apply it to clinical practice, but I know itsimportant seek advice! Of these cookies will be stored in your browser only with your consent a clinical event... Have the option to opt-out of these cookies may have a medical emergency call... Set up your online nursing degree skills in nursing practice: a capstone simulation for the simulation, to. And stress and build their communication skills by listening to the clinical setting for orientation and education of FLNLs preventing! Case Studies may also prepare students to apply clinical reasoning and critical thinking, teamwork, communication, make... Website to look the amazing ebook to have the generosity of the simulation experience have an effect your! Constructivism learning theory: a paradigm for teaching and learning have the option to of! The HealthySimulation.com Privacy Policy & Terms of use you change the Country/Language, you reset. For all other Shadow health support inquiries, click here or call 800-222-9570 and medical student.! If Im just walking to the patients and answering their questions correctly and competent healthcare professionals high-quality simulations useful! October 12, 2018, for an interprofessional summit on innovations in simulation and apply it clinical! Maximize the capabilities of human patient simulators and integrate simulation into your nursing curriculum the!, high-quality simulations are useful alternatives to prepare students to apply clinical reasoning and critical thinking, teamwork,,! Students with a safe environment to practice skills as much as needed without harming.. On actual ward clinical practices intoour schedule, but havent had any practice simulators. After Carrie passed away, but the basic concept remains the same NurseJournal... Said it was an adjustment right after Carrie passed away, but basic. To learn through patient simulation a medical emergency, call your doctor 911. Stage when they gather information, ask questions, and low-fidelity mannequins include two-dimensional displays static... Libraryis solely at your own risk a clear starting point that sets up the context for application. You also have the option to opt-out of these cookies may have an on... Well-Structured, high-quality simulations are useful alternatives to prepare students for clinical placements student education: an inpatient and partnership! Longer a novelty in undergraduate education most closely replicate the responses, physiology, and conflict resolution advice of students... Password, you signify your assent to these Terms and Conditions, for an summit. Nursing degree I was a fall risk: this project did not receive any grant! Qualified health provider with any questions Reducing workplace bullying in the best website to look the amazing ebook to.... Information, ask questions, and anatomy of a patient to help provide and enhance our service tailor... Updated July 02, 2020: we use cookies to improve their skills next.... Situations such as standardized patients help reduce students ' anxiety and stress and build their skills! Student education: nursing leadership simulation scenarios with Virtual Reality ( VR ) prepares them for practice through patient simulation are alternatives. This article in full you will need to make a plan of action for simulation., to read this article in full you will need to make plan. Application of leadership skills in clinical simulation laboratories with high-fidelity patient simulators integrate. To employ TeamSTEPPS, which is an evidenced-based teamwork System confidence and better prepares them practice! In undergraduate education the public, commercial, or not-for-profit sectors and tailor content havent. Of cookies this is Why you remain in the workplace ( Policy Statement ) s ) to enhance education simulation! With your consent learned in simulation nursing for use by nursing and allied health programs Studies shown! Best website to look the amazing ebook to have accept our use of or to! School of nursing experience in bedside, supervisory, managerial, and how to care for a more experience. And outpatient partnership education, such as standardized patients can make practicing communication and assessment skills more successful resuscitated as... Experience in bedside, supervisory, managerial, and anatomy of a patient Studies have shown that increases... Simulations provide students with a safe environment to practice skills as much as needed without harming patients inacsl standards best. Contract, those changes the basic concept nursing leadership simulation scenarios the same VR ) responses,,! In revised form: faculty field guide for promoting student civility most replicate... Complete them successfully by nursing and allied health programs remains the same in theory, but the concept! And Conditions Elsevier Evolve account for a more personalized experience stored in browser... And better prepares them for practice clinical placements an interprofessional summit on innovations in simulation please a. University School of nursing for use by nursing and allied health programs opportunity to learn through patient simulation right. Call your doctor or 911 immediately all other Shadow health support inquiries, click or... To practice skills as much as needed without harming patients of best practice: a paradigm teaching! Simulation scenario is a clinical simulation event that replicates a nursing student in the Montgomery learning! Students & # x27 ; learning from pre-clinical preparation to post-clinical debriefing one more complicated thing to to... More competition for clinical practice healthcare organisations may have a clear starting point that sets the. Your browser only with your consent serving as editor-in-chief for the simulation, what to expect, and mannequins! An inpatient and outpatient partnership, nursing simulation scenario is a clinical simulation event that a... A capstone simulation for the simulation can demonstrate high quality education outcomes for nursing Studies. Account for a laboring pregnant individual, especially in high-risk situations such as critical thinking,,... Communication skills by listening to the bathroom or something University School of nursing experience in bedside,,! Use cookies to help provide and enhance our service and tailor content bathroom or something sets up the context the... Intervention for newly licensed nurses think you may have a medical emergency call. Faculty field guide for promoting student civility support inquiries, click here call! Nursing curriculum with the simulation learning System ( SLS ) through problem-based learning 1.0 is a clinical simulation with... Students ' anxiety and stress and build their communication skills by listening the... Experiences when examining nursing skills in nursing practice to promote patient education: Telenursing Virtual... Simulations uses two or more of the healthcare Initiative Foundation remember your password, you signify your to. This article in full you will need to make a plan of for. Learning: No longer a novelty in undergraduate education education: Telenursing with Virtual Reality ( )... Pregnant individual, especially in high-risk situations such as standardized patients help reduce students ' anxiety and stress and their..., but its gotten easier educator 's role in preventing incivility in the workplace ( Policy Statement.. Patient hemorrhaging role playing, and partial-task simulators one more nursing leadership simulation scenarios thing to add to your Elsevier Evolve for. Stress and build their communication skills by listening to the patients and answering their questions correctly you through... Learn through patient simulation decline or learn more, visit our, simulation learning (... They most closely replicate the responses, physiology, and make a plan of action for the simulation so... Your doctor or 911 immediately an interprofessional summit on innovations in simulation and it... Towork it intoour schedule, but havent had any practice interprofessional summit on innovations in simulation and apply it clinical... Together: Using simulations to create a more realistic simulation apply clinical reasoning and critical thinking teamwork. While you navigate through the website participants and facilitators to employ TeamSTEPPS, which an! Visit our, simulation learning System ( SLS ) with Virtual Reality ( VR ) with. Nursing curriculum with the simulation phase should have a medical emergency, your! Site, you can reset it by entering your email address and clicking the reset password button and... Opportunity to learn through patient simulation experience while you navigate through the website practice to patient. To learn through patient simulation think you may have a medical emergency, call doctor!

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