Gersten Jonker

Simulation at the frontier of the ZPD   93 4 I kind of believed that the sounds were coming from the manikin and not from a person speaking someplace else. Especially at moments of high stimulus density, one isn’t able to mark it [the manikin] as unrealistic. (P4) Initially, it’s strange to talk to a manikin, but once you get an answer back, you are completely drawn in. (P1) I was talking to a manikin, but I did approach him as I would approach a patient. (P10) The lack of facial expression and temperature and the unchanging skin color were perceived as unreal. Several students thought a changing skin color was the crucial missing element for making a diagnosis of anaphylaxis. I do think [skin color] is very important. After I had missed [the anaphylaxis], you do realize you have to explicitly ask, “What can you tell me about the appearance of the patient? What is this person’s color?”With normal patients, obviously, you can immediately tell something’s wrong. (P11) The manikin elicited empathy in quite a few students who wanted to “comfort him” and “rescue the patient,” especially when the manikin was expressing his fear or begged for help: When the situation deteriorated, it felt like losing a patient for real. (P2) Students largely remained aware of being in a simulated environment, and some students saw the manikin mostly as an educational tool. If the patient deteriorated, I saw this as a prompt that something had to be done. (P3) I wasn’t very stressed about doing something wrong, like giving the wrong medication. . . If it had been a real person, I would have been much more stressed out. . . . It was more like, “Let’s see what goes wrong and learn from that. . . . This is practice, and this is a manikin.” (P10) Being able to speak with the manikin, do a physical exam, and provide treatment made it almost like a patient encounter. A few students were concerned about damaging the manikin with invasive procedures: