Gersten Jonker

Simulation at the frontier of the ZPD   95 4 I tried to read the sheet with CPR instructions, to understand them, and then execute them. But then I realized: I’m reading them, but I’m not processing them. I’m not my usual calm self. (P8) Outside the room, before and after the simulation, I had a clear picture of the situation and what course of action to take. As soon as I went inside, I had a blackout. (P8) Students also described feelings related to being frozen in place or in time. Generally, time passed slowly when students felt stuck, and time went faster during periods of activity. I think initially I didn’t move at all. I walked up to the patient, and then I stood there, being stuck and extremely nervous. (P3) The pulse oximeter made a penetrating, beeping sound. It felt like time had frozen. . . . If you don’t know what to do, then every second is painful and feels like a minute. (P3) I thought, “I don’t know what to do”. . . and then time is going so slowly. At those moments, I thought, “Ooh, they might as well come in because there’s no point to it anymore!” (P5) “Not just a game, but still simulation” Every student remained more or less aware of being in a simulation. Some in particular saw almost everything in light of the simulation exercise. The continuous awareness of being in a simulated environment mitigated the effects of stress and helped these students stay composed. I see those ST elevations [elevation of the ST segment on the ECG]. That’s probably just a myocardial infarction. Then I thought, “This is a simulation, what will probably go wrong?” I thought, “He will probably get VF [ventricular fibrillation].” (P9) I was kind of assuming the manikin was going to crash. So I was thinking about the diagnosis: “What could it be? And what could then go wrong?” (P11) It is in my nature to perform best in a demanding and stressful situation. I never experience this as such; rather, I act hyperalert and feel very much at ease. . . . Primarily, it made me happy and euphoric. (P9)