Patient-Centered Simulations: How My Daughter Taught Me About the Power of Simulation for Educating Patients

By: Alaina Herrington

patient centered photoBy now we have all heard about the benefits simulation education has on our learners (Issenberg, Mcgaghie, Petrusa, Gordon, & Scalese, 2005). However, simulation is not just a tool for our students and staff members. It is a tool that can help patients and families learn about upcoming procedures and how to provide care outside the hospital. Through interactive learning, it also helps patients and families talk about their fears. I never considered the power simulation could have on educating our patients and their family members until 2015, when my daughter Adalyn was six years old and cut open her foot, resulting in a visit to the emergency room.

Leventhal’s self-regulation theory proposes that individuals who have a visual idea of an experience will form decreased anxiety, which will lead to reduced hospital stays (Johnson & Leventhal, 1974). Adalyn’s anxiety level was so high that the doctors had a hard time sedating her and the ER staff advised us not to tell her she had stitches. Unfortunately for us, she eventually discovered the spider-like threads on the bottom of her foot. Knowing the stitches would have to be removed eventually, her anxiety level tripled to the point where we needed outside help to prepare for her upcoming hospital visit to remove the stitches.

I thought that if Adalyn could be the ER doctor and remove another little girl’s stitches she would be mentally prepared for her own “procedure.” To simulate her upcoming procedure, my colleague and I dressed Sim Junior in some of Adalyn’s clothes and a blond wig and added a wound in the same area as her wound. We asked Adalyn to be the doctor for the day and gave her a prebriefing on how to talk to her patient and reviewed the steps involved in removing stitches. The simulation was a success! She was still nervous about having her stitches removed but felt more comfortable knowing exactly what to expect. In fact, she told the ER doctor that she had already removed stitches and demanded that she be the one to remove her own.

How Are Hospitals Implementing Patient-Centered Simulations?

Tilbrook, Dwyer, Reid-Searl, and Parson (2017) provide a condensed list of articles on using puppet simulation in health care. Many of the listed articles they discuss describe the use of simulation to prepare children for upcoming surgical procedures and diabetes management. Sigalet and colleagues (2014) used simulation to teach caregivers how to manage seizures at home. Arnold and Diaz (2016) used simulation to teach neonatal home caregivers.

What is the Best Way to Implement Patient-Centered Simulations?

Arnold and colleagues (2018) propose the following principles when providing patient- and family-centered care:

  1. Know the patient is a person who should be valued.
  2. Disclose pertinent patient information in a meaningful and thoughtful manner while allowing the patient and family to participate as part of the health care team.
  3. Allow the patient and family to have an active role in their care.
  4. Create a partnership with patients and family members to collaborate in all phases of their care.

Is there a way you can use simulation to reach your hospital or community in teaching patients and family members?


Arnold, J., & Diaz, M. C. G. (2016). Simulation training for primary caregivers in the neonatal intensive care unit. Seminars in Perinatology, 40, 466–472.

Arnold, J. L., McKenzie, F. R. D., Miller, J. L., & Mancini, M. E. (2018). The many faces of patient-centered simulation: Implications for researchers. Simulation in Healthcare, 13(3S Suppl 1), S51-S55.

Dwyer, T., Reid-Searl, K., & Parson, J. A. (2017). Review: A review of the literature – The use of interactive puppet simulation in nursing education and children’s healthcare. Nurse Education in Practice, 22, 73–79.

Issenberg, S. B., Mcgaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher, 27(1), 10–28.

Johnson J.E. & Leventhal H. (1974). The effects of accurate expectations and behavioral instructions on reactions during a noxious medical examination. Journal of Personality Social Psychology, 29, 710-718.

Sigalet, E., Cheng, A., Donnon, T., Koot, D., Chatfield, J., Robinson, T., … Grant, V. J. (2014). A simulation-based intervention teaching seizure management to caregivers: A randomized controlled pilot study. Paediatrics & Child Health (1205-7088), 19(7), 373–378.

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