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Simulation Trick of the Trade: Blindfold the Leader

2016-11-11T19:03:25+00:00

67f84c2b0bdcd2f857a9a230de27924593f1d40aSimulations are routine now in medical training. But sometimes routine can start to get boring! All learners now know, especially for high fidelity simulations, to prepare for the unexpected. The stable patient will inevitably crash, maybe when your back is turned; the confederate in the room may or may not be a friend or a foe, you may never know! But these twists have become so integral to the simulation case that most learners know how to deal with it, or at the least know to anticipate it. But here is an idea for adding a new challenge to a stale simulation case. Blindfold the leader!

Why do it?

Blindfolding the leader places an emphasis upon a few critical actions that are especially well taught through simulation modality including teamwork. This would especially work well for Sim cases that emphasize teamwork or crisis resource management. Taking away a key sense from the body (vision) forces the learner to use their other sensory assets. When the leader is blindfolded, s/he will also have to rely on the team members to convey information to him/her. For example, s/he will have to ask the team for physical exam findings and cardiorespiratory monitor readings. This re-enforces good leadership such as open communication and shared mental models. This method aids in the development of successful communication habits such as speaking clearly and succinctly, volume control in the resuscitation room, and verbal confirmation of receiving orders. Blindfolding could also drive interesting debriefing conversations.

How to do it?

Simple! Get a blindfold, and place it on the leader prior to starting the simulation. Also, make sure you walk them to their position so they don’t get lost. It’s nice to have the leader facing the correct direction to avoid possible funny or embarrassing situations when they are talking in the wrong direction!

Absolutely make sure to orient the learners to this new method prior to starting the simulation case. Learners can be nervous, especially in simulations. It will be important to disclose as much about simulation cases as possible and make them aware of why the blindfolding method is being incorporated into the case. Once they understand why, they will probably also enjoy the experience.

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Nikita Joshi, MD

Nikita Joshi, MD

ALiEM Chief People Officer and Associate Editor
Clinical Instructor
Department of Emergency Medicine
Stanford University
Nikita Joshi, MD

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  • cg

    We have been using this technique for years during our ACLS simulations with internal medicine residents. This “wild card” really makes participants focus on the techniques of communication – not only between the leader and the team members but also amongst the team members. Surprisingly, we haven’t found issues with having a blindfolded leader face the opposite direction from the team – ensures no peaking from underneath the blindfold! We have many other wild cards such as this we introduce to challenge team behaviors/functioning – would be happy to share if requested.

    • njoshi8

      Hi CG! I know many people have been using this trick, and I am always amused by the stories I hear from people’s experience with it. I absolutely would love to hear more of your tricks. You can either share it here, or email me at njoshi8@gmail.com. If you are ok with it, I can feature them on the blog in another post. Thanks again for reading and replying!

  • Nur-Ain Nadir

    I really enjoy the blind folded approach, just one of things to remember is to use caution with this technique with learners new to simulation. Otherwise as having done it myself is awesome.

    • njoshi8

      Agreed that this is definitely for the advanced learner.. the last thing you want is to alienate the learner or destroy the safe learning environment.