Applying the method

Note:

This website does not replace HFCS training. It is recommended that the instructors who plan to use this pedagogical method attend a course at the nearest training centre.

HFCS Method

HFCS stands for High-Fidelity Clinical Simulation, a teaching technique that applies socio-constructivist theory through the use of simulated practical experiences. According to the Haute Autorité en Santé (2012), HFCS refers to

the use of virtual reality equipment (mannequin or procedural simulator) to reproduce situations or care environments in order to teach diagnostic and therapeutic procedures, clinical situations or decision-making by a healthcare professional or a team of professionals.

HFCS offers another interesting benefit: it allows complex care situations to be reproduced in a controlled environment. During the clinical internship (in a hospital settings, for example), what the students learn depends on the clinical cases that actually occur in the setting (people who are hospitalized or who receive care in outpatient clinics). HFCS lets them explore more complex or unusual clinical situations and allows more students to experience these situations in a controlled environment, before doing so in their future professional practice. The use of HFCS in clinical teaching therefore helps standardize learning and skills.

Facilitator and operator

Reproduce clinical situations that are more complex or rare.

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Students

Perform in a controlled environment

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Clinical teaching

Standardized learning and performance of skills

Activity

For the activity, the participants are placed in three groups of three students (triads). The resulting teams are facilitated by the teacher and personnel to fulfill the needs of the clinical situation at hand (e.g., doctor, respiratory therapist, nursing assistant, patient attendant, family, etc.).

Typically, there are three major steps to HFCS:

1

Briefing session

The briefing session is attended by the team of participants and the teacher. Having read the scenario in advance, the participants are prepared for the clinical simulation that they are about to experience. The briefing usually lasts about 20 minutes.

2

Simulation

Next is the simulation itself. Each triad usually has 15 minutes to intervene in the clinical scenario. The triads may watch their teammates’ performance remotely (e.g., via camera).

3

Debriefing session

Finally, the simulation is followed by a debriefing session. This is a time to review the learning and the difficulties the participants faced. The debriefing lasts between 30 and 40 minutes.

Consistency for each cohort that repeats the same scenario

As previously explained, triads of participants are formed for the HFCS experience. The reason for repeating the clinical case three times is not to increase the level of difficulty in each session but to allow the participants’ learning and interventions to progress. Repetition provides the students with the opportunity to improve their understanding of a clinical situation by learning from their colleagues’ successes and challenges. In doing so, participants can develop their skills in clinical analysis, judgment and intervention. It is best not to change anything in the scenario between each simulation of the same clinical situation with the same cohort of participants.

Creating new scenarios

Using the template available on this website, anyone involved in nursing education can develop new scenarios. Please see the HFCS Resources section for further information to help you develop and/or contribute to the scenarios there.

Adjusting the difficulty of a scenario

You can also change the level of complexity of an existing scenario to adjust it for the students you are working with. For the same pathology, you can have a scenario for beginners or advanced students.

Note on the terminology: briefing and debriefing

Although briefing and debriefing are English terms in the field of nursing, they are also widely used in the French sector and briefing appears in the Robert and Larousse dictionaries.

According to the Office Québécois de la Langue Français (OQLF), the word débriefing is valid for psychology, where it refers to the reflection process that follows a simulation (OQLF n.d.). Since HFCS includes elements of socio-constructivism, the decision was made to use the terms briefing and débriefing in French.

French translations, such as breffage and debreffage exist in the French-language literature, but according to the OQLF, these terms apply mainly to the fields of management and meetings.

When adapting the scenarios from this website, it is permissible to adopt whichever terms best suit your teaching establishment.

Alternatives to the words briefing and débriefing, in French:

  • Briefing : réunion préparatoire, réunion préalable, instructions, révision
  • Débriefing : séance de verbalisation, séance de ventilation, compte-rendu, consolidation des apprentissages

Reference List