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Table 1 Experiment condition design per ambulance mission phase

From: The impact of contextualization on immersion in healthcare simulation

Mission phase Basic Contextualized Fidelity adjustments
(1) Dispatch, ambulance Dispatch delivered from the instructor during introduction Through a realistic two-way communication system Equipment fidelity, functional task alignment
Oral information from the instructor Full visualization, in a driving simulator, of an actual turnout from the station to the address (4 min). Communication with the dispatch center is possible. Equipment fidelity, environmental fidelity, functional task alignment
(2) On scene assessment The instructor informs the team that they are at the scene and that they can start working. Equipment is already in place. Crew physically relocate themselves and equipment to the patients’ apartment. Functional task alignment
  The team enters an apartment (simulated in a lecture room) with physical props and with interiors projected on the walls—which may indicate, e.g., the lifestyle of the patient or give clues about the situation. Ambient sounds and a dog barking behind a half open door were used to further enrich the environment. Environmental fidelity
(3) Initial patient assessment The team interacts with the manikin in a lecture room that represents the home of the patient. The team interacts with the manikin in the apartment. Environmental fidelity
(4) On-scene treatment Medicine is delivered by informing the instructor of the action. Medicine is delivered in a realistic way using RFID tags. Equipment fidelity
Calls to medical control and ECG transmission are handled via the instructor. Calls to medical control and ECG transmission are handled in a realistic way. Equipment fidelity, functional task alignment
(5) Scene departure and transport The manikin is loaded to the stretcher. The team stays in place but verbalize/report to the instructor that they load the patient into the ambulance. The manikin is loaded to the stretcher, brought out of the apartment, and then loaded into the ambulance/driving simulator. Equipment fidelity, environmental fidelity, functional task alignment
Driving is not a part of the simulation but the team may discuss the case and inform the instructor of what they would have done during transport. The simulated trip to the emergency department takes 7 min during which additional treatment is carried out in the ambulance. Equipment fidelity, environmental fidelity, functional task alignment
(6) Patient handover to emergency department The team reports to the attending emergency physician. The team reports to the attending emergency physician.  
  1. The rightmost column indicates which fidelity dimensions that have been affected by the contextualization