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Table 6 Making sense of the clinical presentation

From: An activity theory perspective of how scenario-based simulations support learning: a descriptive analysis

Primary nurse “OK, I’m just going to check your belly.” [Education and Counseling]
Primary nurse Moves gown to expose abdomen.
Primary nurse “Any discomfort in your belly or deep down in your abdomen?” [Diagnostic Questioning]
Patient “Hmm…just a little cramping every now and then.”
Primary nurse “OK, and you'll probably get a little more cramping when you’re nursing too.” [Education and Counseling]
Patient “Yeah, it seems about when it is.”
Primary nurse “Ok, I'm just going to give a quick listen to your belly.” “Have you been having any gas or anything moving?” [Diagnostic Questioning]
Patient “Yeah, I feel it a little bit.”
Primary nurse “OK...we just like to make sure everything is moving again.” [Education and Counseling]
Patient “Yeah…okay.”
Primary nurse Auscultates abdomen [Structured Intervention]
Primary nurse Moves sheets down, places left hand at the base of the patient's’ belly and with right hand palpates for the top of the fundus. [Structured Intervention]
Primary nurse “OK, I’m just gonna feel, see if I can feel the placement of your uterus [Goal], to see if it's shrinking down again.”
Primary nurse Palpates fundus. [Structured Intervention]
Primary nurse “And right here, I'm going to document this as 2 under.” [Education and Counseling]
Patient “Hmm, it’s a little sore when your push.”
Primary nurse “Okay, sorry about that. [Social and emotional support] But, what I’m feeling is good. I’m feeling that your uterus is hard and it shrunk down under your belly button, which is great, that's what we're looking for right now. Every time you have those cramps, is because your uterus is is..uh, getting back to its normal shape.” [Education and Counseling]
  1. The student participant portraying the primary nurse appears to thoughtfully sequence her structured interventions and social interactions (including gathering information from the patient) to construct an understanding of the patient’s condition and uterine height. She makes her understanding of the situation explicit when we she educates and counsels the patient on her findings