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Healthcare

202: Sex, Marriage and Illness

206: Family Dealing with Terminal Illness


215: Living with Chronic Illness - Impact on a Marriage


501: Sexual Intimacy and Terminal Illness


503: Heart Attack - Overcoming Fear & Accepting Change


503B: Heart Attack - Second Interview


503C: Heart Attack - “Medical Refugee”


504: Living with HIV/AIDS


505: HIV/AIDS - Denial & Self-Esteem


506: Surviving a Heart Transplant


601: Pain, Depression & Addiction


603: Ulcers and Alcoholism


603B: Alcoholism and Post-Traumatic Stress Disorder


605: Rheumatoid Arthritis


606: Breast Cancer & Self-Care


607: Teen Asthma


608: Teen Pregnancy and Nutrition


609: Teen Diabetic


610: Recent Widower: In-Home Care


611: Obesity and Depression

806: High-Risk Teen Behaviour


1202: Advocating for the Patient in an Interprofessional Environment


1202B: Case Management of a Patient in an Interprofessional Environment



202: Sex, Marriage and Illness

This married couple wants to rekindle their sex life after the husband’s heart attack.  They are very uncomfortable discussing sex and yet realize the need for help.

LEARNING OBJECTIVES:  demonstrating professionalism, conveying empathy, asking direct and open-ended questions, encouraging dialogue, identifying differing perceptions

SIMULATOR ROLES:     Bill Lee (54)

                                    Martha Lee (52)

STUDENT ROLE:          Counselor/ Nurse

SETTING:                      Sexual health clinic at hospital or family services setting

INFORMATION FOR LEARNERS:           The Lees are seeking information and advice about their sex life, or lack thereof.  Bill had a severe heart attack 4 years ago.  Martha has encouraged him to attend this appointment with her.

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206: Family Dealing with Terminal Illness

This family is struggling to face the impending death of Margaret, wife and mother.  She gets her strength from her faith, but needs someone she can talk to about her fears for herself and her family.

LEARNING OBJECTIVES:  encouraging dialogue, acknowledging feelings, respecting differing perspectives, maintaining professionalism

*CHARACTERS:            Margaret Eaton (46) terminally ill

                                    Al Eaton (47) her husband

                                    Rebecca (15) her daughter

*Note: This simulation is adaptable to the use of one simulator (Margaret Eaton) and some or all of the family members.

LEARNER ROLE:          Social Worker / Nurse

SETTING:                      Hospital

INFORMATION FOR LEARNERS: Margaret has been in the hospital for five days after suffering a grand mal seizure.  She has cancer and has six months to live.  She wants to go home to die.

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215: Living with Chronic Illness - Impact on a Marriage        

This simulation was developed for the Internationally Educated Social Workers and reflects the learning objectives for those students.

This married couple is having problems coping with the husband’s cancer treatment. A counselor must be patient with the husband’s attitude in order to help the couple come to terms with their emotions.

LEARNING OBJECTIVE: listening skills, developing trust, demonstrating empathy, checking perceptions, finding collaborative solutions, demonstrating professionalism

SIMULATORS ROLES:  Steve Bennett, colorectal cancer patient

                                    Mary Bennett, wife

LEARNER ROLE:          Counselor / Nurse

SETTING:                      A counselor’s office

INFORMATION FOR LEARNERS: Mary Bennett made the appointment to see a counselor and Steve reluctantly agreed. Steve is angry and resentful of his condition – battling cancer and needing a colostomy- and has been behaving out of character. Mary is extremely unhappy but feels she should support Steve through his illness.

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501: Sexual Intimacy and Terminal Illness

Nancy Waters recently received a diagnosis of bone cancer in her hip and the prognosis is very bad. This is her second bout with cancer and has been given a few months to live. Although she is receiving physiotherapy after hip surgery, what she really needs is advice about a marriage that’s collapsing under the weight of her illness.

LEARNING OBJECTIVES:  listening skills –attending, acknowledging, interpreting, supporting,

checking perceptions, silence, demonstrating empathy, conveying understanding, developing collaborative solutions

SIMULATOR ROLE:                   Nancy Waters –late 30’s -40’s

LEARNER ROLE:                      Counselor / Nurse (first meeting)

SETTING:                                  Hospital Setting, Counseling Services                                       

INFORMATION FOR LEARNERS:  Since being diagnosed with bone cancer in her hip six months ago, Nancy’s energy has declined. She has concerns about her husband and the growing emotional gap between them. She does not want her children to know that her cancer is terminal as she wants things as normal as possible for everyone.

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503: Heart Attack - Overcoming Fear & Accepting Change            

This simulation was developed in collaboration with the IDPP – Internationally Educated Dietitians Pre-Registration Program

Bill is recovering from a heart attack 11 months ago. A dietitian must help Bill become comfortable with making changes to his diet in the first two interviews.

LEARNING OBJECTIVES: conducting an assessment, developing trust, demonstrating empathy, listening skills, setting goals

SIMULATOR ROLE:       Bill Krulicki (59), heart patient

                     LEARNER ROLE:          Registered Dietitian / Nurse       

SETTING:                      Dietitian’s office at a local Community Health Centre                  

INFORMATION FOR LEARNERS: Bill suffered a heart attack 11 months ago. Though having met with the hospital dietitian and being given guidelines, Bill’s physician is now concerned that over the past months his cholesterol remains high and he has been gaining weight. Bill is not getting the exercise he used to get through work and he is avoiding all physical activity. Bill’s wife, Martha has tried to cook following a heart healthy diet and she has lost 12 lbs. Martha made this appointment for Bill to meet with a Registered Dietitian.

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503B: Heart Attack - 2nd interview                                            

This simulation was developed in collaboration with the IDPP – Internationally Educated Dietitians Pre-Registration Program

LEARNING OBJECTIVES:  listening skills, continuing to build trust, completing assessment, developing collaborative goals

SIMULATOR ROLE:                   Bill Krulicki

LEARNER ROLE:                      Registered Dietitian

SETTING:                                  Dietitian’s office in Community Health Centre

INFORMATION FOR LEARNERS:  Bill booked the follow-up appointment. Martha was to have attended but a work emergency prevented this so Bill is alone again. He did not want to miss his appointment. He has thought about the first meeting and is willing to listen to what the RD has to say and may consider some small changes in his diet.

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503C: Heart Attack - “Medical Refugee”          

This simulation was developed in collaboration with the Collaborative Nursing Program, Ryerson University, George Brown College and Centennial College.

LEARNING OBJECTIVES:  listening skills, continuing to build trust, demonstrating empathy, completing assessment, developing collaborative goals

SIMULATOR ROLE:                   Bill Krulicki

LEARNER ROLE:                      Nurse

SETTING:                                  Nurse / Social Worker’s Office

INFORMATION FOR LEARNERS: 

Bill is back in Toronto for his one year follow-up after a heart attack and bypass surgery. He has flown in alone from Atikokan, north of Thunder Bay and is unfamiliar and uncomfortable with the city. He is anxious about this appointment and about staying overnight in Toronto.

 * More information available upon request.

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504: Living with HIV/AIDS                

This simulation was developed in collaboration with the IDPP – Internationally Educated Dietitians Pre-registration Program

Please note: Though the focus of simulations 504 and 505 is HIV - diet and meeting with a dietitian, Douglas Starr is a rich character and could also seek counseling from a social worker, a psychologist or a nurse.

Douglas was diagnosed as HIV positive three months ago and has been coping with the symptoms. He needs help formulating a diet which will help alleviate some of his symptoms.

LEARNING OBJECTIVES:  listening skills, building trust, demonstrating empathy, developing a collaborative plan, conducting an assessment, maintaining objectivity

SIMULATOR ROLE:       Douglas Starr (25-35), AIDS patient

LEARNER ROLE:          Registered Dietitian                                        
SETTING:                      Office of the Dietitian at a Community Health Centre

INFORMATION FOR LEARNERS:  Douglas has made an appointment with a dietitian to discuss his weight loss, fatigue, nausea, and diarrhea. He has done some research on the importance of diet and HIV. The dietitian will know that Douglas is HIV.

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505: HIV/AIDS - Denial & Self-Esteem                                   

This simulation was developed in collaboration with Janet Chappell and the Department of Nutrition at Ryerson University.

Douglas was diagnosed as HIV positive three months ago and has been coping with the symptoms. He is still in denial about his health status and conflicted about his sexuality

LEARNING OBJECTIVES:  listening skills, responding to non-verbal cues, creating a safe environment, building trust, developing collaborative goals

SIMULATOR ROLE:                   Douglas Starr (25- 35 years old)

LEARNER ROLE:                      Nurse, Registered Dietitian, Social Worker

SETTING:                                  Community Health Centre

INFORMATION FOR LEARNERS:  Douglas has made an appointment to see a dietitian. He is concerned about fatigue and weight gain. He does not present as having a weight problem as on the surface he seems healthy and trim.

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506: Surviving a Heart Transplant                                           

One and a half years after a heart transplant, a patient is still conflicted about having someone else’s heart: he doesn’t feel like himself.

LEARNING OBJECTIVES:  listening skills, asking effective questions, responding to non-verbal cues, demonstrating reflection and empathy, gaining trust, moving the story forward

SIMULATOR ROLE:                   Ian Paige (33)

LEARNER ROLE:                      nurse, social worker

SETTING:                                  hospital, clinic

INFORMATION FOR LEARNERS:  Ian Paige had a history of heart problems from an early age.

After receiving a diagnosis of cardiomyopathy he was scheduled for a transplant and then waited 18 months.  It is now 1.5 years since his surgery and he is healthy enough to return to work but not sure that he wants to do that.  He has come in for a routine follow-up appointment but wants to talk about more than just his heart-health.

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601: Pain, Depression & Addiction

A patient with a painful disease has become an alcoholic.  A counselor must try to make her see the problem and begin to rebuild her life.

LEARNING OBJECTIVES:  establishing rapport, building trust, encouraging dialogue, responding to non-verbal cues, conveying support, acknowledging feelings, highlighting strengths

SIMULATOR ROLES:     Julie Dixon (25 - 35)

LEARNER ROLE:          social worker/nurse

SETTING:                      Hospital     

INFORMATION FOR LEARNERS:  Julie was admitted for tests due to severe joint pain and swelling. She also has a fever.  She has been in the hospital for a couple of days.  Blood and urine tests revealed high alcohol levels.  You have been asked to speak with her about this.

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603: Ulcers and Alcoholism

A middle-aged man refuses to admit his drinking is destroying his life.  Now, it has caused him stomach ulcers and his doctor has recommended that he get some help in dealing with the effects of alcohol in his life.

LEARNING OBJECTIVES:  establishing rapport, building trust, encouraging dialogue, responding to non-verbal cues, conveying support, acknowledging feelings, highlighting strengths

SIMULATOR ROLES:     Mr. Durkin (45-65)

LEARNER ROLE:          Social worker/counselor or nurse

SETTING:                      Hospital / Community Health Centre

INFORMATION FOR LEARNERS: Mr. Durkin went to the doctor because of acute pain in the stomach area that’s aggravated by smoking, drinking and spicy food.  It has wakened him three times this week. The doctor referred him for some tests, but also recommended he speak to a social worker/counselor/nurse.

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603B: Alcoholism and Post-Traumatic Stress Disorder

A middle-aged police officer refuses to admit his drinking is destroying his life.  Now, it has caused him not only a decline in his health but has resulted in his being assigned to a desk job.

LEARNING OBJECTIVES:  establishing rapport, building trust, encouraging dialogue, responding to non-verbal cues, conveying support, acknowledging feelings, highlighting strengths

SIMULATOR ROLES:     Mr. George Durkin (45-55)

LEARNER ROLE:          Psychologist/Social worker/ nurse

SETTING:                      Hospital / Community Health Centre

INFORMATION FOR LEARNERS: George Durkin is a police detective who has been removed from his regular duties working Guns and Gangs to a desk job. It has been strongly recommended that he seek counseling outside the available Police Services. This was suggested in order to provide George with support without his hiding behind his assumptions about police culture.

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605: Rheumatoid Arthritis

This woman is recovering from hip surgery.  Determined to stay active, she wants detailed advice about how to continue her rehabilitation when she is at home.

LEARNING OBJECTIVES:  highlighting strengths, developing a plan, advising, assessing readiness, responding to non-verbal cues

SIMULATOR ROLES:     Delores Boyd (35)

LEARNER ROLE:          Social worker/counselor or nurse

SETTING:                      Hospital

INFORMATION FOR LEARNERS: Mrs. Boyd’s rheumatoid arthritis symptoms (joint pain, stiffness, malaise) have been bad after hip surgery three weeks ago.  This is a post-operative session to assess her state of mind about her illness.

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606: Breast Cancer & Self-Care

This proud & hard-working woman is having difficulty putting her own health needs ahead of the demands of her busy family.

LEARNING OBJECTIVES:  asking direct and open-ended questions, establishing rapport, highlighting strengths, considering options, defining next steps

SIMULATOR ROLES:     Jeanette Lalonde (32)

LEARNER ROLE:          Nurse or social worker

SETTING:                      Hospital     

INFORMATION FOR LEARNERS: Jeanette is coming into the city for breast cancer treatment. She has been offered supportive counseling on a couple of occasions and has decided that she wants to speak with someone.

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607: Teen Asthma

This young adult has experienced an exacerbation of wheeziness after cutting the lawn. She has been asthmatic most of her life and is supposed to take medication to prevent asthma attacks.

LEARNING OBJECTIVES:  building trust, establishing rapport, acknowledging underlying interests, maintaining objectivity, considering options, gaining buy-in

SIMULATOR ROLES:     Angela Pierro (18)

LEARNER ROLE:          Nurse/social worker

SETTING:                      emergency asthma clinic at hospital

INFORMATION FOR LEARNERS:  Angela has been treated for an acute exacerbation of her asthma symptoms at the emergency department. The emergency nurse referred Angela to asthma clinic within the hospital for follow-up related to her uncontrolled asthma and her current level of distress. 

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608: Teen Pregnancy & Nutrition                                             

This simulation was developed in collaboration with the IDPP – Internationally Educated Dietitians Pre-Registration Program     

Please note: Though this simulation was developed with a focus on nutrition, Theresa Hogan is a rich character and different from the other teen-aged girls who are pregnant. Theresa is very positive about having this baby. Theresa could also be seeing a social worker, a nurse, a counselor or a therapist.

This teenage girl discovered she was pregnant and has decided to keep the baby. She has made an appointment with a dietician who can help her understand the importance of healthy eating during pregnancy.

LEARNING OBJECTIVES:  listening skills, building trust, setting an agenda, conducting an assessment, maintaining objectivity, developing collaborative goals

SIMULATOR ROLE:       Theresa Hogan (18) about 8 weeks pregnant

LEARNER ROLE:          Registered Dietitian/Nurse/ Counselor                                        

INFORMATION FOR LEARNERS:  Theresa is pregnant and makes an appointment with a dietitian because she would like to gain as little weight as possible and have a healthy baby. She would like to continue wearing her own jeans and keep everyone guessing. Theresa feels she can handle anything that comes her way.

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609: Teen Diabetic                                                                             This simulation was developed in collaboration with Angela Cuddy and the Department of Nutrition at Ryerson University                                                                                                                            Please Note:  This simulation was originally structured as a demonstration. This structure was to allow students to observe an ineffective and effective assessment as well as expose them to the clients they may well encounter in their practice.

A teenaged girl has been diagnosed with diabetes. A dietician must help her realize that she can make the necessary changes in her nutrition without too much change to daily life.

LEARNING OBJECTIVES:  listening skills, conveying understanding, conducting an assessment, developing collaborative goals and solutions

SIMULATOR ROLES:     Rebecca Phillips – young teenager just diagnosed diabetic

                                    Sharon Phillips, mother

LEARNERS’ ROLE:       Dietician                      

SETTING:                      Office of a Registered Dietitian

INFORMATION FOR LEARNERS:  Rebecca has just been diagnosed with diabetes and needs to monitor and control her blood sugar level in order to keep her diabetes in check. Certain aspects of her diet have to change.  Rebecca’s mother accompanies her to this initial meeting with the dietician.        

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610: Recent Widower - In-Home Care                                   

This simulation was developed in collaboration with Angela Cuddy and the Department of Nutrition at Ryerson University.
                                                                                             Please Note:
  This simulation was originally structured as a demonstration. This structure was to allow students to listen to the client ‘s story and then observe an effective assessment  exposing them to a client they may well encounter in their practice.

Raymond is a patient with chronic renal failure who is without full-time care. He needs to improve his health and nutrition or he will require hospital admission.

LEARNING OBJECTIVES:  listening skills, conducting an assessment, demonstrating empathy, considering options, developing collaborative solutions

SIMULATOR ROLES:     Raymond Zetner (60+)

LEARNER ROLE:          Registered Dietician                 

SETTING:                      Hospital Office of Registered Dietitian after Raymond’s dialysis

INFORMATION FOR LEARNERS:  Raymond, with long standing renal failure and now recently widowed, has no knowledge of cooking or nutrition. However he needs to meet his severe dietary restrictions if he wishes to remain living at home.

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611: Obesity and Depression

This simulation was developed in collaboration with the IDPP – Internationally Educated Dietitians Pre-Registration Program.

An overweight woman is skeptical about seeing a dietitian but needs help understanding and managing her situation.

LEARNING OBJECTIVES:  conducting an assessment, asking effective questions, active listening, developing collaborative goals and solutions

SIMULATOR ROLES:     Sandra Marley (mid 30’s)

LEARNER ROLE:          Dietician

SETTING:                      Community Health Centre          

INFORMATION FOR LEARNERS:  You are a dietician in a Community Health Centre. You have received a phone call from Sandra Marley, who explored the possibility of setting up an appointment with you. During your short phone conversation, Sandra said she had been referred to you by her social worker, whom she has been seeing her for a while now. As an answer to the reason of referral, Sandra said she is struggling with obesity. She mentioned that the therapist convinced her you were a reliable professional. Then she inquired on your experience dealing with obesity and of your success rates. Though Sandra didn’t sound convinced, she booked an appointment with you.

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806: High-Risk Teen Behaviour

A teen-aged girl finds herself facing the possibility of an unwanted pregnancy after a few incidents of “casual sex”.

LEARNING OBJECTIVES: listening skills, demonstrating empathy, building rapport, responding to non-verbal cues, awareness of personal biases

SIMULATOR ROLE:       Winnie Chen

                                    (*Subject to simulator availability)

LEARNER ROLE:          Social worker/Nurse

SETTING:                      Walk-in Clinic (may specialize in sexual health)

INFORMATION FOR LEARNERS:  Winnie has made an appointment to speak with someone about her situation.  She is afraid that she might be pregnant and needs to know her options.

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1202: Advocating for the Patient in an Interprofessional Environment          

This simulation was developed in collaboration with Carolyn Loy and Debbie Gillis at Toronto East General Hospital and Tracey Dyer at Centennial College.

A woman with terminal cancer wants to die at home. She and/or her oldest daughter meet with the health care team to discuss her options.

LEARNING OBJECTIVES: coordinate needs of the patient and family within scope of practice of the team members, develop/practice skills necessary to be responsive to each other’s assessment, negotiate changes in the patient care plan, ensure synthesis of interdisciplinary findings, create a comprehensive and collaborative plan of care

SIMULATOR ROLE:       Mrs. Pink, and/or her daughter Sarah

LEARNER ROLES:        a mix of any of the following: RN, RPN, Social Worker, Physician,  Speech and Language Pathologist, Chaplain, Occupational Therapist, Physiotherapist, Dietician            

SETTING:                      hospital room

INFORMATION FOR LEARNERS:  Mrs. Pink was admitted to the hospital after a fall at home. She has end stage cancer and wishes to return home as soon as possible.

 *More information available for learners upon request.

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1202B: Case Management of a Patient in an Interprofessional Environment         

This simulation was developed in collaboration with Carolyn Loy and Debbie Gillis at Toronto East General Hospital and Tracey Dyer at Centennial College.

A patient with chronic COPD was discharged from the hospital 2 days ago. He is now back following an attack but wants to go home.

LEARNING OBJECTIVES: coordinate needs of the patient within scope of practice of the team members, identify and utilize overlapping scopes, increase awareness of the ways in which team members can communicate their discipline-specific perspectives clearly to others, develop/practice skills necessary to be responsive to each other’s assessment, ensure synthesis of interdisciplinary findings, create a comprehensive and collaborative plan of care

SIMULATOR ROLE:       Mr. Deck, 65

LEARNER ROLES:        a mix of any of the following: RN, RPN, Social Worker, Physician,  Occupational Therapist, Physiotherapist, Dietician, RRT Pharmacist                    

SETTING:                      hospital room

INFORMATION FOR LEARNERS:  Mr. Deck was re-admitted to the hospital only 2 days after discharge. He has a long history of COPD and suffered exacerbation. He has been non-compliant with his medications at home and not coping well living along.

 *More information available for learners upon request.

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