VitalNotes

Paramedic Thinking. Essential Ideas. One Page at a Time.

Scenario Days – Make Learning Stick

Why Scenario Days Matter

Turn Simulation into Lasting Clinical Judgment

Scenario days are more than just tests of skill—they’re training for real complexity: pressure, uncertainty, decision-making, and teamwork.

But here’s the catch: if you don’t process the experience, the learning fades. You walk away with adrenaline, feedback, and maybe a vague memory of what went wrong—but not the kind of insight that sticks.

This page shows you how to lock in those lessons.

Why This Matters

If you don’t reflect after a scenario:

  • You’ll miss the reasoning behind your choices
  • You’ll repeat the same mistakes next time
  • You’ll lose valuable insight to the fog of memory
  • You’ll struggle to transfer learning into real calls

Scenarios are only powerful when paired with structured review.

Post-Scenario Learning Cycle (10–15 minutes)

Here’s a system to turn every scenario into long-term growth:

1. Capture 2–3 Fleeting Notes Immediately

Take 2 minutes and jot raw observations—don’t filter.

  • What happened?
  • What felt confusing or uncertain?
  • What surprised you?
  • What’s one cue you missed or misunderstood?

Example:

  • “Patient had clear lungs but low SpO₂—thought asthma, ended up being PE.”
  • “Fumbled the ASA dose—need to review directive wording.”

2. Write a Quick Literature Note

Pull from the debrief, directive, or textbook to clarify the concept.

  • “PE = sudden SOB, pleuritic chest pain, normal auscultation.”
  • “ASA directive: 160–162 mg PO unless allergy/GI bleed.”

Tip: Rephrase it in your own words. Don’t copy/paste.

3. Create 1–2 Permanent Notes in Obsidian

Now summarize what you understand, with clarity and purpose. One note = one idea.

Example Permanent Note:
Title: O₂ Saturation in Pulmonary Embolism
Low SpO₂ with normal auscultation suggests PE. Ventilation is intact, but perfusion is blocked. Watch for tachypnea, pleuritic pain, and hypoxia with clear lungs.

Linked Notes: [[PE Overview]], [[SOB Differentials]], [[ALS Chest Pain Directive]]

4. Optional: Add an Anki Card

If the insight includes a factual piece (drug, directive, red flag), make a flashcard.

  • Q: “What red flag may point to PE over asthma?”
    A: “Hypoxia + clear lungs + pleuritic chest pain”

5. Bonus: Run a Five Whys Chain

If something really threw you off, go deeper.

“Why did I think it was asthma?”
→ Because the patient was wheezing
→ Why was I focused only on that?
→ Because I overlooked vitals
→ Why did I skip vitals?
→ Because I was distracted by the environment…

This builds self-awareness, not just knowledge.

Example Walkthrough: Silent Chest in Asthma

Scenario
22F in distress. Wheezing absent. Salbutamol given with poor effect.

Fleeting Note
“Expected wheeze, but lungs were quiet—missed the severity.”

Literature Note
“In critical asthma, airflow may be so restricted that wheezing is no longer audible—‘silent chest’ is an emergency.”

Permanent Note
Silent chest = clinical red flag. Absence of wheeze does not mean resolution—may indicate life-threatening airflow obstruction. Requires immediate transport and high suspicion.

Anki Card
Q: “What does silent chest indicate in asthma?” → A: “Severe obstruction / impending respiratory failure”

Scenario Integration Framework

Use this after any lab or simulation:

  • Write 2–3 Fleeting Notes
  • Clarify 1 Concept (Literature Note)
  • Create 1–2 Permanent Notes
  • Optional: Add 1 Anki Card
  • Optional: Run a Five Whys if confused or surprised

This takes 10–15 minutes and turns simulation into insight.

Reflection Prompts

Use one or two after any scenario:

  • What did I miss or misjudge—and why?
  • Did I rely on the wrong cue (appearance, tone, vitals)?
  • What do I need to review now, while it’s still fresh?
  • How would I handle this differently next time?

Final Thoughts

Scenario days don’t teach you unless you mine them for meaning.

With a few minutes of review, you turn pressure into pattern recognition. You sharpen your decision-making. You build clinical judgment—layer by layer.

The best medics aren’t the ones who never mess up. They’re the ones who reflect deeply, learn quickly, and build forward from every experience.

I. Learning Foundations

Build a strong system for thinking, studying, and remembering in high-pressure fields.

II. Practical Application

Move from theory to field-ready practice. These tools help bridge simulation, lab, and real calls.

  • Scenario Days – Make Learning Stick
    How to get more from scenario practice using repetition, debriefs, and learning loops. Turn repetition into retention.
  • Mastering Directive Decision-Making
    A breakdown of how to use directives in real-time, with pattern recognition, logic triggers, and threshold thinking.
  • Reflecting Without Journaling
    Not everyone journals—this guide offers quick, low-resistance alternatives to build metacognition through regular reflection.
  • Lab Integration Guide
    Use lab sessions to build decision-making habits, not just check off skills. Includes scenario prep, debriefing, and error capture.

III. Clinical Reasoning

Develop clarity under pressure. These pages train your diagnostic eye, pattern sense, and mental workflow.

IV. Resources

Your support tools: guides, summaries, templates, and setup walkthroughs.

  • Summary
    Recap of the big ideas behind VitalNotes: learn reflectively, study actively, and build a system that supports decision-making under pressure.
  • Helpful Resources
    Downloadables and quick-reference tools: directive cue sheets, Anki decks, debrief templates, and scenario aids.
  • Anki Setup & Use Guide
    Step-by-step instructions for downloading, customizing, and optimizing Anki for long-term retention.
  • Obsidian Setup & Use Guide
    How to build a clinical note vault in Obsidian: folder structures, templates, and linking strategies.
  • Sources and References
    A list of research and literature that supports the methods taught in the blog, with commentary on their application to clinical learning.