To develop communication and conflict resolution skills, enhance teamwork between senior and junior paramedic staff, practice decision-making under pressure and address the needs of an agitated patient in a professional and empathetic manner.

Ask the Ss as a group to quickly discuss or role-play how to seek support or guidance from a (senior) colleague. This can be followed by brainstorming of calming statements and positive body language.

Characters

Patient:

A young individual with an injured leg, in visible pain, becoming increasingly agitated due to a long waiting time. The patient is expressing frustration and escalating in tone.

Senior Paramedic:

Calm, authoritative, experienced in conflict resolution.

Junior Paramedic:

Eager but less experienced, potentially feeling overwhelmed.

A busy Accident & Emergency department with multiple demands on staff.

Roles Key Behaviours

Agitated Patient:

Behaviours:

Throw things, yell or raise voice, express frustration about waiting and pain, demand immediate attention.

Tone:

Loud, assertive, and increasingly agitated.

Attitude:

Angry, impatient, and focused on getting relief, but may calm down if acknowledged and reassured.

Junior Paramedic (Overwhelmed at Registration Desk):

Display visible signs of stress (e.g., hurried speech, avoiding eye contact), attempt to placate the patient with brief responses, and show hesitation in handling escalating tension.

Tone:

Nervous, apologetic, or uncertain.

Attitude:

Overwhelmed but willing to learn from observing senior paramedic's approach.

Senior Paramedic (De-escalating the Situation)::

Behaviours:

Step in calmly, use open body language, acknowledge the patient’s concerns, validate their frustration, and clearly explain the next steps or expected timeline.

Tone:

Confident, calm, and empathetic.

Attitude:

Focused on de-escalating tension, building trust, and providing clarity while maintaining professionalism.

Arrange a mock A&E environment with props such as a stretcher, chairs, medical notes, and a clock. Position distractions like noise or other simulated patients.

Brief the participants on their roles privately, emphasizing the emotional and situational dynamics. Outline the scenario timeline.

The simulation begins with the agitated patient storming to the paramedics’ desk, throwing object off the desk and complaining about the wait and pain.

The junior paramedic attempts to de-escalate the situation, but his efforts are not effective.

The senior paramedic enters the scene and takes over or assists in addressing the patient’s concerns. Effective communication and teamwork lead to a de-escalation of the patient’s agitation.

The simulation concludes when the patient feels acknowledged and calmer, or a resolution is agreed upon.

By the end of the simulation, the participants should be able to:

1. demonstrate effective communication strategies for de-escalating an agitated patient
2. utilize teamwork in high-pressure situations,
3. apply empathy and professionalism while addressing patient needs,
4. recognize the importance of senior mentorship in developing junior staff’s confidence and skills.

Possible Distractors or Disruptors

Background noise from other simulated patients or medical equipment.

Simulated interruptions, such as another paramedic requesting help or a telephone call.

The patient escalating the challenge.

1. Self-reflection – the participants express their immediate emotional reactions to the simulation
2. Analysis - explore together what happened during the simulation and why.
3. Highlight strengths and areas for improvement.
4. Summarize main takeaways from the session.