On Scene Pre-hospital clinical decision simulator
Free pre-hospital clinical learning

On Scene

Pre-hospital clinical decision simulator

Each case aims to feel like stepping into an actual ambulance job. You are given a scene, make one clinical decision, and the patient responds to what you chose. Good choices move the case forward efficiently; poor choices can delay care, create deterioration or force you into a rescue branch.

Your learning

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Chest pain refusal

A hard case targeting material-risk discussion, use/weighing and a high-risk capacitous refusal.

Consent / CapacityHardRecommended
Signed-in attempts are saved securely to your account. More detailed domain analytics will be added once domain scoring is wired into each branch.
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Educational use: On Scene is an independent educational simulation tool for pre-hospital clinicians. It is not an official NHS or JRCALC product and is not a substitute for current clinical guidelines, local policy or professional judgement.
Case library

Dynamic scenarios

The same case can unfold differently depending on your choices.

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What do you do next?

How On Scene works

Clinical decisions with consequences.

On Scene is a pre-hospital decision simulator. You are placed into an ambulance scenario, given the information available at that moment, and asked what you would do next. Your choices change what happens to the patient.

1. Arrive on scene
2. Make a decision
3. Patient responds
4. Review your route
1

Dynamic branching

There is not always one linear route. A poor decision may delay care, worsen physiology, damage rapport or create a new problem you then have to recover from.

2

Difficulty means something

Easy cases reinforce core priorities. Moderate cases add competing considerations. Hard cases deliberately include several defensible-looking options where nuance, law, prioritisation or pathway knowledge matters.

3

Not just right or wrong

Some choices are appropriate, some are reasonable but less optimal, and others are unsafe. Your route through the case is reflected in the debrief rather than simply stopping at the first mistake.

4

Built for reflection

Signed-in users can build a history of attempts and scores. The longer-term aim is to identify patterns in assessment, reasoning, treatment, safety, communication and disposition, then recommend targeted cases.

Support On Scene

Help keep On Scene free

On Scene is free to use. If you find it useful and want to support ongoing development, hosting and the creation of new scenarios, you can make a small contribution.

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Clinical governance: On Scene is educational software and is not an official NHS or JRCALC product. Scenario content is designed around current UK pre-hospital practice and should be formally validated against full current JRCALC Plus and local service pathways before external clinical use.
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Your domain performance

Complete scenarios while signed in to build a picture of how you perform across different parts of pre-hospital decision-making.

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Completed scenarios

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Case complete

Average decision score: appropriate = 100, reasonable/less optimal = 70, suboptimal/unsafe = 25.

Key learning

Your route through the case