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SBAR Audio Handoff Discussion Pack for Nursing Faculty

Listen to a short handoff, make five private judgments, then reveal the communication tension and a five-minute replay activity. Seven recordings explore alternative versions and related situations involving one fictional patient. Pick one, or a suggested pairing.

See suggested pairings Facilitator PDF

Built for a teaching conversation

  • About 10 minutes per recording. Use one for a brief teaching moment, or choose a pairing below for a 20-minute activity. These are alternative versions of one situation, not a sequence to play in order.
  • Faculty-led and projection-friendly. Learners can make the same private judgments on their own devices.
  • Your five judgments stay private. They are never sent or stored. No account or personal contact details are required.
US-English voices, roles adaptable to your institution. These cases use familiar US nursing roles and terminology, but the communication activity can be adapted locally. This is a formative discussion specimen, not clinical guidance or a validated assessment.

Context question near the start of the guide. Would you use a version developed specifically for another healthcare context?

Why these seven

Same situation, different communication

Recordings 1, 2, 3, and 6 use the same patient, nurse, covering physician, unit, vital signs, and reason for calling. What changes is the communication behavior. Recording 6 keeps the opening word for word and changes how the receiver replies.

Recordings 4 and 5 change the task to shift handoff and ask whether action, owner, time, and loop closure remain observable when responsibility transfers between nurses. Recording 5 moves the same handoff to the bedside, where the patient can hear every word and speak for herself.

Recording 7 changes the task again, to a critical laboratory result travelling from the laboratory to the nurse and on to the physician.

These are alternative versions and related situations on one fictional patient, not seven consecutive events. Recordings 1, 2, 3 and 6 are four versions of the same 6:45 p.m. call. Recording 5 is a shift handoff at the bedside; in Recording 7 the handoff has not yet taken place and Jamie is still the responsible nurse. Choose a pairing rather than playing all seven in order.

Choosing material for one class

Seven recordings are selectable teaching activities, not a single sequence. Each pairing below is one activity. On this page, quality labels and discussion lenses appear when you reveal them. The facilitator PDF deliberately includes these for teaching preparation.

Suggested recording pairings by teaching purpose
Teaching purposeSuggested selectionTime
Establishing a clear escalationRecording 1 and Recording 2About 20 minutes
Transferring responsibility at shift changeRecording 4 and Recording 5About 20 minutes
Maintaining a concern under resistanceRecording 2 and Recording 6About 20 minutes
Adapting structure when the receiver interruptsOptionally after Recording 2.Recording 3About 10 minutes
Communicating a critical resultRecording 7About 10 minutes
Initial escalation and follow-up updateAn optional extension, not a controlled comparison: new information arrives between the two calls.Recording 2 and Recording 7About 20 minutes

Audio handoff · 1:19

Recording 1

Covering-physician call

Jamie Carter, bedside nurse · Dr. Alex Morgan, covering physician

Read before listening

Scenario card for Recording 1

Covering-physician call

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is 6:45 p.m. Jamie Carter, the bedside nurse, is calling covering physician Dr. Alex Morgan about Ms. Martinez in room 412. Her medical record number ends in 4821.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by the covering physician.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Controlled-design note: The physician's response is the same in all three phone recordings. It is part of the controlled exercise, not a treatment recommendation.

The exercise begins after the fictional unit has identified the covering-physician call as one required communication step. It does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the call, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 1

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, bedside nurse: Dr. Morgan, this is Jamie Carter on 4 North, calling about Elena Martinez, MRN ending 4821, in room 412. She's 68, post-op day one after abdominal surgery, with hypertension. Her blood pressure medication was held this morning. At two this afternoon her blood pressure was 128 over 76, heart rate 82, respirations 16, sat 97 percent on room air, and temp 98.4.

  2. Dr. Alex Morgan, covering physician: Okay, Jamie. What's changed?

  3. Jamie: At 6:45 her blood pressure is 96 over 58 and her heart rate is 112. She was alert and oriented earlier. Now she's confused and clammy, and she says she's dizzy when she sits up.

  4. Dr. Morgan: What are you worried about, and what do you need from me?

  5. Jamie: I'm concerned she's deteriorating. I need you to assess her at the bedside by 7:00.

  6. Dr. Morgan: I'm on my way. I'll be at the bedside by 7:00. Get vitals at 6:50. Since it's almost shift change, stay with her until the oncoming nurse takes over. Call sooner if she gets less responsive or her pressure drops further.

  7. Jamie: Got it. Vitals at 6:50, I'll stay with her until the oncoming nurse takes over, and I'll call you sooner if she gets less responsive or her pressure drops further. And you'll be here by 7:00.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 1:15

Recording 2

Covering-physician call

Jamie Carter, bedside nurse · Dr. Alex Morgan, covering physician

Read before listening

Scenario card for Recording 2

Covering-physician call

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is 6:45 p.m. Jamie Carter, the bedside nurse, is calling covering physician Dr. Alex Morgan about Ms. Martinez in room 412. Her medical record number ends in 4821.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by the covering physician.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Controlled-design note: The physician's response is the same in all three phone recordings. It is part of the controlled exercise, not a treatment recommendation.

The exercise begins after the fictional unit has identified the covering-physician call as one required communication step. It does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the call, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 2

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, bedside nurse: Dr. Morgan, this is Jamie Carter on 4 North, calling about Elena Martinez, MRN ending 4821, in room 412. At 6:45 she's newly confused and clammy. Her blood pressure is 96 over 58, down from 128 over 76 at two this afternoon, her heart rate is 112, up from 82, her respirations are 22, up from 16, and her sat is 95 percent on room air, down from 97. I'm concerned she's deteriorating, and I need you to assess her at the bedside by 7:00.

  2. Dr. Alex Morgan, covering physician: Okay. What's her background?

  3. Jamie: She's 68 and post-op day one after abdominal surgery. She was alert and oriented earlier. She has hypertension, and her usual blood pressure medication was held this morning.

  4. Dr. Morgan: I'm on my way. I'll be at the bedside by 7:00. Get vitals at 6:50. Since it's almost shift change, stay with her until the oncoming nurse takes over. Call sooner if she gets less responsive or her pressure drops further.

  5. Jamie: Got it. Vitals at 6:50, I'll stay with her until the oncoming nurse takes over, and I'll call you sooner if she gets less responsive or her pressure drops further. And you'll be here by 7:00.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 1:14

Recording 3

Covering-physician call

Jamie Carter, bedside nurse · Dr. Alex Morgan, covering physician

Read before listening

Scenario card for Recording 3

Covering-physician call

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is 6:45 p.m. Jamie Carter, the bedside nurse, is calling covering physician Dr. Alex Morgan about Ms. Martinez in room 412. Her medical record number ends in 4821.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by the covering physician.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Controlled-design note: The physician's response is the same in all three phone recordings. It is part of the controlled exercise, not a treatment recommendation.

The exercise begins after the fictional unit has identified the covering-physician call as one required communication step. It does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the call, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 3

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, bedside nurse: Dr. Morgan, this is Jamie Carter on 4 North, calling about Elena Martinez, MRN ending 4821, in room 412. At 6:45 she's newly confused and clammy after being alert and oriented earlier. She's post-op day one after abdominal...

  2. Dr. Alex Morgan, covering physician: Hang on. What's her blood pressure and heart rate right now?

  3. Jamie: 96 over 58, and her heart rate is 112.

  4. Dr. Morgan: And what were they earlier?

  5. Jamie: At two this afternoon she was 128 over 76 with a heart rate of 82. She's 68, she has hypertension, and her usual blood pressure medication was held this morning. She also says she's dizzy when she sits up.

  6. Dr. Morgan: Okay.

  7. Jamie: So, to get back to why I'm calling: I'm concerned she's deteriorating, and I need you to assess her at the bedside by 7:00.

  8. Dr. Morgan: I'm on my way. I'll be at the bedside by 7:00. Get vitals at 6:50. Since it's almost shift change, stay with her until the oncoming nurse takes over. Call sooner if she gets less responsive or her pressure drops further.

  9. Jamie: Got it. Vitals at 6:50, I'll stay with her until the oncoming nurse takes over, and I'll call you sooner if she gets less responsive or her pressure drops further. And you'll be here by 7:00.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 0:56

Recording 4

Nurse-to-nurse shift handoff

Jamie Carter, off-going nurse · Taylor Brooks, oncoming nurse

Read before listening

Scenario card for Recording 4

Nurse-to-nurse shift handoff

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is just before 6:50 p.m., shortly before the 7:00 p.m. shift change. Jamie Carter, the off-going nurse, is handing Ms. Martinez in room 412 over to oncoming nurse Taylor Brooks. Her medical record number ends in 4821.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by covering physician Dr. Alex Morgan.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Already pending before this handoff

  • Dr. Morgan is on the way and has agreed to assess Ms. Martinez at the bedside by 7:00 p.m.
  • A complete vital-sign set is due at 6:50 p.m.
  • The responsible nurse is to remain with her and call Dr. Morgan sooner if she becomes less responsive or her blood pressure falls further.

These actions are conditions of the fictional exercise, not a treatment recommendation or universal shift-handoff process. The activity does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the handoff, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 4

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, off-going nurse: Taylor, this is Elena Martinez in 412, and she needs close attention tonight. At 6:45 she was newly confused and clammy, and said she felt dizzy sitting up. Her blood pressure was 96 over 58, down from 128 over 76 at two this afternoon, and her heart rate was 112, up from 82. I'm concerned about the change.

  2. Taylor Brooks, oncoming nurse: Got it. What's pending?

  3. Jamie: Dr. Morgan is on the way and will assess her at the bedside by 7:00. A full set of vitals is due at 6:50. The plan is for someone to stay with her until the oncoming nurse takes over, and to call Dr. Morgan sooner if she gets less responsive or her pressure drops further.

  4. Taylor: Okay. I'll keep an eye on her.

  5. Jamie: She's 68 and post-op day one after abdominal surgery. She was alert and oriented earlier. She has hypertension, and her usual blood pressure medication was held this morning. That's everything.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 1:56

Recording 5

Bedside shift report, patient present

Jamie Carter, off-going nurse · Elena Martinez, patient · Taylor Brooks, oncoming nurse

Read before listening

Scenario card for Recording 5

Bedside shift report, patient present

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is just before 6:50 p.m. on 4 North, shortly before the 7:00 p.m. shift change. Jamie Carter, the off-going nurse, is handing Elena Martinez over to oncoming nurse Taylor Brooks at the bedside. Ms. Martinez is in room 412, and her medical record number ends in 4821. Room 412 is a single room with the door closed. She is awake and can hear the handoff.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by covering physician Dr. Alex Morgan.

She may ask whether her nurse is leaving or say that she still does not feel right, and she may acknowledge the oncoming nurse at the close. Nothing she says adds a fact that is not already on this card.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Already pending before this handoff

  • Dr. Morgan is on the way and has agreed to assess Ms. Martinez at the bedside by 7:00 p.m.
  • A complete vital-sign set is due at 6:50 p.m.
  • The responsible nurse is to remain with her and call Dr. Morgan sooner if she becomes less responsive or her blood pressure falls further.

These actions are conditions of the fictional exercise. They are not a treatment recommendation or a universal shift-handoff process. The exercise does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the handoff, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 5

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, off-going nurse: Ms. Martinez, this is Taylor Brooks. Taylor is going to be your nurse tonight, and I'm going to hand over right here so you can hear everything and tell us if I get anything wrong.

  2. Elena Martinez, patient: Are you leaving? I still don't feel right.

  3. Jamie: I know you don't, and that's what we're going to talk about. I'm staying until Taylor has taken over, and Dr. Morgan is on the way. Taylor, this is Elena Martinez in 412, post-op day one after abdominal surgery. At 6:45 she was newly confused and clammy, and told me she felt dizzy sitting up. Her blood pressure was 96 over 58, down from 128 over 76 at two this afternoon, her heart rate 112, up from 82, her respirations 22, up from 16, and her sat 95 percent on room air, down from 97. I'm concerned about the change.

  4. Taylor Brooks, oncoming nurse: Understood. What's been agreed, and what's still pending?

  5. Jamie: Dr. Morgan will assess her at the bedside by 7:00. A full set of vitals is due at 6:50, and whoever has her is to call Dr. Morgan sooner if she gets less responsive or her pressure drops further. She has hypertension, and her usual blood pressure medication was held this morning.

  6. Taylor: Okay. I'm taking over her care from now. I'll get the full set at 6:50, I'll stay in the room until Dr. Morgan is here by 7:00, and I'll call Dr. Morgan sooner if she's less responsive or her pressure drops further. Ms. Martinez, I'm Taylor. I'm your nurse now, and I'm staying with you until the doctor has seen you.

  7. Ms. Martinez: Alright. Thank you.

  8. Jamie: That's everything, Taylor. Ms. Martinez, Taylor and I have reviewed the changes and the plan, and she's staying with you.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 1:36

Recording 6

Covering-physician call

Jamie Carter, bedside nurse · Dr. Alex Morgan, covering physician

Read before listening

Scenario card for Recording 6

Covering-physician call

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is 6:45 p.m. Jamie Carter, the bedside nurse, is calling covering physician Dr. Alex Morgan about Ms. Martinez in room 412. Her medical record number ends in 4821.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by the covering physician.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Controlled-design note: This is a fourth version of the same 6:45 p.m. call. What changes is how the receiver replies. It is part of the controlled exercise, not a treatment recommendation.

The exercise begins after the fictional unit has identified the covering-physician call as one required communication step. It does not model whether a rapid-response or code process should also be used.

Listen to the conversation, then make five private judgments about the reason for the call, background, stated concern, next step, and confirmed ownership. There is no score or expert answer.

Listen

The handoff for Recording 6

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Jamie Carter, bedside nurse: Dr. Morgan, this is Jamie Carter on 4 North, calling about Elena Martinez, MRN ending 4821, in room 412. At 6:45 she's newly confused and clammy. Her blood pressure is 96 over 58, down from 128 over 76 at two this afternoon, her heart rate is 112, up from 82, her respirations are 22, up from 16, and her sat is 95 percent on room air, down from 97. I'm concerned she's deteriorating, and I need you to assess her at the bedside by 7:00.

  2. Dr. Alex Morgan, covering physician: Jamie, I'm in the ED with two admissions and I can't get up there right now. Recheck her in an hour and call me back if she's worse.

  3. Jamie: I understand you're tied up. She was alert and oriented earlier and now she isn't, and her pressure and heart rate have both moved the wrong way since two this afternoon. I'm not comfortable waiting an hour.

  4. Dr. Morgan: I hear you. I really can't leave the ED yet. Get vitals at 6:50 and call me with those.

  5. Jamie: I'll get vitals at 6:50 either way. Dr. Morgan, I'm concerned she's deteriorating, and I need you to assess her at the bedside by 7:00. If you can't be here by 7:00, I'm going to ask the charge nurse to contact Dr. Okafor, the attending surgeon.

  6. Dr. Morgan: I'm on my way. I'll be at the bedside by 7:00. Get vitals at 6:50. Since it's almost shift change, stay with her until the oncoming nurse takes over. Call sooner if she gets less responsive or her pressure drops further.

  7. Jamie: Got it. Vitals at 6:50, I'll stay with her until the oncoming nurse takes over, and I'll call you sooner if she gets less responsive or her pressure drops further. And you'll be here by 7:00.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Audio handoff · 0:56

Recording 7

Critical result, lab to nurse to physician

Riley Nguyen, laboratory technologist · Jamie Carter, bedside nurse · Dr. Alex Morgan, covering physician

Read before listening

Scenario card for Recording 7

Critical result, lab to nurse to physician

Elena Martinez, 68, is post-operative day 1 after abdominal surgery on 4 North.

It is 6:52 p.m. on 4 North. Jamie Carter is still the nurse responsible for Elena Martinez in room 412, and her medical record number ends in 4821. The shift handoff has not yet taken place. At 6:45 Jamie called covering physician Dr. Alex Morgan about Ms. Martinez's new confusion and changed vital signs.

Ms. Martinez has a history of hypertension, and her usual blood pressure medication was held this morning. She was alert, oriented, and conversing normally earlier in the shift.

Jamie is concerned that the current change may represent deterioration. For this fictional exercise, the unit team has already identified the change as needing review by the covering physician.

For this fictional exercise, an evening complete blood count was drawn at 6:10 p.m. Riley Nguyen, laboratory technologist, telephones the result, reported 6:52 p.m., to the unit. Hemoglobin was 12.4 g/dL on the morning before surgery and is 6.8 g/dL on this draw. The laboratory reports it as a critical value under its own policy and requires a read-back. That designation is a condition of this exercise, not a statement about what hemoglobin value is critical in general.

The 6:45 commitment stands: Dr. Morgan will assess Ms. Martinez at the bedside by 7:00 p.m., a complete vital-sign set is due at 6:50 p.m., the responsible nurse is to remain with the patient until the oncoming nurse has taken over at the 7:00 p.m. shift change, and to call Dr. Morgan sooner if she becomes less responsive or her blood pressure falls further. Dr. Morgan is about two minutes from the unit. That vital-sign set is not part of this recording.

Earlier and current vital signs for the fictional patient
Vital sign2:00 p.m.6:45 p.m.
Blood pressure128/76 mmHg96/58 mmHg
Heart rate82/min112/min
Respiratory rate16/min22/min
Oxygen saturation97% on room air95% on room air
Temperature98.4 degrees Fahrenheit98.8 degrees Fahrenheit

Ms. Martinez is now confused, feels clammy, and reports dizziness when she sits up.

Controlled-design note: The recording contains two calls: the laboratory to Jamie, then Jamie to Dr. Morgan. Dr. Morgan's commitment from the 6:45 call is already in force. It is part of the controlled exercise, not a treatment recommendation.

The exercise begins after the fictional unit has identified the covering-physician call as one required communication step. The critical designation belongs to the fictional laboratory's policy. The exercise does not model whether a rapid-response or code process should also be used, and no part of it asks what the hemoglobin value means clinically.

Listen to both calls, then make five private judgments about the second call in particular, and note where the first call helps you judge the second. There is no score or expert answer.

Listen

The handoff for Recording 7

Fictional case. Synthetically voiced conversation. These cases use US-English voices and familiar US nursing roles. This activity asks you to judge communication behavior, not clinical correctness. The vital signs describe this patient and are not escalation thresholds. The stated arrival times are fictional communication commitments, not recommended waiting periods. A promised arrival does not suspend ongoing assessment or local escalation procedures, and deterioration can require action sooner. Adapt role names and expectations to your institution's policy.

Before playing: Listen once without stopping. Make your five private judgments before revealing the discussion lens.

Transcript and timestamps

  1. Riley Nguyen, laboratory technologist: 4 North? This is Riley in the lab with a critical result on Elena Martinez, MRN ending 4821.

  2. Jamie Carter, bedside nurse: This is Jamie Carter, I'm her nurse. Go ahead.

  3. Riley: Hemoglobin from the 6:10 draw is 6.8 grams per deciliter. That's a critical value, so I need a read-back.

  4. Jamie: Reading back: Elena Martinez, MRN ending 4821, hemoglobin 6.8 grams per deciliter from the 6:10 draw, received at 6:52.

  5. Riley: That's correct. Reported to Jamie Carter at 6:52.

  6. Jamie: Dr. Morgan, it's Jamie on 4 North again about Ms. Martinez in 412. The lab just called a critical hemoglobin of 6.8 from the 6:10 draw. Her pre-op was 12.4.

  7. Dr. Alex Morgan, covering physician: Okay. Noted. I'm two minutes out.

  8. Jamie: Okay. See you in a couple of minutes.

Private check

What did you hear?

0 of 5 selected

Your selections stay in temporary browser state. They are not submitted, scored, compared, or saved, and they disappear when you refresh.

Clear
I heard enough evidence that this behavior was achieved.
Needs discussion
I heard evidence that this behavior was incomplete or unclear.
Not sure
I cannot decide from the recording or would need local context or policy.
1. Was the priority or reason for the call or handoff clear early?
2. Was enough relevant background provided, without unnecessary detail?
3. Did the speaker state an assessment or concern, rather than only reporting facts?
4. Was the expected next step clear, including its urgency or by-when?
5. Did the receiver confirm who would do what and by when?

You can reveal the discussion lens at any time. Completing the private check is optional.

Take it into the room

Facilitate without rebuilding the activity

The printable pack includes the boundaries and timing, the suggested pairings, a self-contained section for each recording, and a reusable blank discussion sheet.

Download the facilitator packExplore the SBAR station

Context question at the end of the guide. Would you use a version developed specifically for another healthcare context?

Version 1.2. The facilitator materials in this discussion pack are licensed under Creative Commons Attribution 4.0 International (CC BY 4.0).

Practical details

Questions faculty may have

Is this a validated SBAR assessment?
No. It is a formative discussion resource. The five judgments help a group make its reasoning visible, but they do not produce a score, benchmark, or claim about competence.
Why does this pack use US-English voices?
This first edition uses US-English voices, role names, and terminology. The communication activity is adaptable to local roles and policy. Educators can register one-tap interest on this page for an India, UK, or Australia edition.
Are my judgments submitted or saved?
No. Your selections remain only in temporary browser state. They are not sent to Lingua CoPilot, compared with other users, or stored after a refresh.
Does the discussion lens teach the correct clinical response?
No. The fixed fictional facts make the communication observable. Some judgments are genuinely arguable in both directions. The lens gives a primary reading alongside the competing interpretations, and does not present any of them as an answer key. The activity does not replace local rapid-response criteria, escalation policy, clinical judgment, or faculty-reviewed teaching material.
How long does the activity take?
Allow about 10 minutes for one recording. The pack suggests pairings for 20-minute activities, so faculty can choose material for one class rather than working through all seven. The recordings are alternative versions and related situations on one fictional patient, not seven consecutive events.
Can learners use the pack directly?
Yes. Learners should judge from this page, where the lens stays closed until they reveal it, or from the reusable discussion sheet at the back of the pack, which carries the five judgments and no interpretation. The rest of the facilitator pack deliberately includes the quality labels and discussion lenses for session preparation, so it is not the learner copy.