In-situ Simulation in the Emergency Department

This month, JC will be looking at simulation medicine and in particular in-situ simulation. Although many of our SIM lab experiences seem far removed from what actually happens at the bedside, there is pretty good evidence that even the most basic hands-on SIM experience is better than no experience. This is particularly notable with uncommonly encountered ED procedures such as cricothyrotomy, precipitous ED delivery or neonatal resuscitation. In-situ simulation occurs within the context of the actual ED environment and is incorporated into the workflow of your busy ED shift. Sounds like fun eh? Actually, when properly designed and implemented, in-situ SIM has been reported to be a highly valued educational and QI activity among ED staff. We will look at some of the available evidence on its utility, suggestions for successful implementation and the characteristics of an effective debriefing environment. 

McGaghie WC et al, Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011 Jun;86(6):706-11  Appraisal

Whitfill T et al, A Simulation-Based Quality Improvement Initiative Improves Pediatric Readiness in Community Hospitals. Pediatr Emerg Care. 2017 Jul 17  Appraisal

 Patterson MD, In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual 2013 Jun 22(6):468-77.  Appraisal

 Couto TB et al, Teamwork skills in actual, in situ, and in-center pediatric emergencies: performance levels across settings and perceptions of comparative educational impact. Simul Healthc. 2015 Apr;10(2):76-84. Appraisal