In Situ simulations are those that occur in the actual clinical environment. In Situ hospital team training provides an opportunity to improve interdisciplinary team dynamics and communication as well as to identify unit-based key systemic errors, in many cases, more effectively than similar training conducted offsite, at the Simulation Center.
Safety Considerations
- All simulated medications should be clearly labeled “for simulation use only” to prevent confusion with actual clinical supplies – can also use food colouring to distinguish more clearly
- There must be adequate staffing during the exercise to ensure patient care is not interrupted.
- Following the simulation, a debriefing, led by a qualified instructor, should take place with all participants. Breakdowns in communication and teamwork and contributing conditions in the work environment will be highlighted during the debriefing.
- Follow-up activities or countermeasures to be implemented as a result of patient safety or systems issues identified through the simulation should be clearly documented and communicated to the team and leadership of the local department.
Depending on the learning objectives of the in situ simulation participants may or may not be made aware ahead of time when it is going to occur. When appropriate be sure to do a pre-brief and if not be prepared to coach participants in the moment to treat it as real and act as they normally would. The debrief is very important to allow participants to identify knowledge and process gaps and to make recommendations for improvement so be sure to allocate sufficient time for this discussion.
In addition to supplying Manikins and equipment for in situ simulation, CSTAR has experienced staff who can work with you to plan and prepare for a successful event. For more information, click here. If you will be doing simulations on a regular basis it is good to label and save any consumable supplies for reuse in a future simulation.
Articles and Resources
- Setup and Execution of In Situ Simulation, Victoria Tapia; Muhammad Waseem.
- In Situ Debriefing in Medical Simulation, Kimberly Schertzer; Laryssa Patti.