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21 Never events in simulation: emotional and professional safety for candidates and facilitators
  1. Amit Mishra,
  2. S Tavabie
  1. Brighton and Sussex University Hospital, UK


Background Simulation has always focused on improving patient safety, either by allowing training to be carried out using manikins/actors instead of real patients or by developing processes which can be transferred to the care of patients. However, safety of candidates and facilitators during a simulation exercise have not been sufficiently explored.

Methodology We present 2 cases from our experience where the safety of candidate and/or facilitator could have potentially been compromised.

In case 1, a candidate froze during the simulation and could not perform cardio-pulmonary resuscitation in a timely fashion. The debrief was confrontational and charged with emotion. There was finger pointing at the candidate. There was silence and a collective grief reaction within the candidate group.

In case 2, a candidate wrote a difficult email after a course, where he described how he had “come away very shaken by (his) own inability to function under pressure” and how it had “left (him) very unhappy at the thought of taking up a further placement”. It had “ultimately left (him) questioning whether (he is) safe to continue”.

Result We would like to explore, by way of a workshop, potential pitfalls within simulation courses where the emotional and professional safety of the candidates and the facilitators may be compromised. We wish to highlight how a sub-optimal experience during a simulation course may be the never event we need to be guard against.

Potential impact Simulation is employed as a teaching tool. It is not expected to be an assessment, and a degree of confidentiality is expected by the candidates. Moreover, it is supposed to be a safe environment for candidates and facilitators to learn and impart learning.

We would like to discuss ways in which the safety of candidates and facilitators can be maintained in this high-risk high-stakes environment.

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