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0026 Development of an in-situ trauma simulation programme at the royal surrey county hospital
  1. Matthew Evans,
  2. Suzi Lomax,
  3. Justin Kirk-Bayley,
  4. Kathryn Gill,
  5. Lorraine Anderson,
  6. Monica Minardi,
  7. Wayne McGearey
  1. Royal Surrey County Hospital, Guildford, UK


Background In situ, multidisciplinary, simulation training is known to improve early trauma care,1 providing staff with relevant, targeted non-technical skills training within real clinical teams.2 Deficits in early trauma care at our institution had been identified. Consequently, an in-situ MDT trauma simulation programme has been developed. The programme has two key aims, firstly to assess and improve technical and non-technical skills, and secondly the concurrent identification of latent errors within the clinical environment to improve trauma care.

Methodology An MDT working party with representation by senior staff from the departments of orthopaedics, emergency medicine, anaesthetics and intensive care was established. Following this, a preliminary survey was distributed to all trauma team staff. Regular trauma call simulations were then delivered unannounced in the ED with structured debrief, evaluation form completion, identification of latent errors and recording of recommendations. These recommendations were escalated to the clinical governance leads.


  1. Preliminary Survey (101 Responders)

    • 21% – had undertaken in-situ simulation.

    • 97% – MDT trauma simulation would improve practice.

  2. Post-Simulation Evaluation (15 Attendees)

    • 93% – in-situ simulation was beneficial (Rating: 5 out of 5).

    • 100% – further simulations would improve practice.

  3. Latent Errors

    • Lack of team member introductions and role allocation.

Conclusion and recommendations This programme not only provides opportunities to train transient trauma team members in a relevant clinical environment, with highly rated feedback, but has also identified an opportunity for a new trauma team brief to improve communication and team working. This trauma team brief, analogous to the WHO checklist prior to surgery, is currently being developed by the MDT working party, with the aim of improving team working and patient care during trauma calls.


  1. Steinemann S, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ 2011;68:472–477

  2. Walker ST, et al. Unannounced in situ simulations: integrating training and clinical practice. BMJ Qual Saf 2013;22(6):453–458

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