Background In situ mobile simulation is a useful tool for the delivery of teaching in the clinical environment. It has known advantages over conventional simulation teaching in an artificial environment, both in terms of flexibility and realism. This type of simulation allows for the delivery of both planned and unplanned simulation teaching. Croydon University Hospital has several in situ simulation training programmes established in various departments. We wanted to evaluate unplanned versus planned in-situ mobile simulation and its impact on team learning outcomes and create an environment to support behavioural change.
Methods Our primary focus was on evaluating which type of simulation best achieved the learning needs of the participants. Prior to the simulations, learning outcomes were developed with the participating teams. These were used to develop focussed simulation scenarios to incorporate their needs. Over a course of 4 months several planned and unplanned in-situ mobile simulations were carried out. Each simulation scenario was followed by a team debrief. These simulations were evaluated using a participant feedback questionnaire focussing on how successfully their learning outcomes were achieved. We compared the feedback between the unplanned and planned groups.
Results Both types of simulation were carried out in A&E, paediatrics, obstetrics and the acute medical unit. The feedback from the planned simulations suggested that the participants were able to use the teaching to consolidate and update their knowledge. The unplanned simulations were more beneficial in achieving the non-technical learning outcomes, such as co-ordinating emergency responses.
Conclusions Both planned and unplanned mobile simulations have the benefit of training staff in their own working environment. Our results showed there were advantages of both planned and unplanned in situ simulation in enhancing individual team resilience to managing unexpected events. As a result we will continue to use blended methods to continue to nurture learning culture.
Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In situ simulation in continuing education for the health care professions: a systematic review. J Contin Educ Health Prof 2012;32(4):243–54
Walker ST, Sevdalis N, McKay A, Lambden S, Gautama S, Aggarwal R, Vincent C. Unannounced in situ simulations: integrating training and clinical practice. BMJ Qual Saf 2013;22(6):453–8
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