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Simulation on the job: an intensive care unit’s report of how in situ simulation has impacted on human factors and ergonomics in the workplace
  1. Sarah Chetcuti,
  2. Kaushik Bhowmick
  1. Department of Anaesthesia and Critical Care, West Suffolk NHS Foundation Trust, Bury St Edmunds, Suffolk, UK
  1. Correspondence to Dr. Kaushik Bhowmick, Anaesthesia and Intensive Care Medicine, West Suffolk NHS Foundation Trust, Suffolk IP33 2QZ, UK; Kaushik.Bhowmick{at}

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Simulation has become a well-integrated part of traditional medical education training. Its advantages have been thoroughly described in the literature with specific emphasis on patient safety. Despite this, its adoption into post-graduate education is limited for a number of reasons including high cost, disruption to clinical duties and inability to recreate nuances of real-life environments. Also, high-fidelity simulation is restricted to a few specialised centres as it is perceived to require dedicated sophisticated equipment.

We describe the development of an in situ simulation programme within an intensive care unit (ICU) to simulate clinical and non-clinical situations with an aim to improve both human factors and clinical skills within a multiprofessional team.


The ICU at the West Suffolk Hospital is a 12-bedded unit which admits approximately 450 patients per year. A simulated ICU bed space was recreated using our Laerdal SimMan EssentialTM, borrowed from our sim-centre however actors also occasionally played the simulated patient. ICU equipment including commonly administered drugs were also made available.

The simulated patient was discussed in routine morning handover ensuring any priorities were relayed to the team. Assessment of the simulated station took place on a routine ward round or earlier according to clinical urgency. A multiprofessional approach to assessment and management was encouraged. The simulated cases were developed with specific learning …

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  • Funding We declare that we have not received any specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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