Simulation does not have to cost a lot of money or require expensive equipment. Effective, engaging simulations can be created with low-tech resources, such as creating a conjoined twin simulator from two store-bought baby dolls attached to each other.30 Simulations conducted in situ take advantage of settings and equipment that are inherently realistic.
Many organizations have invested in simulators and simulation centers. Elaborate or specialized simulators may be useful, but only if they align with the goals of the simulation. Simulation centers may not fully replicate patient care conditions, but they allow more reliable control of the physical environment, scheduling, and replicability.
Experienced simulationists can optimize the planning and conduct of simulations. Simulationists come from diverse professional backgrounds and are often individuals who are passionate about healthcare education, research, and systems improvement and seek tools to advance those objectives.
In Situ Team Training in Primary Care Emergency Teams
Brandstorp and colleagues found that challenging, monthly emergency in situ team trainings organized by local health personnel, including a review, realistic simulations, and debriefings, facilitated many types of learning. “In situ team training was experienced as challenging, engaging, and enabling.”31
As the field is relatively young and rapidly evolving, developmental pathways for simulationists include both experiential learning and formal training ranging from multiday courses to master’s degrees. Many simulationists have backgrounds in clinical care, and some have backgrounds in educational theory, human factors, systems and other types of engineering, psychology, technology, theater, and patient safety. Many draw from more than one field of expertise.
Much can be accomplished and learned even with limited resources and some creativity. The literature is now full of examples of ways simulation can improve patient safety in a variety of practice settings.1,8,11,12,20-22 What may be most important are:
- Clarity about the purpose and goals of individual simulations or the simulation program as a whole.
- Thoughtful design of simulations and selection of simulators.
- Proper preparation of potential participants before simulations.
- Skilled debriefing after simulations, with lessons regularly shared to inform quality and safety activities.
While implementing simulation requires time, an advocate or champion, and skilled facilitation, its benefit to healthcare quality and patient safety makes it an invaluable resource.
