Table 2 Functions of in-situ simulation in healthcare
ISS approach Scoping studies | Objective | Object of enquiry | Not suitable for | Outcomes |
|---|---|---|---|---|
Explore why events occur in complex settings; enable learning from critical or significant untoward incidents | Healthcare systems, processes, environments, pathways and procedures | Individual assessment of performance; incidents considered to have obvious single causes | Identifying and addressing system weaknesses (“latent factors”) to improve quality and safety | |
Design and testing of new work systems and processes including clinical spaces, equipment, information technologies, procedures and pathways | Clinical environments; pathways; complex procedures; equipment performance in dynamic settings; organisational readiness | Behavioural change: the focus is on improving the work system, environment or equipment to meet staff or patient needs | Proactive identification of anticipated unintended consequences; improve efficiency by addressing issues including flow, usability, accessibility and familiarity of space / equipment / procedures | |
Prepare [4, 5, 8, 38,39,40,41, 43, 46, 48,49,50,51, 53, 56, 57, 60, 62] | Practice and develop capability of individuals and team performance | Individual and team performance; non-technical skills and team behaviours; adaptability in performance and resilience during high consequence events | Scenarios which do not involve clinical teams or dynamic settings | Understand the roles and responsibilities of team members and the impact of the clinical environment; identify latent threats and vulnerabilities; improve systems, processes and identify learning needs |
Assess competency in complex clinical settings | Formative or summative assessment of individual and team performance | Organisations which do not foster a ‘just culture and safe learning environment’ | Reduce the theory and practice gap; ensure preparation of staff for real world experiences and identify further learning needs; offer assurances to patients, public, employers and regulators |