International Journal of Healthcare Simulation
Adi Health+Wellness
133 Establishing An Inter-Professional in situ Simulation (ISS) Programme in District General Hospital Emergency Departments (EDS)
DOI 10.54531/ARYJ8432, Volume: 1, Issue: Supplement 1, Pages: A12-A13
Article Type: In Practice, Article History

Table of Contents





In situ simulation (ISS) is an effective educational tool that improves patient safety outcomes [1]. It has been trialled previously in this trust but not regularly and many staff members had never participated. Anticipated challenges included freeing staff from clinical duties, scepticism about simulation training and technical issues.


The aim of the study was to establish a regular programme of inter-professional ISS delivered by a dedicated team in the emergency department (ED).


An ED simulation team was created, including consultants, a senior registrar and two newly appointed simulation junior clinical fellows. Sessions run monthly in both EDs in the trust, taking place in the ‘green’ resus area, in the morning when clinical demand is usually lowest. Participants include doctors and nursing staff of all grades, with cross-speciality involvement. Increasing participation required was influenced by senior management and clinical staff agreeing this was a necessary and valuable tool. Faculty include the ED simulation team and a simulation technician. Scenarios are developed by the team with specific intended learning outcomes, e.g. ALS in COVID-19, assessment of the acutely unwell pregnant patient. Intended learning outcomes are influenced by new guidelines, specific emergency cases or skills and suggestions by staff. The patient has been trialled as an actor and/or SimMan3G, depending on the scenario. Clinical equipment is mostly donated and expired. A structured debrief is led by a senior simulation team member. Key learning from each session is summarized in a ‘Sim News’ poster which is tweeted, disseminated via email to all staff and published on the departmental ‘EMBeds’ website. Participants fill in an anonymous feedback form online and receive a certificate of participation.


Fifty-nine participants from December 2020 to April 2021 gave feedback (see Table 1). Comments included ‘…helped me learn my anaphylaxis protocol’, ‘Teamwork and communication are vital’.
Table 1:
Feedback form results
This simulation session…Average score (10 – strongly agree, 1 – strongly disagree)
…improved my clinical knowledge9.63
…made me more familiar with my working environment9.58
…taught me about current guidelines9.68
…helped me improve my team working9.84
…helped me improve my leadership skills9.21
…helped me improve my communication skills9.53
I enjoyed this simulation session9.74
I would feel more confident managing a similar situation in the future9.58
Simulation is a valuable tool in my training9.74

Implications for practice:

The in situ programme has successfully educated staff; led to changes in guidelines published on ‘EMBeds’; and identified and corrected problems relating to the clinical environment. Staff have found it an enjoyable and valuable experience. The next steps are to increase the frequency of sessions, expand faculty to include a paid senior staff member and include further clinical teams such as blood bank, trauma team and other specialities.

Green, Smith, Elsheikh, and Razaq: 133 Establishing An Inter-Professional in situ Simulation (ISS) Programme in District General Hospital Emergency Departments (EDS)



Goldshtein D, Krensky C, Doshi S, Perelman V. In situ simulation and its effects on patient outcomes: a systematic review. BMJ Simul Technol Enhanc Learn. 2020:6;39. Available from: (accessed 16 June 2021). Establishing An Inter-Professional <i>in situ</i> Simulation (ISS) Programme in District General Hospital Emergency Departments (EDS)&author=&keyword=&subject=In Practice,