International Journal of Healthcare Simulation

Background:

The use of in situ simulation (ISS) within the Emergency Department (ED) has been widely accepted and has shown to be a valuable teaching tool ^[1]. At Mid-Yorkshire NHS Trust, we have been running weekly ISS since October 2020. Within the ED, systems and protocols are frequently audited, guidelines often change, and it can be challenging to disseminate this information. After identifying a clinical need for a cardiac arrest proforma, we considered how best to introduce it. We decided to utilize our weekly ISS to provide a valuable learning opportunity.

Aims:

The aim of the study was to evaluate the effectiveness of using ISS as a learning opportunity to disseminate and trial the introduction of a new cardiac arrest proforma.

Method:

We ran the scenario on two separate occasions involving 11 participants. The simulation involved a low-fidelity manikin and a simulated monitor app. Real equipment is used and the simulation is run in real-time – learners were encouraged to manage the patient as they would in real life. Learners include doctors, nurses, healthcare assistants and student nurses/doctors. Learners are briefed prior to the simulation; in this particular case, the learners were informed that we would be utilizing a cardiac arrest proforma and encouraged to use this. The learners are then debriefed using a promoting excellence and reflective learning (PEARLs) framework and discussion amongst themselves is central to the debrief framework ^[2]. The purpose of this simulation was multi-faceted; firstly, to discuss the team’s management of cardiac arrest and learning around this and, secondly, to discuss the use of the proforma to improve teamwork and patient care. Learners were asked to complete a feedback form.

Results:

Feedback obtained from this simulation concluded that it was a valuable learning opportunity. Figure 1 shows the results of learner responses (n = 11). The scale included was 5 (strongly agree) to 1 (strongly disagree) – an average of responses is included within the graph.

Implications for practice:

Using ISS to trial our proforma allowed us to implement it within the ED. Collating feedback allowed us to make amendments to our proforma based on multi-disciplinary opinions. As well as recognizing that ISS can be used to achieve this purpose, it also provided a valuable learning opportunity. ISS can be used in future to introduce new guidelines, distribute vital information and provide learning.