GENESISS 2—Generating Standards for In-Situ Simulation project: a systematic mapping review

Abstract

Background In-situ simulation is increasingly employed in healthcare settings to support learning and improve patient, staff and organisational outcomes. It can help participants to problem solve within real, dynamic and familiar clinical settings, develop effective multidisciplinary team working and facilitates learning into practice. There is nevertheless a reported lack of a standardised and cohesive approach across healthcare organisations. The aim of this systematic mapping review was to explore and map the current evidence base for in-situ interventions, identify gaps in the literature and inform future research and evaluation questions. Methods A systematic mapping review of published in-situ simulation literature was conducted. Searches were conducted on MEDLINE, EMBASE, AMED, PsycINFO, CINAHL, MIDIRS and ProQuest databases to identify all relevant literature from inception to October 2020. Relevant papers were retrieved, reviewed and extracted data were organised into broad themes. Results Sixty-nine papers were included in the mapping review. In-situ simulation is used 1) as an assessment tool; 2) to assess and promote system readiness and safety cultures; 3) to improve clinical skills and patient outcomes; 4) to improve non-technical skills (NTS), knowledge and confidence. Most studies included were observational and assessed individual, team or departmental performance against clinical standards. There was considerable variation in assessment methods, length of study and the frequency of interventions. Conclusions This mapping highlights various in-situ simulation approaches designed to address a range of objectives in healthcare settings; most studies report in-situ simulation to be feasible and beneficial in addressing various learning and improvement objectives. There is a lack of consensus for implementing and evaluating in-situ simulation and further studies are required to identify potential benefits and impacts on patient outcomes. In-situ simulation studies need to include detailed demographic and contextual data to consider transferability across care settings and teams and to assess possible confounding factors. Valid and reliable data collection tools should be developed to capture the complexity of team and individual performance in real settings. Research should focus on identifying the optimal frequency and length of in-situ simulations to improve outcomes and maximize participant experience.

Simulação in situ de parada cardíaca em fibrilação ventricular para o treinamento de profissionais de enfermagem

“…A simulação in situ não anunciada pode apresentar algumas vantagens em potencial, como avaliação de aspectos organizacionais da unidade, sem uma preparação prévia dos profissionais, contudo, este fato pode desencadear mais estresse psicológico na equipe. 11 Em relação aos cenários na simulação in situ, os manequins empregados podem ser de baixa, média e alta-fidelidade, dependendo da disponibilidade dos mesmos. Contudo, mesmo o uso de manequins de baixa fidelidade, parece ser efetivo para os objetivos de aprendizagem, permitindo a realização desta atividade mesmo em hospitais com menos recursos financeiros.…”

Exploring the safety and quality of mobile X-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study

“…10 In order to understand and assess complex clinical work, in situ simulation studies are usually conducted in fully functioning healthcare facilities. 11 However, addressing issues relating to the built environment after patients have been admitted can be expensive and disruptive. 5 Therefore, some facilities have used in situ simulation to evaluate new spaces in the postconstruction phase, prior to occupation 12 ; examples include a paediatric intensive care unit (ICU) 9 ; outpatient clinics 1 ; trauma operating rooms 13 ; neonatal intensive care 9 14 ; maternal care 15 ; emergency departments [16][17][18][19] and whole hospital transition.…”

Evaluating the safety and quality of portable x-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study

“…In situ simulations conducted in actual clinical environments, rather than in simulation centres, are an effective method used in healthcare to: understand why critical incidents occur; practice and develop individual/team capability; assess individual/team competency; and design and test new clinical spaces and equipment (10). In order to understand and assess complex clinical work, in situ simulation studies are usually conducted in fully functioning healthcare facilities (11). However, addressing issues relating to the built environment after patients have been admitted can be expensive and disruptive (5).…”