Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

Abstract

Objective: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. Methods: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations.Results: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations. Scenario participant responses showed significantly higher ratings for the centre-based simulations for respiratory rate (P = 0.007), pulse (P = 0.036), breath sounds (P = 0.002), heart sounds (P < 0.001) and patient noises (P < 0.001). There was a significant difference in overall rating of the scenario reality by scenario participants in favour of the centre-based simulations (P = 0.005); however, there was no significant difference when rating participant engagement (P = 0.11) and participant learning (P = 0.77). With the centre-based scenarios, nurses rated the reality of the respiratory rate (P < 0.001), blood pressure (P = 0.016) and abdominal signs (P = 0.003) significantly higher than doctors. Nurses rated the overall reality higher than doctors for the centre simulations (96.8% vs 84.2% rated as realistic, P = 0.041), which was not demonstrated in the in situ scenarios (76.2% vs 73.5%, P = 0.65). Conclusion: Some aspects of in situ simulations may be less 'real' than centre-based simulations, but there was no significant difference in selfreported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning.

In situ simulation training in helicopter emergency medical services: feasible for on-call crews?

“…Another possible success factor might be that the crew, in order to minimize time-wasting, went straight from the HEMS base resting area to the brief for simulation and then straight into the simulation itself. We chose a basic manikin, which in a recent study was found to be as effective as a high fidelity manikin in inducing participant self-reported engagement and learning [18].…”

Adaptación de entornos de simulación para mejorar la experiencia formativa.Un estudio de caso de la actividad de simulacionistas en un servicio de urgencias prehospitalarias en Uruguay

“…Contar con un instrumento validado para medir los resultados de este programa podría ser parte de un proceso de posterior mejora. 25 Es posible que el entrenamiento de las habilidades técnicas y no técnicas en los escenarios de emergencia prehospitalaria se vea reflejada en una mejora global de los resultados clínicos y la calidad de atención de los pacientes y sus familias.…”

Evaluation of the feasibility and impacts of in situ simulation in emergency medicine—a mixed-method study protocol

“…In addition, few studies exist on the importance of realism in simulation, but the importance of training in conditions close to real practice has already been shown. 32 For all these reasons, we are working in close partnership with important knowledge users from our institution towards a single, shared goal to improve patient safety. Publications in peer-reviewed journals and international conferences presentations are also planned.…”