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Table 2 Comparison of traditional simulation-based education with the LFS approach, based on selected phases of the simulation setting [72]

From: Variation and adaptation: learning from success in patient safety-oriented simulation training

Simulation setting phases Traditional approach Learning from good performance approach
Pre-briefing and setting introduction Emphasis on the extra-ordinary and possibility to train rare, critical, sensitive, and complex situations.
The debriefer as (facilitating) expert.
Emphasis on the value of existing mundane practice.
The debriefer as partner in the common learning process.
Scenario Conduct Aim to find the edges of the participants’ competences.
Generation of stressful conditions.
Use of error traps to generate debriefing-related experiences.
Complex scenarios in regards to clinical care, human factors issues, and the use of the simulation.
Aim to work through common scenarios including systematic variation along the FRAM [7] aspects:
• Trigger for an action
• Outcome of an action
• Prerequisites for an action
• Resources needed while action is performed
• Time aspects
• Control mechanisms and rules for the action
Debriefing Focus on failure and how to avoid them.
Positive performance mentioned and praised, but not analyzed.
Focus on events “sticking out”: gaps and peaks—failures and good ideas.
Focus on how to systematically produce good performance by adjusting team and care processes to the context.
Focus on the deep analysis of good performance and how to reproduce and re-apply it.
Focus on performance within the corridor of normal performance.
  1. The table emphasizes the contrasts. In practice, both approaches will overlap considerably and/or supplement each other