Study | Aim | Intervention | Control group | In situ/ex situ | Fidelity level (low vs high level mannequin) | Re-test (skill retention) | Outcomes measure | Main results |
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Bond et al. [22] | To share the development of a telehealth solution for shared awareness between the in situ simulation professionals and the ED bedside team caring for the in situ simulated patient, and the eICU nurses participating via telehealth. | 3/4 days workshop with in situ simulation. Site A: 3 sim days Site B: 4 sim days | No | In situ | Patient played by an actor and vital signs generated by Laerdal SimMan. | No | Pre-post self-confidence in using telehealth. Pre-post self-confidence in managing ED patients with sepsis. | Telehealth was feasible with the equipment of choice. Pre-post self-confidence in using telehealth increased from a mean ± SD of 5.3 ± 2.9 to 8.9 ± 1.1 (Δ3.5, p < 0.05). Self-confidence in managing ED patients with sepsis increased from a mean ± SD of 7.1 ± 2.5 to 8.9 ± 1.1 (Δ 1.8, p < 0.05). |
Brewster et al. [23] | To show a new inter-professional team-based simulation, ALS training package would improve critical care staff performance, understanding, and satisfaction with ALS training | A 4-h workshop | No | NR | Resusci Anne®Simulator | Questionnaire 4 months after workshop attendance. | Changes in questionnaire scores pre-course, immediately after, and 4 months after simulation training. | Overall ICU nursing attendance increased from 54 to 71%. Nurses gave higher scores for all criteria when assessing the new ALS training program compared to the previous program. No significant improvement in perceptions of team performance. |
Chan et al. [24] | To evaluate the attitude of participants and their change in knowledge on clinical performance after attending a new training workshop. | 2-day workshop (eight 1-h scenarios) | No | Ex situ | NR | No | Knowledge multiple-choice questionnaire. | Improved knowledge of clinical performance and training was well received. |
Couto et al. [25] | To detect LST in a training program, which combined in situ simulation scenarios with just-in-time and just-in-place self-directed task training in an ED. | 4 simulation weeks with in situ simulation in a year, 14–15 scenarios per simulation week; 10 min scenario, 10 min debriefing. | No | In situ | High-fidelity mannequin (SimMan 3G, SimBaby or SimNewB, Laerdal) | No | LST detected during debriefing. | The training allowed a high rate of detecting LST regardless of theme. Equipment-related LST were more frequently found. |
Dagnone et al. [26] | To share the development and evaluation of a simulation-based competition. | 3-day simulation-based competition, 3–4 scenarios per team. | No | Ex situ | Trained standardized actors | No | Characteristic of participants, their attitudes toward simulation, and their evaluation of the competition. | Participants were extremely satisfied with the event and expressed a strong desire to expand interdisciplinary team training in resuscitation. |
Hicks et al. [27] | To evaluate the feasibility of a simulation-based CRM curriculum for EM residents and identify shifts in team-based behaviors and attitudes. | Precourse learning and 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Four scenarios in total. | No | Ex situ | Two high-fidelity scenarios and two low-fidelity scenarios | No | Pre/post scenarios were scored using Ottawa CRM GRS. Pre-post survey on human factor attitude. | Quality, relevance, and potential impact of training were highly positive. Improvement in Ottawa GRS, but not statistically significant from pre- to post-course. |
Marker et al. [28] | To identify first-year doctors’ perceptions, reactions, and reflection on transfer of skills after simulation-based training | 4-days simulation-based training. | No | Ex situ | High-fidelity | No | Interviews | Increased preparedness. Useful algorithms. Better communication and teamwork. |
Meurling et al. [29] | To explore differential individual training effects for physicians, nurses, and nurse assistants on self-efficacy and experienced quality of collaboration and communication between professionals | 4 h of interactive seminars concerning safe teamwork. 1 day of simulation training, with a team comprising 6 persons. Each team experienced 3–4 scenarios. | Yes | In situ | High-fidelity | No | Self-efficacy questionnaire. SAQ. Staff turnover and sick leave. | Self-efficacy: The effect for women was 0.21 (95% CI 0.039 to 0.371) and for men 0.59 (95% CI 0.308 to 0.876). SAQ: Discrepant attitudes about teamwork between physicians and nurses. The scores for safety climate improved for nurses. Physicians did not change in scores. Sick leave: Nurse assistants decreased their sick leave from 28 to 12%. |
Paltved e t al [30]. | To enhance patient safety attitudes through the design of an in situ simulation program based on a needs analysis involving thematic analysis of patient safety data and short-term ethnography. | One scenario, 2 h per team (45-min scenario, 50-min debriefing) | No | In situ | Simulated patients | No | SAQ and Trainee Reactions Score | An in situ simulation program can act as a significant catalyst for improvement in emergency staff’s safety and teamwork attitudes that might correlate with a more positive patient safety culture. |
Parsons et al. [31] | To design a CRM course for ED residents and to test the course’s efficacy. | ½-h lecture followed by 6 simulation scenarios, 3 active and 3 observed. Scenarios of 15 min with 30 min debrief. | No | Ex situ | High-fidelity (actor or SimMan3G) | No | Ottawa CRM GRS. | Increase in score concerning leadership, problem solving, situational awareness, resource utilization, and communication. Not statistically significant. |
Rasmussen et al. [32] | To identify long-term intended and unintended learner reactions, experiences, and reflections after attending a simulation-based ALS course. | ALS course. Duration NR | No | Ex situ | NR | No | Interviews | “(…) the efficiency dimension of ALS competence is taught well in ALS courses, but that the form and content of these highly structured/model courses are insufficient in training the innovative dimension of competence that is needed for transfer of skills in unstructured, emergency situations.” |
Truta et al. [33] | To assess whether a CRM-oriented team training combining didactic and simulation sessions improves interprofessional EM team performance of non-technical skills. | 1-day (6–7 h) lecture and 6 scenarios (3 active + 3 observed) | No | In situ and ex situ | High-fidelity manikin | Post-test 2 months after intervention | Scale from Flowerdew et al [35]. | Improvement in management and supervision, teamwork and cooperation, decision-making, and situational awareness. Statistically significant improvements in all groups of participants. |
Wong et al. [34] | To investigate agitation care delivery and to evaluate the impact of a team-based simulation on ED staff. | 2-h course, 15 min simulation, focus group interview | No | In situ | Low-fidelity | No | KidSIM ATTITUDES questionnaire. Uniprofessional and interprefessional focus group interviews. | KidSIM: Improvements in attitudinal scores for all questions within the relevance of simulation and opportunities for interprofessional education constructs (all p < 0.001). Interviews: The interprofessional conversations fostered insightful discussions regarding the development of novel team-based strategies and solutions for improved agitation management. |