Stephanie Gillam, Derby Teaching Hospitals NHS Foundation Trust
Simulation has been used for many years as a means of showing the eventual real effects of alternative conditions or actions and can be used when the real system cannot be engaged either because it may not be available or it may be dangerous or unacceptable to do so.
In the complex systems within healthcare, the increasing use of clinical simulation provides a safe environment where participants can learn from their errors without causing harm, thus reducing risk and improving patient safety. Simulation is seen as an innovative means of bridging the gap between practicing on models and treating real patients and is gaining a central role in medical education. Hi-fidelity simulation has been developing over relatively recent times and its strength is widely recognised as a method of enhancing educational messages and examining clinical elements alongside human factors and ergonomics, thus reducing risk.
A more recent enhancement is the development of in-situ simulation which takes simulation into the clinical area as opposed to a simulation centre. Facilitating realistic in-situ simulation requires considerable expertise, equipment and full support from senior clinicians as well as engagement from local staff. A key element in the delivery of this type of training is to ensure that participants understand that this is not any form of test; rather that it is an invaluable learning opportunity.
In-situ simulation has the ability to examine expertise by capturing performance when and where it occurs routinely. Also, importantly, it can be used to identify system errors which would potentially otherwise remain undetected if the same simulation occurred in a purpose built educational environment. In-situ simulation in the Royal Derby Hospital is undertaken in the following clinical areas.
• Emergency Department
• Intensive Care Unit
• Renal Unit
• Renal Ward
• Theatre Recovery
• Children’s Emergency Department
• Paediatric Wards