In Situ Debriefing in Medical Simulation

Abstract

First described in the anesthesia literature in the late 1980s, medical simulation has become an essential part of training in medical education at the undergraduate and graduate level, as well as in nursing and pharmacy education. Traditionally, simulation occurs in dedicated simulation centers. This center-based simulation offers the benefit of being separate from patients and focusing on learning for the individual and the team. Dedicated time is scheduled to participate in this educational activity, and debriefing of the simulation can take part without competing demands of the clinical work environment. In situ simulation differs from a center-based simulation in that it occurs in the actual clinical environment, often using providers and staff who are currently on shift. Because it occurs in the real working environment, it provides opportunities for learning on the unit and organizational level as well. In situ simulation has been used to improve teamwork and communication, as well as helping to identify systems issues and latent patient safety threats. In situ simulations, such as mock codes, may ultimately improve patient outcomes.