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. 2019 Dec 24;6(1):3-9.
doi: 10.1136/bmjstel-2018-000387. eCollection 2020.

In situ simulation and its effects on patient outcomes: a systematic review

Daniel Goldshtein  1 , Cole Krensky  2 , Sachin Doshi  2 , Vsevolod S Perelman  1   3   4
Affiliations

In situ simulation and its effects on patient outcomes: a systematic review

Daniel Goldshtein et al. BMJ Simul Technol Enhanc Learn. .

Abstract

Background: The use of in situ simulation has previously been shown to increase confidence, teamwork and practical skills of trained professionals. However, a direct benefit to patient outcomes has not been sufficiently explored. This review focuses on the effect of in situ simulation training in a hospital setting on morbidity or mortality.

Methods: A combined search was conducted in PUBMED, OVID, WEB OF SCIENCE, CINAHL, SCOPUS and EMBASE. 478 studies were screened with nine articles published between 2011 and 2017 meeting the inclusion criteria for analysis.

Results: This review selected eight prospective studies and one prospective-retrospective study. Three studies isolated in situ simulation as an experimental variable while the remaining studies implemented in situ programmes as a component of larger quality improvement initiatives. Seven studies demonstrated a significant improvement in morbidity and/or mortality outcomes following integrated in situ simulation training.

Conclusion: Existing literature, albeit limited, demonstrates that in situ training improves patient outcomes either in isolation or within a larger quality improvement programme. However, existing evidence contains difficulties such as isolating the impact of in situ training from various potential confounding factors and potential for publication bias.

Keywords: medical education; patient safety; simulation; team training.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Search and selection of included studies.
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