Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

Abstract

ObjectiveAcutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants’ reported experiences.SettingThree research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.MethodsThe intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.ResultsThe in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.ConclusionsThis study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.

Further development of crew resource management training

“…Nevertheless, a training environment should of course be designed in such a way that all participants can find their way around. This is especially necessary if no in situ training takes place [ 22 ]. On the other hand, this can also be seen as a need to conduct in situ training especially in ICU, as all different rooms (storage room and ABG laboratory) and equipment can be included.…”

In Situ Simulation in the Permanent Education of the Intensive Care Nursing Team

“…20 Professional updating is a process that seeks to provide individuals with acquisition of knowledge, so that they reach their professional capacity and personal development. 3 It is considered one of the modern strategies to maintain and increase the knowledge of the professionals, which in turn raises the health status of society. 21 The idea of the ISS as a possibility for training in the professional practice and in real time is contemplated in CSD 2.…”

“…This modality can offer better participation opportunities for the professionals, in addition to being financially advantageous as it does not depend on the organization of highly technological laboratories. 3 The ISS cannot be understood as a substitute for simulation performed in a simulation center, since the training objectives performed in the latter are different and are related to the development of technical and non-technical competence (for example, communication), understood in the logic of a curriculum, for example. On the other hand, the in situ simulation allows the teams to review and reinforce their skills.…”

Simulação in situ como estratégia potencializadora da prática do acolhimento na Atenção Primária a Saúde

“…A literatura nos contempla com exemplos exitosos (Matos, Martins & Martins, 2020;Nicolaides, et al, 2019;Griffin et al, 2019;Halls, Kanagasundaram, Lau-Walker, Diack & Bettles, 2019)de ensino que reforçam o emprego de simulações na formação de profissionais para HNT, em mais variados cenários e distintos graus de complexidade, como naquelas citadas pela PNH, na tangente do desenvolvimento da comunicação com o paciente, nas relações interprofissionais, trabalho em equipe, comunicação de más notícias, questões éticas, conflitos interprofissionais. No ensino auxiliando no desenvolvimento do raciocínio e julgamento clínico por aproximar a teoria da prática, colaborando para a formação de profissionais críticos e reflexivos mais preparados para atuarem nos problemas atuais do cotidiano (Carvalho, 2016 ;Rodrigues, 2020).…”

“…A prática da simulação como método de aprendizado se demonstra muito eficiente, porém encontramos uma lacuna na literatura nacional ao se buscar por artigos científicos que Research, Society and Development, v. 9, n. 12, e2429128185, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i12.8185 relatem esta pratica in situ, ou seja, no local de trabalho onde as práticas de saúde ocorrem no mesmo ambiente de realização das ações dos profissionais de saúde. As ocorrências de cenários in situ na literatura internacional não se assemelham a realidade local do sistema de saúde brasileiro (Halls, Kanagasundaram, Lau-Walker, Diack & Bettles, 2019).…”