Training for teamwork through in situ simulations
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* Asta Sorensen
* Jon Poehlman
* John Bollenbacher
* Scott Riggan
* Stan Davis
* Kristi Miller
* Thomas Ivester
* Leila Kahwati

## Abstract

*In situ* simulations allow healthcare teams to practice teamwork and communication as well as clinical management skills in a team's usual work setting with typically available resources and equipment. The purpose of this video is to demonstrate how to plan and conduct *in situ* simulation training sessions, with particular emphasis on how such training can be used to improve communication and teamwork. The video features an *in situ* simulation conducted at a labour and delivery unit in response to postpartum hemorrhage.

*   Delivery
*   Obstetrics
*   Gynaecology

In situ simulations are conducted in real clinical environments to allow healthcare teams to practice teamwork and communication, and clinical management skills, in a team's usual work setting with typically available resources and equipment. Such training improves reliability and safety of high-risk situations, allows for experiential learning, and improves the ability to identify and address latent threats and systems issues. Recent programmes and studies have demonstrated that in situ simulations improve unit safety culture, patient outcomes, knowledge, practical skills, communication and team performance, and reduce adverse event costs. Although multiple benefits of in situ simulations exist, support to individual hospitals and units for implementing in situ simulation has been limited.

The purpose of this documentary-style video is to demonstrate how to plan and conduct in situ simulation training, with particular emphasis on how such training can be used to improve communication and teamwork. The video features an in situ simulation conducted at a labour and delivery unit. In addition to instructional content, most of the scenes show unscripted, yet authentic footage, of simulation facilitators and a healthcare team planning, running and debriefing a simulation, and demonstrate the use of visual media during the simulation debriefing—a process that provides a forum for shared learning experiences.

This video will facilitate the implementation and routine use of in situ simulations, as it allows prospective users to visualise techniques difficult to convey in other media forms and training modalities.⇓


The video is part of a toolkit that will become available in late 2016. More information on the toolkit is available on the Agency for Healthcare Research and Quality website ([http://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/perinatal-care/index.html](http://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/perinatal-care/index.html)).


## Footnotes

*   Contributors AS was involved in the substantial contributions to the conception and design of the work; drafting the work and revising it critically for intellectual content; and final approval of the version to be published; accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JP, JB, SD, KM, TI and LK were involved in the substantial contributions to the conception and design of the work; drafting the work and revising it critically for intellectual content; and final approval of the version to be published. SR was involved in the drafting the work and revising it critically for intellectual content and final approval of the version to be published.

*   Competing interests None declared.

*   Funding Funding for this work was provided by the Agency for Healthcare Research and Quality Contract No. HHSA290201000024I Task Order 3.

*   Provenance and peer review Not commissioned; internally peer reviewed.

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