In Situ Simulation for Residents

in situ practice for medical residents

As medical residents enter hospitals for their residency requirements, the challenges of making the transition from education to practice become obvious. Nurses can struggle this time of year, too, as they juggle to care for their patients and answer questions from resident interns.

One way many residency programs address these challenges is by introducing in situ (or “on-site”) simulation. The introduction of new practitioners into a hospital marks a learning curve for everyone. Simulation can smooth out and minimize the learning curve for greater reliability and better patient outcomes.

Emergency medicine especially benefits from in situ simulation, and has been leading the way in implementation. Since 2008, more than 90 percent of 179 accredited emergency medicine programs in the United States report using simulation for resident education, with 85 percent using manikin simulators.

Benefits of In Situ Simulation

    1. Preventing medical errors: Medical errors cause nearly 250,000 preventable patient deaths annually. Lapses in skill or coordination of care, mistaken diagnoses, and preventable complications of care have grave consequences for patients. By having interns complete simulation scenarios, task training, and online learning, these errors can be reduced.

    2. Learning the care environment: Residents are introduced to an unfamiliar setting where they are expected to immediately start diagnosing and treating real-life patients. A simple orientation about the equipment that is available is inadequate. In situ simulation introduces interns to their new work environments, including fellow staff members, protocol, processes, and equipment.

    3. Building teamwork: On-site learning with other staff, from fellow residents to nurses, doctors, paramedics, and senior residents, creates a support system for new interns. Practicing rare but critical events with a rotating team can help residents learn how to manage team dynamics.

    4. Reducing stress: An unfamiliar work environment that requires the application of new skills, plus having to make life and death decisions, can create chronic anxiety and doubt. In situ simulation with the right scenarios builds staff confidence, competence, and compliance.

Incorporating simulation into a residency program lets interns perform procedures in action, and gives attending physicians the opportunity to gauge resident’s abilities to function in their environment, all while protecting the patient.
Pocket Nurse offers complete simulator and manikin solutions, including several from Laerdal®.

The “July Effect:” Are You Using Simulation to Smooth out the New Intern Learning Curve?, Laerdal

214 thoughts on “In Situ Simulation for Residents

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