Simulation training is increasingly used as an educational tool and can improve teamwork and safety culture. Set at two Danish hospitals, this study evaluated perceived safety culture before and after a four-day in situ simulation training emphasizing team training, communication, and leadership. After the training, safety attitudes improved, but the effect was more pronounced at the acute care hospital compared to the hospital handling mainly elective procedures.

Simulation training is used by hospitals to improve patient care. This study describes the experience of one Danish hospital shifting from simulation training at external centers to in situ training. The shift to in situ training identified several latent safety threats (e.g., equipment access, lack of closed-loop communication, out-of-date checklists) and these findings led to practice changes.