Healthcare trainees and junior clinicians are often reluctant to speak up about safety concerns. This qualitative study found that simulation training to enhance speaking up behaviors had lasting effects among advanced care paramedics and respiratory therapists as they moved from training into practice. Respondents highlighted the importance of experience for speaking up and the benefits of high-impact simulation training.

Simulation training is used to improve technical and nontechnical skills among healthcare teams. This study evaluated the impact of a one-hour interdisciplinary in situ simulation training on code response, teamwork, communication and comfort during intraoperative resuscitations. After simulation training, researchers noted improvements in technical skills of individuals and teams (e.g., CPR-related technical skills).

Situational awareness (SA) requires recognizing situations, interpreting them, and predicting how the situation may unfold in the future. Paramedics and emergency medical technicians (EMT) participated in a video simulation to assess their SA at each of the three stages. Quantitative results indicated the providers were not situationally aware during the simulation.

Debriefing is an effective method for improving individual, team, and system performance, and skilled facilitators can enhance the effectiveness of the debrief. Researchers analyzed 50 video-recorded debrief sessions to assess the interactions between debriefer and participants to identify the type of communication that resulted in increased participant reflection. Advocacy-inquiry prompted increased reflection.

Simulation is becoming more common in healthcare education programs, but often focuses on in-hospital, skills-based training aimed at developing team human factors skills. This systematic review included 72 studies from 2004-2021 that included human factors skills with a variety of different designs, types of training interventions, and assessment tools and methods. The authors concluded that simulation-based training was effective in training teams in human factors skills; additional work is needed on the retention and transfer of those skills to practice.

Telehealth is increasingly used to connect rural hospitals with specialists in other areas and can improve patient outcomes. This study found that in situ simulation training in rural emergency departments resulted in small increases in the use of telemedicine for patients presenting with sepsis and led to improvements in sepsis process care outcomes.

In situ simulations are an effective method to identify latent safety threats (LST). Seventy-four in situ cardiac arrest simulations were conducted in one hospital, identifying 106 unique LSTs. Four LSTs were deemed imminent safety threats and were immediately resolved following debrief; another 15 were prioritized as high-risk.

Improving student and resident education and involvement in quality improvement and patient safety is a goal of graduate medical education. Researchers at Oregon Health & Science University developed a simulation-based medical education curriculum for multidisciplinary residents and fellows. The pilot cohort reported significantly improved reactions, attitudes and confidence, and knowledge and skills.

Health profession schools are increasingly using interprofessional simulation-based education (IP-SBE) for learners to understand each other’s roles in team-based care. Learners’ ability to feel psychologically safe during IP-SBE is necessary for full learner participation. This scoping review analyzed 27 studies of psychological safety within IP-SBE. Learners were more likely to feel safe in well-designed simulations with facilitators who are experienced in pre- and de-briefing. Barriers to psychological safety included hierarchy, being observed, uncertainty, and poorly designed and delivered simulations.

Closed-loop communication is essential to effective teamwork, particularly during complex or high-intensity clinical scenarios. This study found that participation in a one-day simulation team training for pediatric intensive care unit (PICU) nurses led to significant improvements in closed-loop communication in real-life clinical situations.

Rapid response systems (RRS) are widely used to identify signs of rapid deterioration among hospitalized patients.  Using in situ simulation, researchers identified obstacles to effective RRS execution, including inconsistent education and documentation, lack of interpersonal trust, and low psychological safety.

Standardized and virtual patient encounters are often used to develop medical and nursing students’ diagnostic reasoning. Through educational interventions including virtual patients, medical students increased their diagnostic accuracy compared to baseline and the completeness and efficiency in the differential diagnosis increased.

Simulation training is a valuable tool to improve patient care. In this study, researchers explored latent safety threats identified during multidisciplinary simulation-based team training delivered to 21 hospitals in New Zealand. Common latent threats were related to knowledge and skills, team factors, task- or technology-related factors, and work environment threats.

Air medical transport carries unique patient safety risks. In this study, researchers used simulation training and healthcare failure mode and effect analysis (HFMEA) to identify latent safety threats related to patient transport via helicopter. This approach identified 31 latent safety threats (18 were deemed critical) related to care coordination, facilities, equipment, and devices.