Simulation

Simulation is used in health care education to replace or amplify patient experiences with scenarios designed to replicate real health encounters using lifelike mannequins, physical models, standardized patients, or computers.[1] In obstetric practice, studies have shown that simulation improves provider emergency response, such as reducing neonatal brachial plexus injury after shoulder dystocia.[2]

In-situ simulation, scenarios performed on working patient units, can drive quality and safety by improving teamwork or by focusing on identifying problems in delivering care where complex processes are involved. Simulation is particularly useful for training individuals or teams in high-acuity, low-volume scenarios and is now a required component in accredited obstetrics and gynecology residency training programs and maintenance of certification programs. The ultimate goal of simulation is to decrease morbidity and mortality. As providers on the front lines, OB/GYN hospitalists should be champions for simulation as a tool for achieving and maintaining safety and high-quality care in the hospital setting.

Knowledge

OB/GYN hospitalists should be able to:

  • List examples of evidence-based benefits of simulation in obstetrics.
  • Discuss the ways in which simulation may be used to enhance a hospital’s or system’s safety, quality assurance, and process improvement programs.
  • Describe the advantages and disadvantages of in-situ vs simulation-center simulations.
  • Distinguish between low- and high-fidelity simulation equipment.
  • List the key components of high-quality simulation drills.
  • Discuss the principles of team leadership and crew resource management in team-based simulation.
  • Explain the components of a debrief and its role in simulation.
  • Identify resources for OB/GYN simulation drills and training.

Skills

OB/GYN hospitalists should be able to:

  • Develop or participate in the development of simulation drills in the workplace.
  • Determine whether in-situ or simulation-center simulation would be more appropriate for a particular scenario.
  • Lead low-fidelity simulation drills; lead or participate in high-fidelity simulation drills.
  • Integrate team training principles into simulation.
  • Facilitate a debrief and establish a standard of including a debrief in every simulation exercise.

Self-Awareness and Collaborative Attitudes

OB/GYN hospitalists should be able to:

  • Collaborate to design and run multidisciplinary simulation drills and encourage and facilitate participation by all members of the health care team.
  • Seek out lifelong learning opportunities to maintain low-frequency, high-acuity skills.

System Organization and Improvement

OB/GYN hospitalists should be able to:

  • Advocate for simulation as an integral part of quality assurance and process improvement initiatives, staff and resident education, patient safety initiatives, team training, and building a culture of safety.
  • Identify opportunities for simulation and participate in simulation drills.
  • Advocate for and support efforts to establish a standard of debriefing after near misses and adverse events.

References

  1. Passiment M, Sacks H, Huang G. Medical Simulation in Medical Education: Results of an AAMC Survey. Association of American Medical Colleges, 2011. Available at: https://www.aamc.org/download/259760/data/medicalsimulationinmedicaleducat... . Accessed for verification May 2019.
  2. Draycott TJ, Crofts JF, Ash JP, et al. Improving neonatal outcome through practical shoulder dystocia training. Obstet Gynecol. 2008;112(1):14-20.  [PMID:18591302]
Last updated: August 30, 2021