Abstract
Introduction High-fidelity team-based simulation has been identified as an effective way of teaching
and evaluating both technical and nontechnical skills. Several studies have described
the benefits of this modality in a variety of acute care settings, but a lack of standardized
methodologies has resulted in heterogeneous findings. Few studies have characterized
high fidelity simulation across a broad range of acute care settings and integrated
the latest evidence on its educational and patient impact.
Methods The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical
studies from the last 10 years, investigating high fidelity team-based simulation
in surgical, trauma, and critical care training curricula.
Results Seventeen studies were included. Interventions and evaluations were comprehensively
characterized for each study and were discussed in the context of four overarching
acute care settings: the emergency department/trauma bay, the operating room, the
intensive care unit, and inpatient ad hoc resuscitation teams.
Conclusions The use of high-fidelity team-based simulation has expanded in acute care and is
feasible and effective in a wide variety of specialized acute settings, including
the emergency department/trauma bay, the operating room, the intensive care unit,
and inpatient ad hoc resuscitation teams. Training programs have evolved to emphasize
team-based, multidisciplinary education models and are often conducted in situ to
maximize authenticity. In situ simulations have also provided the opportunity for
system-level improvement and discussions of complex topics such as social hierarchy.
There is limited evidence supporting the impact of simulation on patient outcomes,
sustainability of simulation efforts, or cost-effectiveness of training programs.
These areas warrant further research now that the scope of utilization across acute
care settings has been characterized.
Keywords
teaching - simulation training - team training - high fidelity simulation training
- education - simulation-based medical education
