Introduction: 

Emergency medicine (EM) is a complex specialty requiring the mastery of various competencies. Simulation allows the acquisition, the training and retention of technical and non-technical skills. In situ simulation (ISS) is simulation in the usual working environment with usual team members. The rationale for ISS is based on the importance of environmental fidelity and its potential impact on learning. ISS also offers to the possibility of identifying the conditions that could lead to errors; these are called Latent Safety Threats (LST). ISS offers the possibility of training in order to identify and anticipate errors beforehand, therefore enhancing patient safety.

Our hypothesis is that in situ simulation in an emergency department is feasible, safe, and is associated with benefits for both the staff and the patients.

This study aims at showing ISS is feasible, safe and is associated with stress reduction and self-confidence improvement for the participants.

Methods:

Two distinct phases are planned:

• Phase 1: Implementation of an ISS program with selected emergency professionals to assess acceptability and safety and prove the validity of our concept. The number of cancelled sessions and the reasons for cancellation will be collected in order to establish feasibility criteria. Semi-structured interviews will be conducted to evaluate the acceptability of the intervention.
• Phase 2: Evaluation of the impact of the simulation training. The impact measurement will be based on validated questionnaires from the literature for the assessment of self-confidence, psychosocial risks and perceived stress among emergency professionals. 

This mixed methodology includes a qualitative method for the assessment of feasibility and acceptability and quantitative method for the assessment of safety, stress, skills of the participants and the number of LSTs identified during the simulations.

Impact for EM:

This is an original unanswered research question associated with a major practical impact. ISS offers the possibility for pragmatic, regular simulation training in response to specific local needs.