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Multiprofessional in situ simulation is an effective method of identifying latent patient safety threats on the gastroenterology ward
  1. Elizabeth Uttley,
  2. Deborah Suggitt,
  3. David Baxter,
  4. Wisam Jafar
  1. Medical Education, Stockport NHS Foundation Trust, Stockport, UK
  1. Correspondence to Dr Wisam Jafar, Gastroenterology, Stockport NHS Foundation Trust, Stockport SK2 7JE, UK; wisam.jafar{at}


Objective In situ simulation (ISS) is an effective training method for multiprofessional teams dealing with emergencies in high pressured environments. A regular ISS programme was organised for the multiprofessional gastroenterology team with a primary objective of identifying, classifying and addressing latent patient safety threats and secondary objectives of improving team confidence and individual role recognition.

Method 22 unannounced ISS sessions (averaging approximately one session every 6 weeks and four participants per session) were conducted between February 2017 and August 2019 involving multiprofessional team members. The sessions centred around the following four common gastrointestinal emergency scenarios: massive upper gastrointestinal haemorrhage; biliary sepsis (cholangitis) and shock; postendoscopic retrograde cholangiopancreatography complications including perforation and cardiac arrest. Following the simulation, the faculty, which included nurses and doctors, facilitated a structured debrief session and action plan to identify and address latent errors.

Results 96 participants from nursing, medical, physician associate and pharmacy backgrounds took part in the simulation programme. Analysis of collected latent safety threats identified the following four themes: education and training; equipment; medication and team working. Analysis of anonymously completed questionnaires identified that 95% of participants had a perceived better understanding of their role and 86% felt more confident in assessing an unwell patient. 96% of participants felt comfortable during the debrief.

Conclusion ISS provides a unique opportunity to train the multiprofessional gastroenterology team in their own high-pressured environment, helping identify and address latent patient safety threats and improve perceived participant confidence and role recognition.

  • clinical decision making
  • gastrointestinal bleeding

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  • Contributors EU wrote and edited the manuscript, acted as a faculty team member, collected and analysed data. DS wrote and edited the manuscript, acted as a faculty team member, collected and analysed data and wrote simulation scenarios. DB supported the faculty; edited and critically appraised the manuscript. WJ wrote and edited the manuscript, analysed data, acted as a faculty team member and wrote and facilitated simulation scenarios. All authors approved the submitted manuscript

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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