A "chamber of errors" adaptation to assess pharmaceutical assistants' knowledge in chemotherapy preparation

French preparation guidelines state that pharmacy staff who manipulate cytotoxic drugs have to follow specific training. In order to assess the pharmaceutical assistants' skills and knowledge, we developed a "Cytotoxic Preparation Centralized Unit (CPCU) of errors," derived from the Canadian concept of "Chamber of horrors." A table listing 20 mistakes to track down was created and each pharmaceutical assistant spent 20 min in the "CPCU of errors" with the pharmacist, who wrote down the spotted mistakes in real time. Among the 21 trained pharmaceutical assistants, 15 were evaluated. On average, 11.9 mistakes on 20 were detected. The lowest score was 7 spotted errors on 20 and the highest was 16 on 20. Those results should be qualified depending on pharmaceutical assistants' years of experience in the preparation of chemotherapy. Those results may be explained by the way the role-playing was conducted. The simulation was not conducted during an actual preparation using the usual equipment. One of the major obstacles was the difficulty to clear some time for this project because its realization required a full-time pharmacist and the referring pharmaceutical assistant in addition to the evaluated pharmaceutical assistants. Overall, the staff feedback was positive and the role-playing led to a reminder of theoretical knowledge and the good use of some devices. It would be interesting to develop this type of project through a regional oncology network to create a medium that can be used by other hospitals.