In situ simulation training in emergency departments: what patients really want to know

Despite the use of in situ simulation in the emergency department (ED) for training staff to better manage critical events, little is known about how such training is experienced by patients in the ED during these simulations. We therefore aimed to explore ED patient knowledge and perceptions about staff training for emergencies, as well as their views about simulation generally, and in the ED setting specifically.

In this qualitative study, we used an interpretive approach involving video elicitation and semistructured interviews with patients who were waiting for treatment in the ED. Patients who agreed to participate were asked about their knowledge of simulation and were then shown a short video of a simulated resuscitation from cardiac arrest. We asked participants open-ended questions about their perspectives on the film and their views and about simulation training in the ED. Interviews were audio recorded, transcribed and analysed using thematic analysis.

We interviewed 15 participants. Most had little or no prior knowledge of simulation training. Watching the video elicited emotional responses in some participants, and pragmatic responses concerning staff training in others, with most participants viewing simulation training as useful and necessary. Participants said that to avoid unnecessary stress, they would prefer to be notified of when simulations were occurring, and what they could expect to see and hear during simulations. Most participants predicted that they would be willing to wait slightly longer (approximately 30 min) to see a doctor while simulation training was conducted, provided they did not require urgent medical attention.

Patient-centred care and care partnerships between patients and healthcare professionals underpin New Zealand healthcare and medical education ideologies. This requires effective communication between all parties, as evident in our study of in situ simulation training in the ED.