Introduction

Simulation is a method used to substitute or enhance real experiences with guided, interactive experiences that are reminiscent of or replicate aspects of the real world.In situ simulation takes this technique directly to the places where health care is rendered, with the health team acting in a simulated scenario within their work environment.

Objective

To describe the pilot in situ simulation experience conducted at an accident and emergency unit, highlighting the opportunities to assess the care system, teamwork and detection of latent safety threats (LSTs).

Methods

The study was applied at the Ibirapuera Unit of the Hospital Israelita Albert Einstein and performed by the Albert Einstein Realistic Simulation Centre.A scenario was presented wherein a 45-year old patient whose acute coronary syndrome evolves into cardiac arrest.A 30-minute hybrid simulation involving the use of an actor and high fidelity simulator (SimMan 3G®).A checklist was used and the simulation was filmed in order to evaluate skills and attitudes in a structured 1-hour long debriefing.

Results

The experience provided a technical, behavioural and system assessment. Four LSTs were detected and it enabled a guided reflection on teamwork.

Conclusion

This pilot contributed to achieving the objectives proposed with the scenario and demonstrated opportunities for training and improvement.In situ simulation may be used systemically in the future for continuous team training, aimed at improving service quality and patient safety.