Introduction: Junior residents in the SingHealth Emergency Medicine Residency Program receive 16 hours of protected time monthly for formal teaching sessions. consisting of classroom teaching and hands-on sessions in simulation centers. Evaluation of the program indicated gaps in the training (from program evaluation committee, faculty and residents survey, 360 evaluations, clinical competency committee). Specifically, residents reported i) limited leadership opportunities in resuscitation scenarios, ii) lack of formal inter-professional education (IPE), and iii) insufficient exposure to department-specific resuscitation setups and workflows. To address these gaps, in-situ simulation training was introduced, with the following objectives: • Help residents develop effective team leadership skills, with a focus on non-technical skills. • Foster IPE, enhance collaboration, communication, and role clarity within the team. • Build familiarity with departmental resuscitation setups and workflows by training in actual work environments. Methods: • Session frequency and duration – Three half-day in-situ training sessions during junior residency • Scenario rotation and leadership opportunities – residents take turns leading a variety of resuscitation scenarios, each focusing on department-specific workflows and system-based practices. • Hi-fidelity manikins to simulate realistic physiological responses, with technical support from simulation center staff. • Nursing participation to enhance the realism of scenarios and foster interprofessional interactions. • Specialist-led debriefings Results: Post-training feedback was highly positive. Key highlights include i) High satisfaction scores - the mean score for the session was 4.8 out of 5, a score notably higher than most other training sessions, ii) Perceived improvement in critical thinking, clinical decision-making, and confidence in leading resuscitations, iii) Increased familiarity with emergency department workflows and equipment. Conclusion: Utilization of in-situ training could better equip junior residents with the skills required to lead resuscitation teams as they progress into senior roles. Further methods of assessment (e.g., direct observation of leadership and decision making during scenarios by faculty using structured assessment tools) are planned to assess knowledge gain and behavioral changes.
Ang et al. (Sun,) studied this question.