Clinical simulation has established itself as an essential methodology in healthcare training, enabling the development of technical and non-technical skills in controlled and safe environments. This study proposes a randomized trial that compares the impact of two learning contexts-a simulation center and the in situ simulation (ISS) environment in the operating room-on the training of interprofessional teams. The aim is to evaluate the effectiveness and efficiency of each context in the acquisition and performance of technical and non-technical skills, as well as participants' perceptions of realism, teamwork, and patient safety. The randomized experimental design reinforces the methodological rigor and internal validity of the results, allowing the identification of important differences between the two approaches. The scarcity of studies on interprofessional simulation in a real clinical context underscores the relevance of this research, which may provide scientific evidence to guide training policies and promote safer, more collaborative practices. It is expected that the results will contribute to improving interprofessional training programs and supporting the systematic integration of ISS in the healthcare field, especially in high-complexity environments.
The increasing complexity of healthcare and the need for a coordinated response among different professionals make interprofessional teamwork an essential element for patient safety and quality of care. In this context, clinical simulation has established itself as a fundamental teaching and learning methodology, allowing the training of technical and non-technical skills in controlled and safe environments. Among the different simulation modalities, in situ simulation (ISS) has gained prominence because it occurs in the clinical context itself, involving real teams and resources of the hospital environment. This approach favors the identification of latent threats to safety and the analysis of workflows and communication in high-pressure scenarios. In addition, ISS has demonstrated a positive impact on safety culture and the performance of multidisciplinary teams. Several studies support that simulation based on interprofessional teams promotes mutual understanding of roles, respect between disciplines, and effective coordination during critical situations. The integration of professionals from different areas in realistic scenarios enhances collaborative learning and strengthens communication, leadership, and decision-making skills, central aspects of Non-Technical Skills (NTS). Despite the available evidence, there is still a gap in the literature regarding the direct comparison between simulation in a training center and ISS in the hospital setting, particularly in the surgical center, an environment characterized by professional interdependence and high technical complexity. Thus, this study proposes a randomized trial comparing the impact of ISS and simulation in a training center on the formation of interprofessional teams. The aim is to systematically evaluate the effect of each context on the acquisition and performance of technical and non-technical skills, as well as on professionals' perception of realism, training effectiveness, and patient safety. This study, therefore, aims to contribute to the development of more effective training strategies based on scientific evidence.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
108
Simulation scenario carried out in situ. The training team will consist of 3 facilitators (who will always be the same throughout the study), with each scenario having only 2 facilitators and the principal investigator. Each group will be subjected to the same simulation scenario, the process of which is approximately 60 minutes, divided into: Briefing - 10 min; Scenario Development - 15 minutes; Debriefing - 30/35 min.
Simulation scenario carried out in the Simulation Center. The training team will consist of 3 facilitators (who will always be the same throughout the study), with each scenario having only 2 facilitators and the principal investigator. Each group will be subjected to the same simulation scenario, the process of which is approximately 60 minutes, divided into: Briefing - 10 min; Scenario Development - 15 minutes; Debriefing - 30/35 min.
ULS Matosinhos - Hospital Pedro Hispano
Matosinhos Municipality, Portugal
Faculty of Medicine, University of Porto
Porto, Portugal
Simulation Effectiveness (SET-M)
Measured with Simulation Effectiveness Tool - Modified (SET-M). SET-M is a 19-item tool with a three-point Likert scale that measures effectiveness by capturing student feedback on three domains. The higher the score, the more effective the simulation training.
Time frame: Immediately after the simulation session (Day 1)
Simulation Effectiveness (ICCAS)
Measured with the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). ICCAS is a 20-item self-report tool with a seven-point Likert scale that evaluates the participants' competencies in six dimensions before and after the simulation. Participants complete the tool after simulation training, but rate their abilities twice: once as they recall them before training, and after that training is done. The higher the score, the more effective the simulation training.
Time frame: Immediately after the simulation session (Day 1)
Simulation Design Evaluation
Evaluated using Simulation Design Scale (SDS) - Student version. SDS is a 20-item tool with a five-point Likert scale designed to evaluate five design features of instructor-developed simulations. The instrument has two parts: the presence of specific features in the simulation and the importance of those features to the learner. The higher the score, the higher the evaluation of the design feature.
Time frame: Immediately after the simulation session (Day 1)
Simulation Debriefing Assessment
Measured with the Debriefing Assessment for Simulation in Healthcare (DASH) Short version for students and for instructors. DASH for students has students evaluating the instructors in 6 elements with a seven-point Likert scale, while DASH for instructors is a self-assessment tool with the same structure. The higher the score, the higher the debriefing skill.
Time frame: Immediately after the simulation session (Day 1)
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