Chao Yen Huang¹
Ming Che Tsai¹ and Sai Wei Ho¹
1 Chung Shan Medical University and Hospital 

Assessment is crucial in healthcare education, but psychiatric ward staff lacks practical experience in emergencies, leading to suboptimal patient care. To address this, we introduced in-situ simulation and evaluated its effectiveness through qualitative analysis. 

A scenario involving a patient with arrhythmia after acute delirium was designed, recorded, and replayed using mobile video systems for debriefing. Trainees completed reflective writing, and thematic analysis was conducted on their essays. 

Results:
Twelve essays revealed four main themes: 

1. Practical application: In-situ simulation is more effective than traditional classroom teaching in converting knowledge into practical patient care. 

2. System-based practice: The diverse patterns of patients and ward designs influence the efficiency of resuscitation. Therefore, trainees can implement changes directly in the clinical environment after completing the curriculum to enhance resuscitation quality. 

3. Interprofessional teamwork: The curriculum is instrumental in fostering effective team resource management. 

4. Future Improvement: Trainees recommended printing ACLS algorithm cards to minimize errors due to unfamiliarity. In addition, redesigning the ward by incorporating suggestions like installing an oxygen wall or resuscitation bed can positively impact patient outcomes. 

Trainees reported that in-situ simulation improved patient care by transforming knowledge into practice, directly implementing changes in the clinical environment, facilitating team resource management, and suggesting improvements to enhance patient safety. 

In-situ simulation proved highly effective in enhancing knowledge and behavior, as evidenced by the proposed improvement plan. In addition, using clinical equipment in the workplace familiarized trainees with algorithms and improved their performance in emergencies. Overall, in-situ simulation improved resuscitation quality, teamwork, and patient safety in the psychiatric ward. Such assessments are crucial for advancing healthcare education and training. 

In conclusion, the assessment of in-situ simulation in the psychiatric ward demonstrated its effectiveness in improving resuscitation quality, fostering effective teamwork, and enhancing patient safety. 

References (maximum three) 

1. Yu J, Lee w, Kim M, et al. Effectiveness of simulation-based interprofessional education for medical and nursing students in South Korea: a pre-post survey. BMC Medical Education 2020;20:476. 

2. Wakeman D, Langham MR. Creating a safer operating room: Groups, team dynamics and crew resource management principles. Seminars in Pediatric Surgery 2018;27:107-113.