Dorai Raj D Appadorai 

The prevalence of the ageing population is phenomenally escalating and thus, the sprouting of nursing homes globally is set to grow. Transferring an unwell patient from the nursing home to a tertiary centre for medical care is almost a knee jerk practice, owing largely to less competent or confident healthcare professionals in these settings. This compels the necessity of ensuring that healthcare professionals are periodically assessed and competent in managing common acute medical scenarios within the nursing home setting. Primarily, this ensures that nursing home residents receive prompt and accurate care by providers who are robust in their approach, within the safe, familiar and controlled space of the nursing home. In situ simulation has been used to assess and remodel performance in real time, while providing an interactive and reflective learning experience. Simulation based education is widely known to unravel hidden cognitive errors at workplace, reframe mental models and enhance interprofessional collaboration during a crisis. Nursing homes often face manpower crunch, due to the heavy caregiving or medical burden posed by residents. The focus at nursing homes is largely to comply to routine care and ensuring that each resident survives to live another day. Conitunous education is commonly neglected. Most clinicians or nurses are not able to leave the confines of the home to attend simulation training at dedicated centres or tertiary settings. It is however, imperative that their clinical competence and decision making skills are assessed and refined periodically. Periodic assessments and reflection informs and drives future practice. Therefore, in situ simulation based training brings the experience to nursing homes. Trainee performance is assessed and collated through qualitative and quantitative data. Outcomes from in situ training can be shared and extrapolated across other elder care institutions for improved patient safety outcomes and potentially reduced unnecessary hospitalization. 

References (maximum three) 

1) Using in situ simulation to improve in-hospital cardiopulmonary resuscitation: Authors - G. Lighthall, T. Poon, T. K. Harrison 

2) Integrating Human Patient Simulation into Associate Degree Nursing Curricula: Faculty Experiences, Barriers, and Facilitators: Authors - K. Adamson