Abstract:

Introduction:
In situ simulation (ISS) has become an essential tool in medical education, providing realistic and immersive training experiences in actual clinical settings. This method allows healthcare professionals to practice and refine their skills, making it particularly beneficial for managing critical conditions such as eclampsia - a severe obstetric emergency that requires prompt and effective intervention. This study aims to reinforce knowledge, attitudes, and teamwork training, and to demonstrate feasibility of ISS to identify latent safety threats (LSTs) in managing eclampsia at Hung Vuong Hospital.

Methods:
A multidisciplinary team of doctors, nurses, midwives, and respiratory therapists participated in an unannounced ISS scenario involving a 36-year-old postpartum patient experiencing eclampsia in the postoperative care unit during their shift. The simulation lasted 20 minutes, followed by 60 minutes of debriefing, and was video recorded. Primary outcomes included participants' perceptions of the simulation's impact on patient care and its educational value. The secondary outcome was the identification and classification of LSTs.

Results:
Sixteen healthcare providers participated in the ISS. Post-simulation surveys indicated high satisfaction, with participants reporting enhanced knowledge and positive attitudes towards managing eclampsia. All participants rated the simulations as extremely valuable or valuable, with no reports of minimal clinical impact. Additionally, 69% of participants expressed interest in further ISS training for other critical scenarios such as heart failure during labor, postpartum hemorrhage, and acute asthma in pregnancy. Seventeen LSTs related to medication administration and resource availability were identified. Examples of threats identified include lack of essential medications/ equipment and communication gaps.

Conclusion:
ISS has proven to be an effective method for detecting LSTs and reinforcing team training behaviors. The ISS program at Hung Vuong Hospital significantly improved the knowledge, attitudes, and teamwork skills of healthcare professionals. The positive feedback supports the regular integration of ISS into medical training programs. Future research should explore the long-term outcomes and scalability of ISS across different clinical settings.

Keywords:

In situ simulation, knowledge, attitudes, teamwork, patient safety, eclampsia, healthcare training, quality improvement.