Why in situ sim for general practice?

There is expanding interest in simulation in health care to create a safe space to train individuals and increasingly to build health care team skills. While the published evidence for improved patient outcomes is hard to come by, there are reviews and surveys that suggest simulation does improve confidence and that there are credible patient safety reasons to practice health care tasks in simulation.

General practice for the main part is a single doctor and patient en devour. Certainly there can be practice nurse assistance or calling in a colleague for a second opinion however this is quite different to the hospital ward, emergency department or operating theatre where a team of health care providers orbit around the patient, each adding their portion of care.

Where general practice does become a team is with the management of a crisis in the practice.  With evidence for the patient safety role of Crisis Resource Management (CRM) and the so called soft skills of health care, I was interested in how this could be brought into the general practice rooms.

From the above Emergency Medicine Australasia journal article the stated key elements are important to all areas of health care management in a crisis and not just the hospital:

Carne, B, Kennedy M Review Article: Crisis Resource Management in emergency medicine EMA (2102)24,7-13


These core CRM skills are not natural to general practitioners however, given that we practice largely alone and do not work as a team around one patient.  In a crisis however we are drawn together and working better together must improve patient care for resuscitation and hand over to the ambulance services.

My goal then is create a path for our clinic to develop appropriate CRM skills and for simulation to be a way for us to get there.




Author: gpsimulation

urban general practitioner in Melbourne, Australia

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