Editing Simulation (section)

===Improving patient safety===
Patient safety is a concern in the medical industry. Patients have been known to suffer injuries and even death due to management error, and lack of using best standards of care and training. According to Building a National Agenda for Simulation-Based Medical Education (Eder-Van Hook, Jackie, 2004), "a health care provider's ability to react prudently in an unexpected situation is one of the most critical factors in creating a positive outcome in medical emergency, regardless of whether it occurs on the battlefield, freeway, or hospital emergency room." Eder-Van Hook (2004) also noted that medical errors kill up to 98,000 with an estimated cost between $37 and $50&nbsp;million and $17 to $29&nbsp;billion for preventable adverse events dollars per year.

Simulation is being used to study patient safety, as well as train medical professionals.<ref name=":0">{{cite journal|last1=Groves|first1=Patricia S.|last2=Bunch|first2=Jacinda L.|last3=Cram|first3=Ellen|last4=Farag|first4=Amany|last5=Manges|first5=Kirstin|last6=Perkhounkova|first6=Yelena|last7=Scott-Cawiezell|first7=Jill|date=19 October 2016|title=Priming Patient Safety Through Nursing Handoff Communication: A Simulation Pilot Study|journal=Western Journal of Nursing Research|volume=39|issue=11|language=en|pages=1394–1411|doi=10.1177/0193945916673358|pmid=28322631|s2cid=32696412|issn=0193-9459}}</ref> Studying patient safety and safety interventions in healthcare is challenging, because there is a lack of experimental control (i.e., patient complexity, system/process variances) to see if an intervention made a meaningful difference (Groves & Manges, 2017).<ref>{{cite journal|last1=Groves|first1=Patricia S.|last2=Manges|first2=Kirstin|date=24 August 2017|title=Understanding Nursing Handoffs: Safety Scholarship in Nursing|journal=Western Journal of Nursing Research|volume=39|issue=11|language=en|pages=1391–1393|doi=10.1177/0193945917727237|pmid=28835189|issn=0193-9459|doi-access=free}}</ref> An example of innovative simulation to study patient safety is from nursing research. Groves et al. (2016) used a high-fidelity simulation to examine nursing safety-oriented behaviors during times such as [[change-of-shift report]].<ref name=":0" />

However, the value of simulation interventions to translating to clinical practice are is still debatable.<ref name=":1" /> As Nishisaki states, "there is good evidence that simulation training improves provider and team [[self-efficacy]] and competence on manikins. There is also good evidence that procedural simulation improves actual operational performance in clinical settings."<ref name=":1">{{cite journal |vauthors=Nishisaki A, Keren R, Nadkarni V |title=Does simulation improve patient safety? Self-efficacy, competence, operational performance, and patient safety |journal=Anesthesiol Clin |volume=25 |issue=2 |pages=225–36 |date=June 2007 |pmid=17574187 |doi=10.1016/j.anclin.2007.03.009 }}</ref> However, there is a need to have improved evidence to show that [[crew resource management]] training through simulation.<ref name=":1" /> One of the largest challenges is showing that team simulation improves team operational performance at the bedside.<ref name=":2">{{cite journal|title=Empowering Sustained Patient Safety|journal=Journal of Nursing Care Quality|volume=30|issue=3|pages=240–6|language=en-US|doi=10.1097/NCQ.0000000000000103|pmid=25479238|year=2015|last1=Stewart|first1=Greg L|last2=Manges|first2=Kirstin A|last3=Ward|first3=Marcia M|s2cid=5613563}}</ref> Although evidence that simulation-based training actually improves patient outcome has been slow to accrue, today the ability of simulation to provide hands-on experience that translates to the operating room is no longer in doubt.<ref>{{cite journal |author1=Zendejas B |author2=Brydges R |author3=Hamstra SJ |display-authors=etal |title=State of the evidence on simulation-based training for laparoscopic surgery: A systematic review |journal=Ann Surg |volume=257 |issue=4 |pages=586–93 |date=2013|doi=10.1097/SLA.0b013e318288c40b|pmid=23407298|s2cid=25367431 }}</ref><ref>{{cite journal |vauthors=Pandey VA, ((Wolfe JHN)) |title=Expanding the use of simulation in open vascular surgical training |journal=J Vasc Surg |volume=56 |issue=3 |pages=847–52 |date=2012|pmid=22836105|doi=10.1016/j.jvs.2012.04.015|doi-access=free }}</ref><ref>{{cite journal |vauthors=Palter VN, Grantcharov TP |title=Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room |journal=Ann Surg |volume=259 |issue=3 |pages=443–48 |date=2014 |doi=10.1097/sla.0000000000000254|pmid=24503910 |s2cid=43162924 }}</ref>

One of the largest factors that might impact the ability to have training impact the work of practitioners at the bedside is the ability to empower frontline staff (Stewart, Manges, Ward, 2015).<ref name=":2" /><ref>{{citation|doi=10.1111/nuf.12161|pmid=27194144|title=Maximizing Team Performance: The Critical Role of the Nurse Leader|journal=Nursing Forum|volume=52|issue=1|pages=21–29|year=2017|last1=Manges|first1=Kirstin|last2=Scott-Cawiezell|first2=Jill|last3=Ward|first3=Marcia M|doi-access=free}}</ref> Another example of an attempt to improve patient safety through the use of simulations training is patient care to deliver just-in-time service or/and just-in-place. This training consists of 20&nbsp; minutes of simulated training just before workers report to shift. One study found that just in time training improved the transition to the bedside. The conclusion as reported in Nishisaki (2008) work, was that the simulation training improved resident participation in real cases; but did not sacrifice the quality of service. It could be therefore hypothesized that by increasing the number of highly trained residents through the use of simulation training, that the simulation training does, in fact, increase patient safety.