BMJ Open (Sep 2023)

Exploring barriers and enablers to simulation-based training in emergency departments: an international qualitative study (BEST-ED Study)

  • ,
  • Paul O'Connor,
  • Etimbuk Umana,
  • Brian McNicholl,
  • Ella Murphy,
  • Marcus Jee,
  • Daniel Khamoudes,
  • John J O’Donnell,
  • Binchy James,
  • Bronwyn R McDermott,
  • Dillon Michelle,
  • Ackloo Rajnita,
  • Gobin Avishka,
  • Qurratalain Fatimah,
  • Davis Jamie,
  • Eduard Turcuman,
  • Roche F Adam,
  • Lee Solmi,
  • Madden Marian,
  • Torpey Tracey,
  • McMackie Eamonn,
  • Brennan Simone,
  • Ambyr Reid

DOI
https://doi.org/10.1136/bmjopen-2023-073099
Journal volume & issue
Vol. 13, no. 9

Abstract

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Introduction Simulation-based training (SBT) has gained significant traction within emergency medicine. The growing body of evidence describes the benefits that SBT can bring. However, identifying barriers and enablers when establishing successful SBT programmes in busy emergency departments (EDs), and ensuring longevity of such programmes, can be difficult.Objective We aim to identify barriers and enablers to SBT in busy EDs.Methods We explored and analysed the thoughts, experience and opinions of professionals involved in SBT and organisational support. 32 participants across 15 international sites were invited to a semistructured interview process. We included participants from a variety of backgrounds, from clinical staff to management staff. Transcribed interview data was classified and coded based on capability, opportunity and motivation behaviour (COM-B) domains and analysed based on theoretical domains framework. Frequency of the most mentioned thematic domain among participants is reported.Results The interview data revealed several common themes, including the following: knowledge and skills (90%), support and leadership (96%), mental barriers (87.5%), local culture (96.6%), dedicated space (65.2%), time constraints (46.8%), social influence (87.5%), education (90.6%), professional development (68.75%), exams (59.3%) and personal goals (93.75%). Management staff was observed to prioritise resource, staffing and flow, while the clinical cohort tended to focus on specialty and personal development when it came to simulation training in the ED.Conclusion Potential barriers and enablers to SBT and in situ simulation for EDs were identified through interviews conducted in this study. The central themes in terms of barriers and enablers were local culture, leadership, individual needs, resources and optimisation. A tailored approach is vital for establishing a successful SBT and in situ simulation programme.