title: Unannounced in situ simulation of obstetric emergencies: staff perceptions and organisational impact.
abstract: OBJECTIVE
  To describe how unannounced in situ simulation (ISS) was perceived by healthcare professionals before and after its implementation, and to describe the organisational impact of ISS.
  
  
  METHODS
  Ten unannounced ISS involving all staff were scheduled March-August 2007. Questionnaire surveys on staff perceptions were conducted before (2003-2006) and after (2007-2008) implementation of unannounced ISS. Information from the debriefing sessions following each ISS constituted a proxy measure of the organisational impact of the ISS.
  
  
  RESULTS
  Five out of ten of the unannounced ISS scheduled were conducted. Twenty-three members of the staff at work on a scheduled day for ISS were randomly selected to participate. Questionnaires before implementation revealed that 137/196 (70%) of staff members agreed or strongly agreed that ISS was a good idea and 52/199 (26%) thought it likely to be stressful and unpleasant. Questionnaires completed after implementation showed significantly more staff members, 135/153 (89%), thought ISS was a good idea. A significantly higher amount of staff members 50/153 (33%) found it to be stressful and unpleasant, and among midwives, 15/59 (25%) were anxious about ISS, whereas none of the obstetricians reported this. Information obtained through debriefing sessions generated learning points.
  
  
  CONCLUSIONS
  The number of staff members with a positive perception of multiprofessional unannounced ISS increased after implementation; however, one-third considered ISS to be stressful and unpleasant and midwives more frequently so. The specific perception of ISS by each healthcare profession should be taken into account when planning ISS. The information from the debriefing sessions showed that implementation of ISS had an impact as it provided information required for organisational changes.
authors.affiliation: Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jette Led
authors.initials: JL
authors.lastname: Sørensen
authors.affiliation: Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Lottrup
authors.affiliation: Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: van der Vleuten
authors.affiliation: Department of Obstetrics, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Kristine Sylvan
authors.initials: KS
authors.lastname: Andersen
authors.affiliation: Department of Obstetrics, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Simonsen
authors.affiliation: Department of Obstetrics, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Emmersen
authors.affiliation: Department of Biostatistics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Susanne
authors.initials: S
authors.lastname: Rosthøj
authors.affiliation: Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003718:Denmark; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D008953:Models, Anatomic; D064887:Observational Studies as Topic; D009773:Obstetric Nursing / Q000193:education*; D009774:Obstetrics / Q000193:education*; D016544:Patient Simulation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: MEDICAL EDUCATION & TRAINING; OBSTETRICS