title: Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education: a qualitative study.
abstract: OBJECTIVE
  To examine how the setting in in situ simulation (ISS) and off-site simulation (OSS) in simulation-based medical education affects the perceptions and learning experience of healthcare professionals.
  
  
  METHODS
  Qualitative study using focus groups and content analysis.
  
  
  METHODS
  Twenty-five healthcare professionals (obstetricians, midwives, auxiliary nurses, anaesthesiologists, a nurse anaesthetist and operating theatre nurse) participated in four focus groups and were recruited due to their exposure to either ISS or OSS in multidisciplinary obstetric emergencies in a randomised trial.
  
  
  METHODS
  Departments of obstetrics and anaesthesia, Rigshospitalet, Copenhagen, Denmark.
  
  
  RESULTS
  Initially participants preferred ISS, but this changed after the training when the simulation site became of less importance. There was a strong preference for simulation in authentic roles. These perceptions were independent of the ISS or OSS setting. Several positive and negative factors in simulation were identified, but these had no relation to the simulation setting. Participants from ISS and OSS generated a better understanding of and collaboration with the various health professionals. They also provided individual and team reflections on learning. ISS participants described more experiences that would involve organisational changes than the OSS participants did.
  
  
  CONCLUSIONS
  Many psychological and sociological aspects related to the authenticity of the learning experience are important in simulation, but the physical setting of the simulation as an ISS and OSS is the least important. Based on these focus groups OSS can be used provided that all other authenticity elements are taken into consideration and respected. The only difference was that ISS had an organisational impact and ISS participants talked more about issues that would involve practical organisational changes. ISS and OSS participants did, however, go through similar individual and team learning experiences.
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: Danish Institute for Local and Regional Government Research (KORA), Copenhagen, Denmark.
authors.forename: Laura Emdal
authors.initials: LE
authors.lastname: Navne
authors.affiliation: Danish Institute for Local and Regional Government Research (KORA), Copenhagen, Denmark.
authors.forename: Helle Max
authors.initials: HM
authors.lastname: Martin
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
authors.affiliation: Department of Anaesthesiology, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Charlotte Krebs
authors.initials: CK
authors.lastname: Albrecthsen
authors.affiliation: Department of Obstetrics, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Berit Woetmann
authors.initials: BW
authors.lastname: Pedersen
authors.affiliation: The Research Unit Women's and Children's Health, Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Kjærgaard
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
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003718:Denmark; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000193:education*; D010348:Patient Care Team; D011247:Pregnancy; D036301:Qualitative Research
keywords: MEDICAL EDUCATION & TRAINING; OBSTETRICS; QUALITATIVE RESEARCH; in situ simulation; interprofessional