Simulcast Journal Club is a monthly series that aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education. Each month we publish a case and link a paper with associated questions for discussion. Inspired by the ALiEM MEdIC series, we moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field.
The journal club relies heavily on your participation and comments and while it can be confronting to post your opinions on an article online, we hope we can generate a sense of “online psychological safety” enough to empower you to post! Your thoughts are highly valued and appreciated, however in depth or whatever your level of experience. We look forward to hearing from you.
Title : “Dial M for Trochar”
“He’s dead.” sobbed Catherine as Nimali hugged her tightly. The steady thumps of hail hitting the roof outside partially muffled the sound of her tears.
“I mean, Snythe was the meanest paediatric intensivist I’d ever met, but he didn’t deserve to be stabbed through the heart with an Intercostal Catheter Trocar while acting as a Simulated Trauma Patient.”.
Nimali winced. “The police are going to be here any minute. Catherine, what happened? Tell me every detail.”.
Catherine’s eyes glazed with painful recollection.
“Well, we had the end of year staff meeting, everyone was here except you and Nitin, and some of the junior trainees had organised a ‘Registrar Revenge’ Simulation. Snythe had agreed to be the Simulated Patient, and he was wearing a metal chest protector with a box of fake blood over the top of it. We were supposed to put a chest drain in, but we had just started the scenario when the power went out. It was pitch black in the Sim room, and we were joking around. Then we all heard a scream.”
“When the lights came back on, Snythe was dead. And for a few seconds we laughed! We thought it was a Sim!”.
“Surely it was an accident?” asked Nimali. “A horrible horrible accident. I know Snythe had a lot of enemies, I mean, but why would you think this was murder?”.
“The note.” Whispered Catherine in shock. She slowly opened her clenched fist and a crumpled piece of paper unravelled. A sentence made out of paper clippings was just visible on the inside.
Nimali unrolled it and read the words aghast.
Nimali shuddered. Next month’s Quality and Safety meeting was going to be interesting.
The Article (open access via the link) :
While our case study has descended into a farcical murder mystery, simulation safety remains a serious and potentially deadly issue. Scaffolding on from last month’s simulcast coverage of Raemer et al’s “Simulation Safety First : An Imperative” we’d like to explore one of the cases referenced within that article : a case report in which 45 patients were exposed to simulated (and non sterile) saline.
The case report is open access and well worth a read. We hope in combination with Raemer et al’s editorial it will provide you a stimulus for reflection on Sim safety within your hospital.
For our journal clubbers this month :
- What reflections does this case report prompt on your own facility’s practice?
- What resources and strategies have you found useful to maintain simulation safety within your own service?