Table 3

Advantages, disadvantages and similarities of simulation environments

Skills centresIn situ
AdvantagesTrained faculty to design and deliver simulation

Trainees removed from work environment ‘bleep free’ time
On site—can be fitted into clinical workload
Allows the system to be tested as it would be for real event—personnel, equipment, environment (identifies latent failure)
Equitable access—involves domestics, porters
May be more effective
Enhanced fidelity
DisadvantagesDifficulties releasing staff for offsite training (often 1–2 days)
Unlikely to be able to train whole team together
Often expensive to attend courses
Time has to be limited as in clinical environment may be seen by patients—may feel less ‘safe’ for both patients and staff often small core faculty
SimilaritiesEducationally robust
Can be linked to curriculum outcomes
Can be used as a workplace based assessment
Adaptable to any technical and non-technical skills teaching
Permits deliberate practice—novice to expert