• Jeanne-Marie Guise, Nancy K Lowe, Shad Deering, Patricia O Lewis, Christen O'Haire, Lori K Irwin, Molly Blaser, Laurie S Wood, and Barbara G Kanki.
• Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregan Health & Science University, Portland, Oregan, USA. guisej@ohsu.edu
• Jt Comm J Qual Patient Saf. 2010 Oct 1;36(10):443-53.

BackgroundEvidence from other high-risk industries has demonstrated that teamwork skills can be taught and effective teamwork may improve safety. Increasingly, health care providers, hospital administrators, and quality and safety professionals are considering simulation as a strategy to improve quality and patient safety.Mobile Obstetric Simulation And Team Training ProgramA mobile obstetric emergency simulation and team training program was created to bring simulation technology and teamwork training used routinely in other high reliability fields directly to health care institutions. A mobile unit constituted a practical approach, given the expense of simulation equipment, the time required for staff to develop educational materials and simulation scenarios, and the need to have a standardized program to promote consistent evaluation across sites. Between 2007 and 2009, in situ simulation of obstetric emergencies and teamwork training was tested with more than 150 health care professionals in labor and delivery units across four rural and two community hospitals in Oregon. HOW DO ORGANIZATIONS DETERMINE WHICH TYPE OF SIMULATION IS BEST FOR THEM? Because simulation technologies are relatively costly to start and maintain, it can be challenging for hospitals and health care professionals to determine which format (send staff to a simulation center, develop in-house simulation program, develop a consortium of hospitals that run a simulation program, or use a mobile simulation program) is best for them.ConclusionsIn situ simulation is an effective way to develop new skills, to maintain infrequently used clinical skills even among experienced clinical teams, and to uncover and address latent safety threats in the clinical setting.

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