The Why, Who, What, and Where to Implement a Simulation Program in Obstetrics and Gynecology

  • Kay DanielsEmail author
Part of the Comprehensive Healthcare Simulation book series (CHS)


When implementing a simulation program, the initial question is WHY? Why are you embarking on a simulation program? Is it for residency training, team performance improvement, or improvement of your unit workflow with identification of latent system errors? After the WHY is clearly defined, the subsequent questions, who, what, and where, are easily answered. WHO do you need to accomplish the predetermined goal, and how do you best engage them. The WHO includes identifying your learners, team members, and the stakeholders. All must be committed to ensure the program will be a success. Strategies to engage WHO vary and options are discussed. The WHAT encompasses the curriculum and equipment including creating a safe zone where learners can practice new and difficult skills without judgment. WHERE defines the site of the simulation whether it is a simulation lab, in situ on labor and delivery, or a classroom, each offering pros and cons. Strategies for a careful and thoughtful introduction of a simulation program are presented. Successful planning will ensure your effort will become an integral component of a comprehensive patient safety program.


Strategies for the implementation of a simulation program 


  1. 1.
  2. 2.
  3. 3.
  4. 4.
    Nielsen P, Mann S. Team function in obstetrics to reduce errors and improve outcomes. Obstet Gynecol Clin N Am. 2008;35:81–95.CrossRefGoogle Scholar
  5. 5.
    Austin N, Goldhaber-Fiebert S, Daniels K, Arafeh J, Grenon V, Welle D, Lipman S. Building comprehensive strategies for obstetric simulation drills and communication. Anesth-Analg. 2016;123(5):1–10.CrossRefGoogle Scholar
  6. 6.
    Gee D. Using simulation to decrease medical liability. Accessed 18 Feb 2017.
  7. 7.
    Preston P, Lopez C, Corbett N. How to integrate findings from simulation exercises to improve obstetric care in the institution. Semin Perinatol. 2011;35:84–8.CrossRefGoogle Scholar
  8. 8.
    Bender J. In situ simulation for system testing in newly constructed perinatal facilities. Semin Perinatol. 2011;35:80–3.CrossRefGoogle Scholar
  9. 9.
    Auguste T, Boswick A, Loyd M, Battista A. The simulation of an ex utero intrapartum procedure to extracorporeal membrane oxygenation. J Pediatr Surg. 2011;46:395–8.CrossRefGoogle Scholar
  10. 10.
    Olejniczak E, Schmidt N, Brown J. Simulation as an orientation strategy for new nurse graduates: an integrative review of the evidence. Simul Healthc. 2010;5:52–7.CrossRefGoogle Scholar
  11. 11.
    Hargreave L, Nichols A, Shanks S, Halamak L. A handoff report card for general nursing orientation. J Nurs Adm. 2010;40(10):424–31.CrossRefGoogle Scholar
  12. 12.
    Krajewski A, Filppa D, Staff I, Singh R, Kirton O. Implementation of an intern boot camp curriculum to address clinical competencies under the new accreditation Council for Graduate Medical Education supervision requirements and duty hour restrictions. JAMA Surg. 2013;148(8):727–32.CrossRefGoogle Scholar
  13. 13.
    Minha S, Shefet D, Sagi D, Berkenstadt H, Zvi A. “See one, Sim one, do one ” a national pre-Internship boot-camp to ensure a safer “student to doctor” transition. PLoS One. 2016;11(3):e0150122.CrossRefGoogle Scholar
  14. 14.
  15. 15.
    Lipman S, Daniels K, Cohen SE, Carvalho B. Labor room setting compared with the operating room for simulated perimortem cesarean delivery. Obstet Gynecol. 2011;118(5):1090–4.CrossRefGoogle Scholar
  16. 16.
    Rudolph J, Raemer D, Simon R. Establishing a safe container for learning in simulation the role of the Presimulation briefing. Simul Healthc. 2014;9(6):339–49.CrossRefGoogle Scholar
  17. 17.
    Hamman W, Beaudin-Seiler B, Beaubien J, Gullickson A, Gross A, Orizondo-Korotko K, et al. Using in situ simulation to identify and resolve latent environment threats to patient safety: case study involving a labor and delivery ward. J Patient Saf. 2009;5(3):184–7.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyStanford Health CarePalo AltoUSA

Personalised recommendations