Introduction: In-situ simulation offers a realistic training environment with a higher level of fidelity compared to other simulation models. It is associated with enhanced knowledge retention and a higher level of composure during real clinical encounters. One common barrier to undertaking in-situ simulation is the concern that it contributes to a delay in providing patient care. In this study we gave patients in the waiting room seven hypothetical emergency medical scenarios, two of which were training simulation scenarios, and we asked them how long they would be willing to delay their care if the different scenarios were actually occurring in the emergency department (ED). Our objective was to investigate whether patients in the ED waiting room would be willing to delay their care if they knew that there were simulation training scenarios occurring.
\nMethods: This was a prospective convenience sample of participants conducted at a Level 1 trauma centre. Participants completed a survey that presented seven hypothetical scenarios, including two in-situ simulation scenarios. They were then asked to indicate the amount of additional wait time they would deem acceptable for each scenario.
\nResults: Responses to the two in-situ simulation scenarios indicated that 342 (40%) and 335 (40.5%) of the 827 study participants, respectively, were willing to wait > 40 minutes for these to occur. In contrast, and after controlling for age, sex, waiting time, and time of recruitment, subjects reported they would tolerate shorter wait times for simulation scenarios than for real patient-care scenarios. [Willingness to wait > 40 minutes for the five real scenarios ranged from 70.5–79.9%, P < .05).
\nConclusion: While patients demonstrated lower tolerance for simulation-related delays than for routine clinical care, our results showed that most were still willing to wait up to an additional hour to allow in-situ simulation to proceed. These findings indicate that in-situ simulation is broadly acceptable to patients and supports its continued use in clinical settings.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"In-situ Simulation"},{"word":"education"},{"word":"Waiting Room"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5mc9p4r0","frozenauthors":[{"first_name":"Alice","middle_name":"","last_name":"Rogan","name_suffix":"","institution":"Wellington Hospital, Department of Emergency Medicine, Wellington, New Zealand","department":""},{"first_name":"Euan","middle_name":"","last_name":"Watt","name_suffix":"","institution":"Wellington Hospital, Department of Emergency Medicine, Wellington, New Zealand","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Murphy","name_suffix":"","institution":"Florida State University, College of Medicine, Department of Emergency Medicine, Sarasota, Florida","department":""},{"first_name":"Emily","middle_name":"","last_name":"Wheeler","name_suffix":"","institution":"Florida State University, College of Medicine, Department of Emergency Medicine, Sarasota, Florida","department":""},{"first_name":"Lisa","middle_name":"","last_name":"Woods","name_suffix":"","institution":"Victoria University, School of Mathematics and Statistics, Wellington, New Zealand","department":""},{"first_name":"Sagar","middle_name":"","last_name":"Galwankar","name_suffix":"","institution":"Florida State University, College of Medicine, Department of Emergency Medicine, Sarasota, Florida","department":""},{"first_name":"Brad","middle_name":"","last_name":"Peckler","name_suffix":"","institution":"Wellington Hospital, Department of Emergency Medicine, Wellington, New Zealand","department":""}],"date_submitted":"2025-07-07T22:09:40.304000Z","date_accepted":"2025-11-29T22:01:11.513000Z","date_published":"2026-04-14T20:39:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48916/galley/50356/download/"}]}