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Simulation-based training and assessment in healthcare are now commonplace in the majority of industrialised nations. The role of standardised patients, high-fidelity and low-fidelity manikins, synthetic, animal and virtual reality platforms, and simulation suites, are accepted, and integrated into training curricula in medical and nursing schools, and residency programmes. Despite this widespread use, only a handful of studies have assessed the impact of simulation-based education on patient and health system outcomes, and these studies have their focus on procedural skills such as central line insertion or laparoscopic surgery.1 2 Furthermore, the emphasis of such studies has been on simulation-based education as a tool to impact early learners, with minimal consideration of its use for independent practitioners such as attending physicians and experienced nurses.
An emerging area of simulation-based education is just-in-time training, or as it was termed by Niles et al in 2009, ‘rolling refreshers’, which comprised a portable manikin/defibrillator system to provide automated corrective feedback to optimise cardiopulmonary resuscitation (CPR) skills of paediatric intensive care unit staff.3 All of the 420 participants were independent practitioners, including nurses, physicians and respiratory therapists, with providers who undertook frequent refresher sessions (denoted as more than two per month), achieving CPR skills success three times more rapidly than those who were infrequent users of the simulation sessions. In 2013, Scholtz et al described a study for a central venous catheter (CVC) dressing change programme, …