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Original Article
DOI: 10.1016/j.enfcle.2021.03.001
Available online 16 March 2021
Use of clinical simulation to train healthcare teams in conflict management: A scoping review
Uso de la simulación clínica para entrenar equipos en el manejo de conflictos durante los cuidados en salud: una revisión sistemática exploratoria
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Francisca Putza,
Corresponding author
fcputz@uc.cl

Corresponding author.
, Eduardo Kattana, Jose M. Maestreb
a Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
b Hospital Virtual Valdecilla, Santander, Spain
Received 14 January 2020. Accepted 12 October 2020
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Table 1. Search strategy.
Table 2. Summary of the selected papers.
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Abstract
Objective

To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review.

Methods

A structured literature review was performed with the terms [Clinical Simulation OR Patient Simulation OR Simulation Training OR High Fidelity simulation Training] AND [Conflict OR Conflict Resolution] in the following databases: MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS y DOCUMED. Articles were considered if they involved clinical simulation oriented to training of healthcare professionals or trainees in conflict management, using clinical scenarios, and excluding those studies older than 20 years. Absence of debriefing was not considered an exclusion criterion, neither the use of simulation along with other methodologies. A quantitative analysis was performed.

Results

10 articles were retrieved, mostly with quasi-experimental designs, in which clinical simulation was designed as an interprofessional training and was used with multiple other methodologies like roleplay, reflexive practice and audiovisual aids, strategy that suggest an increase its effectivity. Different scenarios have been recreated, like decision-making divergences and management of medical errors, in order to apply the competences of mediation, communication, emotional skills among others, and followed by debriefing. The use of validated scales and conventional assessment methods reveal a positive impact on satisfaction, perception and learning of students, as well as transfer to clinical practice and decrease in errors.

Conclusion

Multiple studies describe and support the use of clinical simulation for training in management and resolution of conflicts among healthcare professionals. Simulation is accepted by participants, developing transfer of skills and competences and impact at the organizational level. Nonetheless, studies are recent and limited in number, making this area a developing field that promotes future research.

Keywords:
Clinical simulation
Conflict management
Team training
Interprofessional education
Resumen
Objetivo

Explorar y analizar el uso de la simulación clínica para la formación y/o capacitación de equipos clínicos en el manejo y resolución de conflictos en salud, mediante una revisión sistemática exploratoria.

Método

Se realizó una búsqueda con los términos [Clinical Simulation OR Patient Simulation OR Simulation Training OR High Fidelity simulation Training] AND [Conflict OR Conflict Resolution] en las bases de datos MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS y DOCUMED. Los límites fueron el uso de la simulación clínica orientado a la formación en el manejo de conflictos en estudiantes o profesionales de la salud, con uso de escenarios clínicos, excluyendo aquellos con más de 20 años. No se consideró excluyente el uso o no de debriefing, ni el uso de simulación junto a otras metodologías. Se realizó un análisis cualitativo.

Resultados

Se obtuvieron diez artículos, mayoritariamente cuasi-experimentales en los cuales la simulación clínica se utiliza prioritariamente de forma interprofesional para la capacitación en manejo de conflictos clínicos en conjunto a otras metodologías tales como role play, práctica reflexiva y uso de recursos audiovisuales, lo cual sugiere aumentar su efectividad. Se han recreado situaciones como discrepancia en la toma de decisiones y manejo de errores médicos, buscando aplicar competencias de mediación, comunicación y habilidades emocionales entre otras, seguidas de debriefing. La aplicación de escalas validadas y métodos convencionales revelan un impacto positivo en la satisfacción, percepción y aprendizaje de los participantes, así como en la transferencia y disminución de errores atribuidos a la atención.

Conclusión

Los estudios utilizan y apoyan el uso de la simulación clínica para la formación en el manejo y resolución de conflictos en salud, siendo aceptada por los participantes, generando transferencia e impacto a nivel organizacional. Sin embargo, los estudios son limitados y recientes, siendo un campo aún en desarrollo que invita a futuras investigaciones.

Palabras clave:
Simulación clínica
Manejo de conflictos
Entrenamiento de equipos
Educación interprofesional

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