Sağlıkta Simülasyon Tabanlı Eğitimin Hasta Güvenliği Üzerindeki Etkilerinin İncelenmesine Yönelik Bütünsel Bir Yaklaşım: Bir Sistematik Derleme

Abstract

Bu sistematik derleme, simülasyona dayalı eğitimin sağlık hizmetlerinde hasta güvenliği üzerindeki etkilerini bütünsel olarak ortaya koymayı amaçlamaktadır. Çalışmada, simülasyon tabanlı eğitimin hasta güvenliğini nasıl etkilediğini, özellikle de hasta güvenliğini iyileştirmek için simülasyon tabanlı eğitimin nasıl uygulandığını inceleyen çalışmaları incelemek için sistematik bir inceleme metodolojisi kullanılmıştır. Çalışma amacına göre tasarlanan arama ile Science Direct (n=306), Scopus (n=49), Springer (n=61), Medline (n=74), PubMed (n=70), Web of Science (n=50) veri tabanları olmak üzere 610 çalışma tespit edilmiştir. Yirmi iki (22) çalışma, arama kriterlerine göre sistematik olarak tarandıktan sonra sentezlenmiştir. Sonuçlar, simülasyona dayalı eğitimin hasta güvenliği riskini azalttığını, sağlık personelinin özgüvenini artırdığını, kaynakların etkin kullanımını sağladığını, ekip uyumunu artırdığını ve maliyetleri düşürdüğünü göstermiştir. Bu çalışma, hasta güvenliğinde simülasyona dayalı eğitimin, hasta-ekip uyumu ve sağlık kurumları açısından olumlu sonuçlarını ortaya koymaktadır. Hasta güvenliğinde simülasyona dayalı eğitimin benimsenmesi, hem sağlık profesyonellerinin hem de sağlık ve eğitim kurumlarının gündemine yeni ve bütüncül bir yaklaşım getirmektedir. Hasta güvenliğinde simülasyon tabanlı eğitim konusunda literatürde umut verici sonuçlar bulunsa da, çalışmaların önemli bir kısmının literatür ve kamuoyu çalışmaları olduğu göz önüne alındığında, bu konuda daha fazla çalışmaya ihtiyaç bulunduğu değerlendirilmektedir.

Keywords

• Hata Önleme
• Tıbbi Hatalar
• Hasta Güvenliği
• Simülasyon
• Simülasyon Tabanlı Eğitim

A Holistic Approach to Examine the Effects of Simulation-Based Education on Patient Safety in Healthcare: A Systematic Review

Abstract

This systematic review aims to holistically reveal the effects of simulation-based education on patient safety in healthcare. This study used a systematic review methodology to examine studies about how simulation-based education effect patient safety, particularly applying simulation-based education to improve patient safety. With the search designed based on study purpose in databases, 610 studies were identified Science Direct (n=306), Scopus (n=49), Springer (n=61), Medline (n=74), PubMed (n=70), Web of Science (n=50). Twenty-two (22) studies were synthesized after systematic screening based on study criteria. Results indicated that simulation-based education reduces the risk of patient safety, increases the self-confidence of healthcare staff, ensures effective use of resources and increases team cohesion, and reduces costs. This study reveals the positive results of simulation-based education in patient safety in terms of patient, team harmony and health institutions. It brings a new holistic approach to the agenda of medical professionals, health and educational institutions to adopt simulation-based education in patient safety. Although there are promising results in the literature on the simulation-based education in patient safety, further studies on the subject are needed, considering that a significant part of the studies are literature and opinion studies.

Keywords

• Error Prevention
• Medical Errors
• Patient Safety
• Simulation
• Simulation-Based Education

References

1. Andersen, P., Downer, T., Spencer, A., & Willcocks, K. (2020). Using observational simulation teaching methods in professional development to address patient safety. Collegian, 27(2), 207-212. https://doi.org/10.1016/j.colegn.2019.07.005
2. Bates, D. W., & Singh, H. (2018). Two decades since to err is human: an assessment of progress and emerging priorities in patient safety. Health Affairs (Millwood), 37(11), 1736-1743. https://doi.org/10.1377/hlthaff.2018.0738
3. Bokka, L., Ciuffo, F., & Clapper, T. C. (2024). Why simulation matters: A systematic review on medical errors occurring during simulated health care. Journal of Patient Safety, 20(2), 110-118. https://doi.org/10.1097/pts.0000000000001192
4. Brown, J., Kelly, M. A., McGough, S., Fagence, A., Bosco, A. M., Mason, J., & Albrecht, M. A. (2020). The impact of simulation on graduate entry master's students' confidence to provide safe patient care: A longitudinal study. Clinical Simulation in Nursing, 45, 6-15. https://doi.org/10.1016/j.ecns.2019.12.001
5. Bursiek, A. A., Hopkins, M. R., Breitkopf, D. M., Grubbs, P. L., Joswiak, M. E., Klipfel, J. M., & Johnson, K. M. (2020). Use of high-fidelity simulation to enhance interdisciplinary collaboration and reduce patient falls. Journal of Patient Safety, 16(3), 245-250. https://doi.org/10.1097/pts.0000000000000277
6. Campbell, K., Gardner, A., Scott, D. J., Johnson, J., Harvey, J., & Kazley, A. (2023). Interprofessional staff perspectives on the adoption of or black box technology and simulations to improve patient safety: A multi-methods survey. Advances in Simulation, 8(1), 24. https://doi.org/10.1186/s41077-023-00263-2
7. Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality and Safety, 30(2), 96. https://doi.org/10.1136/bmjqs-2019-010206
8. Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x

9. Institute of Medicine Committee on Quality of Health Care in, A. (2000). In L. T. Kohn, J. M. Corrigan, & M. S. Donaldson (Eds.), To err is human: Building a safer health system. National Academies Press (US). https://doi.org/10.17226/9728
10. Ironside, P. M., Jeffries, P. R., & Martin, A. (2009). Fostering patient safety competencies using multiple-patient simulation experiences. Nursing Outlook, 57(6), 332-337. https://doi.org/10.1016/j.outlook.2009.07.010
11. Jeong, J. H., & Kim, E. J. (2020). Development and evaluation of an sbar-based fall simulation program for nursing students. Asian Nursing Research (Korean Soc Nurs Sci), 14(2), 114-121. https://doi.org/10.1016/j.anr.2020.04.004
12. Jung, S. J., Song, J.-E., Bae, S. H., Lee, Y., Gwon, S. H., & Park, J.-H. (2023). Simulation-based training program on patient safety management: A quasi-experimental study among new intensive care unit nurses. Nurse Education Today, 126, 105823. https://doi.org/10.1016/j.nedt.2023.105823
13. Kim, B., & Yu, S. (2024). Factors affecting the patient safety activities of hospital nurses: A cross-sectional study focusing on shared leadership. Safety science, 174, 106460. https://doi.org/10.1016/j.ssci.2024.106460
14. Kim, N.-Y. (2021). Nursing students' informal learning of patient safety management activities. Healthcare (Basel, Switzerland), 9(12). https://doi.org/10.3390/healthcare9121635
15. Kurutkan, M.N., Orhan,F. & Kaygısız, P. (2017). Bibliometric analysis of patient safety literature example of thesis and articles in Turkish, Health Care Acad J, 17(4) ,253-259, https://doi.org/10.5455/sad.13-1513948006
16. Le, A., Lee, M. A., & Wilson, J. (2023). Nursing handoff education: An integrative literature review. Nurse Education in Practice, 68, 103570. https://doi.org/10.1016/j.nepr.2023.103570
17. Lee, M. Y., & Kim, S. S. (2018). A safety simulation program for operating room nurses. Clinical Simulation in Nursing, 18, 6-13. https://doi.org/10.1016/j.ecns.2017.12.005
18. Lilford, R., Stirling, S., & Maillard, N. (2006). Citation classics in patient safety research: An invitation to contribute to an online bibliography. Quality & Safety in Health Care, 15(5), 311-313. https://doi.org/10.1136/qshc.2005.017178
19. Lopez, C. M., Laffoon, K., & Kutzin, J. M. (2024). Use of Simulation for improving quality and patient safety. Nursing Clinics of North America, 59(3), 463-477. https://doi.org/10.1016/j.cnur.2024.01.006
20. Lynch, A. (2020). Simulation-based acquisition of non-technical skills to improve patient safety. Seminars in Pediatric Surgery, 29(2), 150906. https://doi.org/10.1016/j.sempedsurg.2020.150906
21. Madden, C., Lydon, S., Cupples, M. E., Hart, N. D., Curran, C., Murphy, A. W., & O'Connor, P. (2019). Safety in primary care (SAP-C): A randomised, controlled feasibility study in two different healthcare systems.| BMC Family Practice, 20(1), 22. https://doi.org/10.1186/s12875-019-0909-8
22. Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. BMJ, 353, i2139. https://doi.org/10.1136/bmj.i2139
23. McArthur, A., Klugárová, J., Yan, H., & Florescu, S. (2015). Innovations in the systematic review of text and opinion. JBI Evidence Implementation, 13(3). https://journals.lww.com/ijebh/fulltext/2015/09000/innovations_in_the_systematic_review_of_text_and.11.aspx
24. Mhyre, J., Ward, N., Whited, T. M., & Anders, M. (2020). Randomized controlled simulation trial to compare transfer procedures for emergency cesarean. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(3), 272-282. https://doi.org/10.1016/j.jogn.2020.01.006
25. National Library of Medicine (2008). Translation of the hippocratic oath. Retrieved 20.06.2025 from https://www.nlm.nih.gov/hmd/topics/greek-medicine/index.html#case1
26. Oh, J. W., & Kim, J. E. (2023). Effectiveness of a virtual reality application-based education programme on patient safety management for nursing students: A pre-test-post-test study. Nursing Open, 10(12), 7622-7630. https://doi.org/10.1002/nop2.2001
27. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. International Journal of Surgery, 88, 105906.
28. Park, J., & Kim, K. J. (2021). Effects of patient deterioration simulation using inattentional blindness for final year nursing students: A randomized controlled trial. Nurse Education Today, 106, 105080. https://doi.org/10.1016/j.nedt.2021.105080
29. Phrampus, P. E. (2018). Simulation and integration into patient safety systems. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 13(4), 225-226. https://doi.org/10.1097/SIH.0000000000000332
30. Qayumi, K., Pachev, G., Zheng, B., Ziv, A., Koval, V., Badiei, S., & Cheng, A. (2014). Status of simulation in health care education: An international survey. Advances in Medical Education and Practice, 5, 457-467. https://doi.org/10.2147/AMEP.S65451
31. Raemer, D., Hannenberg, A., & Mullen, A. (2018). Simulation safety first: An imperative. Advances in simulation, 3(1), 25. https://doi.org/10.1186/s41077-018-0084-3
32. Schmidt, E., Goldhaber-Fiebert, S. N., Ho, L. A., & McDonald, K. M. (2013). Simulation exercises as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5 Pt 2), 426-432. https://doi.org/10.7326/0003-4819-158-5-201303051-00010
33. Shaw, T. J., Pernar, L. I., Peyre, S. E., Helfrick, J. F., Vogelgesang, K. R., Graydon-Baker, E., Chretien, Y., Brown, E. J., Nicholson, J. C., Heit, J. J., Co, J. P., & Gandhi, T. (2012). Impact of online education on intern behaviour around joint commission national patient safety goals: A randomised trial. BMJ Quality & Safety, 21(10), 819-825. https://doi.org/10.1136/bmjqs-2011-000702
34. Şen, H. (2025). Occupational accidents in Türkiye’s health sector: A decade of evidence from TURKSTAT and SGK (2013–2023). Turkish Medical Journal, 10(3),92-101. https://doi.org/10.70852/tmj.1736096
35. Thomas, F., Chung, S., & Holt, D. W. (2019). Effects of ecmo simulations and protocols on patient safety. The Journal of Extracorporeal Technology, 51(1), 12-19. Retrieved 11.06.2025 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436167/pdf/ject-51-12.pdf
36. Usher, K., Woods, C., Conway, J., Lea, J., Parker, V., Barrett, F., O'Shea, E., & Jackson, D. (2018). Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study. Nurse Education Today, 66, 82-89. https://doi.org/10.1016/j.nedt.2018.04.013
37. Wakeman, D., & Langham, M. R., Jr. (2018). Creating a safer operating room: Groups, team dynamics and crew resource management principles. Seminars in Pediatric Surgery, 27(2), 107-113. https://doi.org/10.1053/j.sempedsurg.2018.02.008
38. WHO. (2023). Patient safety. Retrieved 06.05.2025 from https://www.who.int/news-room/fact-sheets/detail/patient-safety