A mock code, or medical simulation, is a structured training exercise designed to replicate a real-life medical emergency, such as cardiac arrest, in a controlled setting. These simulations allow interdisciplinary healthcare teams to practice immediate response skills and procedural adherence without risk to an actual patient. The primary goal is to improve overall team performance, refine individual competency, and ensure compliance with established advanced life support protocols. This rehearsal environment helps staff move beyond theoretical knowledge to practical application, reducing errors and response times during high-stakes events.
Preparing the Simulation Environment
The success of a mock code begins with creating an environment that closely mirrors the actual clinical setting, often referred to as in-situ simulation. This staging involves positioning a high-fidelity manikin on a patient bed, surrounded by standard unit equipment, including a functional crash cart, defibrillator, and monitoring devices. The manikin should be capable of displaying realistic physiological signs, such as an electrocardiogram rhythm, blood pressure, and oxygen saturation. The facilitator controls these signs remotely to simulate patient deterioration.
Scenario design must be specific, starting with clear, predetermined learning objectives that focus on a particular clinical challenge, such as treating ventricular fibrillation or managing pulseless electrical activity. Before the simulation starts, all participants must receive defined roles, including a designated team leader, a compressor, an airway manager, and a medication recorder. Assigning these responsibilities promotes immediate role clarity and minimizes confusion during the initial moments of the simulated emergency response.
Executing the Scenario
Execution begins immediately once participants encounter the simulated patient, often starting with a brief pre-scenario handover detailing the patient’s baseline history. The instructor, acting as the scenario facilitator, controls the manikin’s physiological changes and introduces information, such as laboratory results or patient status updates, as the team requests them. This controlled progression ensures the scenario evolves based on the team’s actions, rewarding correct interventions or challenging them with further deterioration.
Maintaining realism requires adherence to established protocols, such as the American Heart Association’s Advanced Cardiac Life Support (ACLS) algorithms, which dictate the sequence of defibrillation, compressions, and medication administration. The team must demonstrate effective closed-loop communication: a member who receives an order, such as “give one milligram of epinephrine,” repeats the order back to confirm it before administering the drug. The facilitator manages the flow of time, often employing “time jumps” to fast-forward through prolonged tasks like chest compressions, allowing the team to focus on decision-making points.
Conducting the Post-Code Debrief
Immediately following the scenario, the post-code debrief is the most valuable phase, providing a structured opportunity for reflection and learning. This session must be separated from any formal grading or individual evaluation, focusing instead on observable behaviors and system issues to maintain a psychologically safe environment. A common structured approach begins by allowing participants to share their immediate reactions and emotional responses to the high-pressure situation.
The discussion then moves into an analysis phase, often using a “plus-delta” model. The team first identifies what went well (the “pluses”), such as effective team leadership or timely defibrillation. Next, they discuss areas for improvement (the “deltas”), which often center on clinical decision-making or communication breakdowns. The facilitator guides this conversation, prompting participants to analyze why certain actions were taken and encouraging self-correction rather than simply dictating mistakes. The session concludes by summarizing the key takeaways and committing to specific, actionable changes that can be integrated into future clinical practice.