A mock code simulation is a structured training exercise designed to replicate a real-life medical emergency, such as cardiac arrest. This method utilizes realistic settings, equipment, and scenarios to test the response of a healthcare team. Simulation training provides a safe environment for practitioners to practice high-stakes, low-frequency events without risk to actual patients. This organized training improves team communication, procedural mastery, and overall coordination during time-sensitive clinical events. The goal is to enhance team performance, which directly supports improved patient outcomes during actual emergencies.
Pre-Simulation Planning and Role Assignment
The foundation of any successful simulation begins with clearly defined, measurable learning objectives. These objectives guide the scenario design and focus the team’s efforts on specific areas of practice, such as mastering Advanced Cardiac Life Support (ACLS) protocols or refining synchronized cardioversion. The scenario must be tailored to challenge the team in relation to these predefined learning targets and allows for objective measurement during the subsequent debriefing.
The simulation environment must be meticulously prepared to mirror the actual clinical setting. This involves selecting a dedicated room and ensuring all necessary equipment is present and functional. Setting up realistic monitoring equipment that displays dynamic patient data maintains the fidelity of the exercise. This preparation helps immerse the team and encourages them to treat the scenario as a real event.
The crash cart must be stocked with “mock” supplies, clearly labeled to distinguish them from actual medication and equipment. This includes placebo medications, simulated intravenous fluids, and non-functional defibrillator pads. Mannequins are positioned to allow for realistic chest compressions and airway management practice. Ensuring the equipment is ready prevents unnecessary delays and confusion once the scenario is initiated.
A structured approach to role assignment is implemented before the simulation to prevent hesitation and confusion. Specific positions are designated, ensuring that high-quality chest compressions are maintained without interruption. Every participant must clearly understand their designated responsibilities and the scope of their actions.
Role Assignments
- Team Leader who manages the overall flow
- Recorder responsible for documentation
- Airway Manager
- Medication Nurse
- Compressor role, or multiple compressors
Participants receive a pre-simulation briefing outlining the ground rules and safety measures. This briefing clarifies the “fiction contract,” where participants agree to treat the scenario as real, and identifies the “safe word” or signal to pause the simulation if a participant feels overwhelmed. Establishing these boundaries early maximizes the learning potential while ensuring a supportive and non-punitive training atmosphere.
Real-Time Scenario Execution
Execution begins with a trigger event that introduces the team to the simulated patient, often a rapid deterioration or an unexpected collapse. Maintaining realism requires the facilitator to use dynamic patient monitors to display changing cardiac rhythms and vital signs. This visual and auditory input forces the team to rely on clinical assessment skills.
The facilitator’s role shifts to observer, monitoring team dynamics and adherence to protocols. They provide necessary information, such as lab results or patient history, only when requested by the team leader, simulating the information flow of a real emergency. The facilitator must resist the urge to intervene directly.
Intervention is reserved for safety concerns or when the team has reached a critical learning moment and is unable to progress, where a subtle prompt may be offered. The simulation should allow the team to make errors, as analyzing these mistakes during debriefing is a powerful learning tool. Fidelity is maintained when the facilitator remains largely invisible.
The team must execute the procedural flow, adhering closely to established algorithms like the ACLS guidelines for managing cardiac arrest. This involves performing effective chest compressions at a rate of 100 to 120 per minute and a depth of at least two inches. The Medication Nurse must accurately simulate the timing of drug administration, such as epinephrine every three to five minutes.
Coordination requires diligent teamwork, including efficient switching of compressors every two minutes to prevent fatigue and maintain compression quality. The Recorder is responsible for accurately logging the time of all interventions, defibrillations, and medication doses. This detailed procedural execution tests both individual skills and the team’s ability to communicate under pressure.
The scenario concludes when a predetermined “stop” point is reached. This may be the patient achieving Return of Spontaneous Circulation (ROSC), when the learning objective is met, or after a set period. The facilitator then immediately transitions the group into the debriefing phase.
Post-Simulation Debriefing and Feedback
The learning derived from a simulation is largely determined by the quality of the debriefing. This session must begin promptly after the stop point while the events and emotions are still fresh in the participants’ minds. The environment should be psychologically safe, encouraging open reflection without fear of punitive judgment.
A common and beneficial structure for the debriefing session is the Advocacy-Inquiry method. The facilitator first advocates (states an observation) and then inquires (asks the participant’s perspective). This framework shifts the focus from simple criticism to a shared exploration of decisions and actions, fostering reflective practice. The discussion moves away from simply listing errors and toward understanding the underlying thought processes.
Feedback must remain focused on observable behaviors, procedural compliance, and team dynamics, rather than personality or intent. Discussion topics often include communication clarity, adherence to the two-minute compression switch, and the effectiveness of the team leader’s command. Analyzing video recordings can provide objective evidence to support the discussion points.
The final step involves documenting the key learning points, performance metrics, and identified areas for improvement. This documentation is crucial for tracking progress across subsequent training sessions and informing future curriculum design. Integrating the lessons learned into actual clinical practice closes the loop.