Room of horrors simulation in healthcare education: A systematic review.

Objectives: A room of horrors simulation is one tool that healthcare educators use to improve learners' awareness of patient safety hazards and other critical matters in a safe and controlled environment. This review aimed to summarize research on use of room of horrors simulation in healthcare education, examine its effectiveness, and recommend directions for future education and research.

Design: A systematic review of the literature.

Data Sources: Relevant publications in English were identified in PubMed, Embase, CINAHL, Scopus, and dissertation databases, and through a manual search of the reference lists of included articles.

Review Methods: The systematic review and its reporting process conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Included articles were evaluated for quality using the Mixed Methods Appraisal Tool. Two authors independently extracted data from each article, and two additional authors confirmed the accuracy of the extracted data. The "horrors" used in the studies' simulations were mapped into 13 different incident types.

Results: Sixteen studies were included in the final review. All of them were conducted in Western countries. Simulation scenarios were developed based on existing resources, expert guidance, or patient safety concerns frequently reported at a particular institution. The number of horrors per scenario ranged from nine to 68, with the most common being medication-related and clinical procedure-related incidents. Participants completed a room of horrors simulation as individuals, a team, or both. When competing as a team, the team sizes ranged from two to 11. Studies reported high participant satisfaction.

Conclusions: Room of horrors simulation is a useful teaching tool for healthcare students and professionals. However, there is little conclusive evidence about the ideal composition and size of teams, and therefore this merits more research attention, as does attention to the longer term impacts on learners.