Interactive learning in a Room of Horrors
Attention to patient safety risks can be trained: in a Room of Horrors. In this training room, errors and risks that are a danger to patient safety are hidden. Participants try to discover them, individually or as a team.
Simulated training – hands-on experience just like real life
A «Room of Horrors» is a place where professionals can train in patient safety. In one or more specially prepared rooms (e.g. patient room, laboratory, dining room), medical errors and risks are hidden. The participants then try to discover them. This method raises awareness, trains attention in a fun way, while encouraging problem-solving as a team. Unlike learning from a theory-based approach, in a Room of Horrors the hazards of everyday clinical life can be experienced hands-on.
Since such a training can be set up easily and only with few technical resources, this type of interactive learning is suitable for institutions of all sizes. Using the Foundation's manuals, the simulation can be implemented in hospitals, medical practices and retirement and nursing homes.
Room of Horrors in the hospital
In 2019, the Foundation developed a manual for setting up a Room of Horrors in hospitals as part of a research project. The manual contains six themed situations: Internal Medicine, Geriatrics, Orthopedics, Cardiac Surgery, Pediatrics and Medication Room. It was tested in 13 hospitals. In October 2021, the manual was updated and a debriefing guide was added.
The 13 hospitals completed anonymous feedback forms that were used to collect data and assess the method. In addition, the Foundation carried out observations in nine of the hospitals. The results show that a Room of Horrors is a well-received method for enhancing employees' situational awareness. Participants rated the Room of Horrors as recommended (98%), relevant (96%), and educational (95%), and 95% said they had learned from other members of the group. The results of the study are published in the Journal of Patient Safety.
Room of Horrors in retirement and nursing homes
In 2021, a manual for implementing a Room of Horrors in retirement and nursing homes was developed. The manual contains two situations for simulation training: in a resident's room and in the dining hall.
The new scenarios were developed in cooperation with experts and were implemented in six pilot institutions. Following the training, a debriefing was conducted to resolve and discuss the hidden errors and risks. This evaluation came to comparable results as in the hospital. The majority of the 332 participants found the training in the Room of Horrors was «somewhat to very» instructive (95%) and would «likely or definitely» recommend participation to their colleagues (99%). The project managers in the six pilot institutions also rated the training as positive and would recommend it to others.
Room of Horrors in medical practices
A manual for primary care physicians and pediatricians was also developed in 2021. It contains six patient cases (three pediatric cases and three primary care cases) and a list of additional errors and risks that can be set up without case histories.
Piloting and evaluation
The new scenarios were developed in consultation with experts and underwent a practical test during piloting. Five practices and one medical interdisciplinary training center participated. The pilot run showed that the Room of Horrors concept can be successfully transferred from the hospital to the outpatient setting. Professionals who have completed the Room of Horrors, as well as those responsible for its implementation, rated the training as very positive. All participants found the hidden errors and risks to be relevant and would recommend the experience to others.
«The training in the Room of Horrors has made our team aware of patient safety in a new way. Since we started checking for errors and risks together, CIRS reports are rising.»
The manuals are downloadable as PDF in German. The Word template can be obtained upon request.
Download poster template
A template poster is available for promoting the room of horrors in hospitals and can be downloaded as a PDF file. It is also available as a JPEG and as a Word template. Upon request, a customizable version can be requested from: infonoSpam@patientensicherheit.noSpamch.
Media coverage (in German)
- «Schweiz Aktuell» berichtet aus der Hirslanden Klinik Beau-Site in Bern, die zu Schulungszwecken einen «Room of Horrors» eingerichtet hat. Zur Sendung vom 21.9.2020
- Was geschieht im «Room of Horrors»? Das Gesundheitsmagazin «Puls» von Fernsehen SRF1 hat Andrea Käppeli, Pflegeexpertin am Spital Muri AG, beim interaktiven Training über die Schulter geschaut. (Sendeminute 00:50–06:56) Zur Sendung vom 2. September 2019
The materials were developed and piloted as part of two projects in 2019 and 2021. Both projects were financially supported by the Federal Office of Public Health FOPH.