Introduction: simulation can be a powerful tool to improve interprofessional teamwork and improve patient outcomes. This manuscript aims to describe a simulation intervention and explore its potential benefits and barriers to its successful implementation to inform future work.

Methods: this is a prospective observational study. We conducted 22 in situ simulation sessions in the operating room within a General Surgery division. Observations of surgical teams were conducted before the simulation, on the day of the simulation, and 3 to 4 months after the simulation. Team performance was measured using the NOTECHS scale, an instrument designed to assess the non-technical skills of interprofessional teams. Direct observation was used to assess teamwork, and variation in scores was assessed using ANOVA. Qualitative semi-structured interviews were conducted with participants to explore benefits and barriers of the intervention, and analyzed using content analysis.

Results: no change in team performance was observed using the NOTECHS scale. Participants described not being prepared enough to benefit from the sessions, voiced concerns regarding unequal role of participants in the simulation, and reported a fear of being judged by other team members during the sessions.

Conclusion: overall, we identified multiple potential barriers to implementation of in situ simulation as interprofessional teamwork training. The challenges identified here can inform the design and implementation of future teamwork training interventions.