Unlocking safety and quality: exploring factors which contribute to procedural teams’ management of iatrogenic complications through interprofessional simulation

Abstract Background Simulation-based procedural training is a significant focus of healthcare education, however training in complications arising from procedures is variable and context-specific. We argue that without this, procedural competence and patient safety may be compromised. Using interprofessional simulation, our aim was to explore and better understand factors that contribute to the quality and safety of healthcare teams when managing procedural complications. These findings can be used to inform the design of future educational interventions dedicated to enhancing patient care through the provision of procedural complication training. Methods This study was conducted across two hospital sites. We designed an interprofessional, in-situ, simulation-based intervention, focussing on potential complications of bronchoscopy. This was delivered on four occasions, between January 2025 – February 2025. Data collection involved audio-recording simulation debriefings which were transcribed then analysed using reflexive thematic analysis, sensitised by Bandura’s Social Cognitive Theory. Results Sixteen participants were recruited – eight respiratory registrars and eight endoscopy nurses. Three themes were generated which influence quality and safety within procedural teams: Clinical Experience Shapes Anticipation and Sensemaking, Teams Distribute Practical and Cognitive Work and The Environment Extends or Constrains Cognition. Conclusion This study provides important insights into factors which underpin safe and effective management of procedural complications within interprofessional teams. The themes highlight the multifaceted nature of team performance during these adverse events. Our findings emphasise that technical competence alone is insufficient for the management of procedural complications and that patient safety relies on the integration of experience, team adaptation and supportive systems. We provide a guide, centred around Bandura’s SCT, to facilitate the design and delivery of future educational interventions aiming to enhance the quality and safety of procedural teams.