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Clin Teach. 2017 Apr;14(2):90-94. doi: 10.1111/tct.12549. Epub 2016 Jun 21.

Sequential simulation of a patient journey.

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Centre for Engagement & Simulation Science, Imperial College London, UK.
North West London Integrated Care Programme, UK.



To develop an intervention for educating pharmacists (community and hospital) about integrated care and their role in implementing it.


We developed a sequential simulation derived from a patient's journey, with the key scenario featuring a community pharmacist. The scenarios were designed with input from pharmacists and patients, and emphasised the point that operating in silos can have an affect on the patient. Operating in silos can have an affect on the patient EVALUATION: Evaluation was by questionnaire, field notes and analysis of video material. Of the 37 participants in total, 21 (56.7%) responded to the questionnaire, and 19 of the 21 expressed that they felt the event was a good or excellent educational experience, had improved their confidence in their capability to improve patient care, and said that their knowledge and understanding of integrated care had been enhanced. The sequential simulation was appreciated as a way of visualising integrated care, with 19/21 describing it as good or excellent. Further themes were identified through video analysis and field-note analysis.


Sequential simulation is a novel and practical approach to present current care pathways, aiming to generate a mutual focus, create participant empathy and bring the conventionalities of integrated care to life. We consider this approach helpful in preparing frontline staff to participate in integrated care.

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