Constructing Shared Mental Models in High-Acuity Clinical Trajectories: A Narrative Review and Proposed Framework for Multidisciplinary Simulation Integrating Pre-Hospital, Emergency, and Surgical Disciplines
Abstract
Background: High-acuity patient crises, particularly those involving complex surgical pathologies like bariatric or endocrine emergencies, demand seamless coordination across pre-hospital, emergency, and surgical teams. Traditional siloed training often fails to prepare these disparate groups for the intense collaboration required, leading to breakdowns in communication, role confusion, and delayed decision-making. Aim: This narrative review aims to synthesize current evidence on multidisciplinary simulation (MDS) as a pedagogical tool to build shared mental models, enhance interprofessional communication, and clarify role responsibilities among EMS, Emergency Medicine, Nursing, and General Surgery teams during time-sensitive events. Methods: A structured literature search was conducted across PubMed, CINAHL, Scopus, and Web of Science (2010-2024) using keywords related to simulation, interprofessional education, teamwork, and the specified clinical domains. Included literature focused on simulation involving at least three of the target disciplines in high-acuity settings. Results: The analysis reveals that MDS effectively improves non-technical skills, including situational awareness, closed-loop communication, and leadership. Scenario design principles emphasizing realism, cognitive fidelity, and structured debriefing are critical. Successful implementations, such as "Field-to-OR" or "Clinic-to-ICU" pathways for surgical complications, demonstrate improved clinical outcomes, including reduced time-to-intervention and enhanced team psychological safety. Conclusion: Multidisciplinary simulation is a powerful, evidence-based strategy for constructing the shared cognitive frames necessary for managing complex patient crises. To bridge persistent gaps in care continuity, healthcare institutions must prioritize and institutionalize immersive, cross-disciplinary simulation training that mirrors the high-stakes, interdependent nature of real-world emergency care.
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Copyright (c) 2025 Albalihed Mohanad Mtrokh, Abdulkhaliq Mashni Alamri, Emad Atallah Oudah Almashari, Abdalmalek Mtrouk H Alblyhed, Sultan Ghanem Alruwaili, Khalid Sulaiman Alanazi, Ahmed Essa Alkhaldi, Dr. Haddaj Abdulmohsen Alkuraya, Ali Mohammed Khader Alhazmi, Fahad Asri Jaddua Alhazmi, Amani Margel Othman Alhazmi, Rayan Riyadh Abdullah Aldandani, Mona Margel Othman Alhazmi, Aisha Lafi Alhazmi, Bushra AlKhalifah
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