In Situ Simulation Training in Lifeguard Organisations (DROWN_INSITU)

In Situ Simulation Training in Lifeguard Organisations: a Danish Retrospective Study From 2018-2023

This retrospective study will analyse a dataset consisting of 919 in situ simulation assessments collected between 2018 and 2023 in a Danish nationwide surf lifeguard organisation. The primary objective is to estimate the pass/fail ratio of in situ simulation assessments. The secondary objective is to analyse risk factors associated with a failed assessment. These results may guide future efforts to improve the Danish surf lifeguard training program.

Study Overview

• Status: Completed
• Conditions: Drowning; Drowning, Near; Drowning and Nonfatal Submersion; Drowning and Submersion While in Natural Water; Drowning/Submersion
• Intervention / Treatment: Other: In situ simulation assessment

Detailed Description

Background: Once weekly on all lifeguard-supervised beaches during the summer holiday period, a lifeguard instructor sneaks undetected into the primary surveillance zone between the flags and raises a hand to indicate a drowning scenario. This is called in situ simulation and is used to assess Danish surf lifeguards' rescue and medical skills. It is an unannounced test occurring during working hours, followed by feedback and training with the lifeguard instructors. Previous data indicate that approximately 1 in 5 lifeguards fail the in situ assessment. Analysing data from in situ simulation assessments may pinpoint areas for future improvement.

Objectives: The primary objective is to estimate the pass/fail ratio of in situ simulation assessments. The secondary objective is to analyse risk factors associated with a failed assessment. These results may guide future efforts to improve the Danish surf lifeguard training program.

Methods: This retrospective study will analyse a dataset consisting of 919 in situ simulation assessments collected between 2018 and 2023 in a Danish nationwide surf lifeguard organisation. Data on the local conditions (e.g., wave height, time of the day, and the number of beach visitors) and the in situ evaluation (pass/fail) were extracted directly from the predefined variables. Data on failure reasons were extracted through manual validation of the semi-structured free text fields by four independent observers. Any discrepancies were resolved by a senior member of the research group.

• Study Type: Observational
• Enrollment (Actual): 768

Contacts and Locations

Study Locations

• Denmark
  • Region Zealand
    • Næstved, Region Zealand, Denmark, 4700
      • Prehospital Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The participants from this study are all trained in the nationwide Danish lifeguard organisation according to the International Life Saving Federations standards.

Description

Inclusion Criteria:

• All in situ assessments in the nationwide Danish lifeguard organisation from 2018 to 2023.

Exclusion Criteria:

• Blank entries
• Dublets

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Passed in situ assessment; This group passed their in situ assessment (summative assessment)	Other: In situ simulation assessment; Unannounced in situ simulation assessment during working hours
Failed in situ assessment; This group failed their in situ assessment (summative assessment)	Other: In situ simulation assessment; Unannounced in situ simulation assessment during working hours

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pass/fail ratio of in situ simulation assessments	To estimate the pass/fail ratio of in situ simulation assessments.	All in situ assessments from 2018-2023 will be included in this analysis.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Risk factors associated with a failed assessment	To analyse risk factors associated with a failed assessment	All in situ assessments from 2018-2023 will be included in this analysis.

Collaborators and Investigators

• Sponsor: Prehospital Center, Region Zealand
• Investigators: Study Director: Helle C Christensen, Ass. Prof., Prehospital Center, Region Zealand

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2018
• Primary Completion (Actual): December 31, 2023
• Study Completion (Actual): December 31, 2024

Study Registration Dates

• First Submitted: March 13, 2024
• First Submitted That Met QC Criteria: March 13, 2024
• First Posted (Actual): March 20, 2024

Study Record Updates

• Last Update Posted (Actual): June 4, 2025
• Last Update Submitted That Met QC Criteria: June 1, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Simulation; In situ simulation; Drowning; Lifesaver; Lifeguard
• Additional Relevant MeSH Terms: Wounds and Injuries; Pathologic Processes; Death; Drowning; Near Drowning
• Other Study ID Numbers: DROWN_INSITU

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data will be available from the corresponding author upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No