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

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.