Dr. Andrew Petrosoniak: Design Thinking, Optimizing the physical space and the pre-brief!

“In a well-designed emergency medicine space, team members might not need to rely heavily on explicit CRM principles because the environment naturally facilitates better coordination and efficiency”. Welcome to my conversation with Dr. Andrew Petrosoniak, emergency physician and trauma team leader at St. Michael’s Hospital. We talk about designing workspaces that promotes implicit coordination. We talk about the 5 stepts of design thinking as a great method for improvement and change instead. See how this improved blood delivery in trauma care and more important how it is a form of co-creation instead of top down solutions. As an bonus Andrew gives 3 steps for an effective pre-brief!

Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital and an Assistant Professor in the Department of Medicine at the University of Toronto. He has completed a Master of Science in medical education where he focused on the use of in situ simulation (practice in the actual workplace) in procedural skill acquisition.


Pre-briefing In trauma situations and the three key questions
Importance of designing physical spaces in healthcare.
Examples of poorly designed environments and their impact.
Comparison between healthcare environments and high-performance settings like F1 pit stops.
Introduction to design thinking and its application in healthcare.
Steps in the design thinking process.
Discussion on continuous improvement and iterative processes.
Examples of design thinking in action, such as designing trauma bays.
The power of design thinking in creating user-centered solutions.
Importance of feedback in the design process.
Case study: Designing MRI and CT scan experiences for children.
Differences between design thinking and traditional quality improvement methods.
Preparing healthcare teams for high performance through environment design.




Petrosoniak, A., & Hicks, C. M. (2013). Beyond crisis resource management: new frontiers in human factors training for acute care medicine. Current opinion in anaesthesiology26(6), 699–706. https://doi.org/10.1097/ACO.0000000000000007

Petrosoniak, A., & Hicks, C. (2021). Design, build, train, excel: using simulation to create elite trauma systems. International anesthesiology clinics59(2), 58–66. https://doi.org/10.1097/AIA.0000000000000312

Petrosoniak, A., Hicks, C., Barratt, L., Gascon, D., Kokoski, C., Campbell, D., White, K., Bandiera, G., Lum-Kwong, M. M., Nemoy, L., & Brydges, R. (2020). Design Thinking-Informed Simulation: An Innovative Framework to Test, Evaluate, and Modify New Clinical Infrastructure. Simulation in healthcare : journal of the Society for Simulation in Healthcare15(3), 205–213. https://doi.org/10.1097/SIH.0000000000000408

Argintaru, N., Li, W., Hicks, C., White, K., McGowan, M., Gray, S., & Petrosoniak, A. (2021). An Active Shooter in Your Hospital: A Novel Method to Develop a Response Policy Using In Situ Simulation and Video Framework Analysis. Disaster medicine and public health preparedness15(2), 223–231. https://doi.org/10.1017/dmp.2019.161

Petrosoniak, A, Sherbino, J, Beardsley, T, Bonz, J, Gray, S, Hall, AK et al.. Are we talking about practice? A randomized study comparing simulation-based deliberate practice and mastery learning to self-guided practice. CJEM. 2023;25 (8):667-675. doi: 10.1007/s43678-023-00531-0. PubMed PMID:37326922 .

Petrosoniak, A, Gabriel, J, Purdy, E. Stop asking if it works, start making it happen: exploring barriers to clinical event debriefing in the ED. CJEM. 2022;24 (7):673-674. doi: 10.1007/s43678-022-00396-9. PubMed PMID:36274091 .

Truchot, J., Boucher, V., Li, W., Martel, G., Jouhair, E., Raymond-Dufresne, É., Petrosoniak, A., & Emond, M. (2022). Is in situ simulation in emergency medicine safe? A scoping review. BMJ open, 12(7), e059442. https://doi.org/10.1136/bmjopen-2021-059442

Hicks, C., & Petrosoniak, A. (2018). The Human Factor: Optimizing Trauma Team Performance in Dynamic Clinical Environments. Emergency medicine clinics of North America, 36(1), 1–17. https://doi.org/10.1016/j.emc.2017.08.003