Following an investigation where ten times the amount of prescribed insulin was given to a patient during the administration of treatment for hyperkalaemia, learning needs were identified. It was from this incident outcome that the aim for this project arose. Create a hyperkalaemia simulation that can be delivered trust wide with only one facilitator. The simulation was run on the medical wards that the staff were familiar with to allow us to identify policies and process gaps as well as learning needs. The simulation only required two registered nurses and with the debriefing session usually took around 40 minutes. This limits the impact on busy wards allowing for safe staffing levels to be maintained. Simulation incident forms were completed for each session to highlight and raise awareness of identified learning points to both ward managers and local governance leads. The first error that impacted the simulation was the spelling affecting the access to treatment guidelines contained within a Trust policy. The Trust we work for is proud to be multinational, and we found that the majority of our colleagues that have received education oversees used the more widely recognized spelling in Europe of hyperkalemia. This was escalated and the second spelling was added as a keyword, after this change the problem was not repeated in subsequent simulations. It led to further reviews of Trust policies and has driven a change in keywords within the policy portfolio. The second and third errors were around lack policy and treatment flowchart awareness and poor knowledge on how to navigate the intranet to find policies. Although the participants in the simulation left with a good awareness of the policy and practices accessing the policy and flowchart during the session, it had become apparent that this was a wider Trust issue. Therefore, communication posters were made to highlight the policy and treatment flowchart for hyperkalaemia. Using a QR code staff could play a short video showing how to access the Trust policies from the intranet page after the sessions. Future plans include collaboratively using simulation to test systems and highlight learning points for other incidents or errors that arise throughout the Trust. Also, we look to utilize Dynamic QR codes [1] that allow for the content connect to the QR code to be updated without the poster having to be reprinted and laminated allowing for a live document. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A98 Lessons learned from hyperkalaemia simulation: improving policy & practice","authors":"Carly Cooper, Katy Howe, Ben Hester","doi":"10.54531/evzd9469","DOIUrl":"https://doi.org/10.54531/evzd9469","url":null,"abstract":"Following an investigation where ten times the amount of prescribed insulin was given to a patient during the administration of treatment for hyperkalaemia, learning needs were identified. It was from this incident outcome that the aim for this project arose. Create a hyperkalaemia simulation that can be delivered trust wide with only one facilitator. The simulation was run on the medical wards that the staff were familiar with to allow us to identify policies and process gaps as well as learning needs. The simulation only required two registered nurses and with the debriefing session usually took around 40 minutes. This limits the impact on busy wards allowing for safe staffing levels to be maintained. Simulation incident forms were completed for each session to highlight and raise awareness of identified learning points to both ward managers and local governance leads. The first error that impacted the simulation was the spelling affecting the access to treatment guidelines contained within a Trust policy. The Trust we work for is proud to be multinational, and we found that the majority of our colleagues that have received education oversees used the more widely recognized spelling in Europe of hyperkalemia. This was escalated and the second spelling was added as a keyword, after this change the problem was not repeated in subsequent simulations. It led to further reviews of Trust policies and has driven a change in keywords within the policy portfolio. The second and third errors were around lack policy and treatment flowchart awareness and poor knowledge on how to navigate the intranet to find policies. Although the participants in the simulation left with a good awareness of the policy and practices accessing the policy and flowchart during the session, it had become apparent that this was a wider Trust issue. Therefore, communication posters were made to highlight the policy and treatment flowchart for hyperkalaemia. Using a QR code staff could play a short video showing how to access the Trust policies from the intranet page after the sessions. Future plans include collaboratively using simulation to test systems and highlight learning points for other incidents or errors that arise throughout the Trust. Also, we look to utilize Dynamic QR codes [1] that allow for the content connect to the QR code to be updated without the poster having to be reprinted and laminated allowing for a live document. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"158 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs. Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations. 2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year. This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A107 Mental Health Simulation for Foundation Doctors: Bridging the gap of placement variation","authors":"Lisa Stevens, John Sterling","doi":"10.54531/ixgd1670","DOIUrl":"https://doi.org/10.54531/ixgd1670","url":null,"abstract":"There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs. Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations. 2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year. This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UK-based doctors in training have faced major disruption, loss of training opportunities and increased risk of burnout due to covid-19 [1,2]. Furthermore, the intensified post-covid strain on services continues to hamper efforts to restore training. A bottom-up review across departments at both of our sites revealed demand across specialties and grades for increased simulated training opportunities. Further highlighting the need for additional simulation programmes, simulated training has recently been demonstrated to reduce risk of burnout [3]. To restore lost learning opportunities, improve morale and promote team cohesion, we began a project to embed simulated training at a departmental level. A key aim of this project was to give departments ownership of their simulation programmes, to promote autonomy, tutor upskilling and sustainability. We systematically reviewed the curricula for all specialties with doctors-in-training across our two sites in order to establish how training needs could be met with simulation. Consultant ‘simulation lead’ positions were offered to consultants in each department. Following this, we met with each assigned simulation lead to perform a scoping exercise - thus establishing specific training needs and opportunities within each department. The medical education team used this information to support each department to develop its own simulated training programme and support its delivery. Crucially, unlike many simulated training opportunities, our programme is not tied to a particular training scheme nor does it incur any fees. This allows equal access to the programme for both locally employed doctors and Health Education England trainees. We worked with 13 departments in developing simulation-based training programmes. Eight departments had a single lead identified, three shared lead positions and in two departments no consultants assumed the position of lead. Experience and enthusiasm varied by department. In departments where a simulation lead was not identified, the education department has supported other team members such as Clinical Nurse Specialists and specialty registrars to devise and deliver sim-based training. Anonymized Microsoft Forms based post-course questionnaire responses completed by 42 participants to date have been overwhelmingly positive (outlined in Percentage of attendees rating the following areas as ‘agree’ or ‘strongly agree’ Our scheme has led to embedding of effective simulated training programmes across specialties at our sites, leading to sustainably improved training opportunities for post graduate doctors in the post covid era. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A29 Simulation Integration: A Multispecialty Programme Embedding Simulation within Departmental Teaching Programmes in two Cardiothoracic Centres","authors":"Alasdair Frater, Dominic Lowcock","doi":"10.54531/shsu1468","DOIUrl":"https://doi.org/10.54531/shsu1468","url":null,"abstract":"UK-based doctors in training have faced major disruption, loss of training opportunities and increased risk of burnout due to covid-19 [1,2]. Furthermore, the intensified post-covid strain on services continues to hamper efforts to restore training. A bottom-up review across departments at both of our sites revealed demand across specialties and grades for increased simulated training opportunities. Further highlighting the need for additional simulation programmes, simulated training has recently been demonstrated to reduce risk of burnout [3]. To restore lost learning opportunities, improve morale and promote team cohesion, we began a project to embed simulated training at a departmental level. A key aim of this project was to give departments ownership of their simulation programmes, to promote autonomy, tutor upskilling and sustainability. We systematically reviewed the curricula for all specialties with doctors-in-training across our two sites in order to establish how training needs could be met with simulation. Consultant ‘simulation lead’ positions were offered to consultants in each department. Following this, we met with each assigned simulation lead to perform a scoping exercise - thus establishing specific training needs and opportunities within each department. The medical education team used this information to support each department to develop its own simulated training programme and support its delivery. Crucially, unlike many simulated training opportunities, our programme is not tied to a particular training scheme nor does it incur any fees. This allows equal access to the programme for both locally employed doctors and Health Education England trainees. We worked with 13 departments in developing simulation-based training programmes. Eight departments had a single lead identified, three shared lead positions and in two departments no consultants assumed the position of lead. Experience and enthusiasm varied by department. In departments where a simulation lead was not identified, the education department has supported other team members such as Clinical Nurse Specialists and specialty registrars to devise and deliver sim-based training. Anonymized Microsoft Forms based post-course questionnaire responses completed by 42 participants to date have been overwhelmingly positive (outlined in Percentage of attendees rating the following areas as ‘agree’ or ‘strongly agree’ Our scheme has led to embedding of effective simulated training programmes across specialties at our sites, leading to sustainably improved training opportunities for post graduate doctors in the post covid era. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is recognized that clinical placements are sometimes limited for allied health professionals (AHPs) [1]. This, coupled with the ‘People Plan’ [2], which highlights the need for increasing numbers of AHPs in the workforce, has led to considerations of alternatives to traditional clinical placements. We were approached by a podiatry undergraduate programme to assist with delivering a podiatry simulated placement, for BSc and separately for MSc podiatry students, each for three days, for the academic year 2022/2023. Development of the simulated placement took five weeks; it was collaborative, with input from HEI academics, subject specialists, and simulation-based educationalists. Six scenarios were created which aligned with the HCPC Standards of Proficiency for Podiatrists [3]. These reflected the breadth of experiences students might have experienced in a clinical placement; they focused on communication and behaviours. Actors were involved in playing the roles of simulated colleagues, patients, and relatives, with experienced facilitators setting up a safe, non-threatening, immersive learning environment, covering triggers and time outs in the pre-brief. The following were areas covered: Scope of practice and autonomous practice Professional judgement Culture, equality, diversity and non-discriminatory practice Confidentiality and professionalism Team working Communication skills, face to face and telephone Safe practice environments The learning was underpinned by a communication skills framework enabling students to structure their conversations and behaviours appropriately. Reflection was used post debrief and explored the subsequent day. All scenarios were presented as either forum theatre or fishbowl simulation, with all students being present in the same space as the simulation. Evaluation was positive from both BSc and MSc groups. Students highly rated the structured approach provided by the communication framework stating it helped them converse effectively and build rapport with patients, relatives and colleagues. The inclusion of actors, although daunting for some initially, added hugely to their learning experience. Students commented on how they felt more prepared for real-world situations and how they hadn’t appreciated the breadth and impact of their practice. Simulated placements can offer a safe and controlled environment for podiatry students to develop their skills and engage in vital conversations with patients, relatives and colleagues. Facilitators should adapt to different confidence levels and learning styles of the students and actors fully briefed and in line with these adaptations. These simulated real-life placements are replicable and can help in preparing a workforce fit for purpose. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A112 Vital conversations for student podiatrists: a ‘real’ simulated placement","authors":"Jess Spencer, Carrie Hamilton, Rachel Forss, Channine Clarke","doi":"10.54531/zvph2192","DOIUrl":"https://doi.org/10.54531/zvph2192","url":null,"abstract":"It is recognized that clinical placements are sometimes limited for allied health professionals (AHPs) [1]. This, coupled with the ‘People Plan’ [2], which highlights the need for increasing numbers of AHPs in the workforce, has led to considerations of alternatives to traditional clinical placements. We were approached by a podiatry undergraduate programme to assist with delivering a podiatry simulated placement, for BSc and separately for MSc podiatry students, each for three days, for the academic year 2022/2023. Development of the simulated placement took five weeks; it was collaborative, with input from HEI academics, subject specialists, and simulation-based educationalists. Six scenarios were created which aligned with the HCPC Standards of Proficiency for Podiatrists [3]. These reflected the breadth of experiences students might have experienced in a clinical placement; they focused on communication and behaviours. Actors were involved in playing the roles of simulated colleagues, patients, and relatives, with experienced facilitators setting up a safe, non-threatening, immersive learning environment, covering triggers and time outs in the pre-brief. The following were areas covered: Scope of practice and autonomous practice Professional judgement Culture, equality, diversity and non-discriminatory practice Confidentiality and professionalism Team working Communication skills, face to face and telephone Safe practice environments The learning was underpinned by a communication skills framework enabling students to structure their conversations and behaviours appropriately. Reflection was used post debrief and explored the subsequent day. All scenarios were presented as either forum theatre or fishbowl simulation, with all students being present in the same space as the simulation. Evaluation was positive from both BSc and MSc groups. Students highly rated the structured approach provided by the communication framework stating it helped them converse effectively and build rapport with patients, relatives and colleagues. The inclusion of actors, although daunting for some initially, added hugely to their learning experience. Students commented on how they felt more prepared for real-world situations and how they hadn’t appreciated the breadth and impact of their practice. Simulated placements can offer a safe and controlled environment for podiatry students to develop their skills and engage in vital conversations with patients, relatives and colleagues. Facilitators should adapt to different confidence levels and learning styles of the students and actors fully briefed and in line with these adaptations. These simulated real-life placements are replicable and can help in preparing a workforce fit for purpose. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"25 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simulation faculty should be trained and competent [1, 2]. A strategic objective of the Health Education and Improvement Wales (HEIW) Simulation team is to provide equitable access to a standardized simulation faculty development programme across Wales. A consultation process involving meetings, focussed discussions and webinars with key stakeholders, educators and clinicians from a range of professional backgrounds was carried out. The following priority areas were identified: development of a tiered programme supporting a competency-based approach to develop educational skills, knowledge and behaviours required to deliver high quality simulation-based education and training (SBET) in safe learning environments to promote interprofessional SBET and offer flexible and accessible faculty training opportunities. A tiered programme framework consisting of 3 standalone courses (essential, advanced and expert) comprising 4 blended learning modules each, was designed collaboratively and informed by the literature [2,3]. Following content mapping and creation by experts, the Essential Course was launched in October 2022. It entails 5 hours of self-directed e- learning followed by a 5-hour facilitated (virtually or face to face) session, fully funded by HEIW. Advanced Course content is under development, due to commence in March 2024. Thirty-eight participants completed the essential course between October 2022 and February 2023, Learners were asked to rate the usefulness of each e-learning module on a Likert scale, with 1 equating to ‘not at all’ and 5 to ‘very much’. The number of participants that evaluated each module and reported them ≥4 is as follows: ‘Introduction to simulation’ Evaluation of the essential course e-learning modules Response rate to the evaluation of the face-to-face sessions was 24/28 (86%) and 8/10 (80%) for the virtual session. All responders 32/32 (100%) rated the face to face and virtual sessions ≥4 regarding relevance and usefulness, with 31/32 (97%) agreeing that the learning objectives were met. Common themes identified as ‘most useful’ were the ability to practise running a scenario and opportunity to practise debriefing and gain feedback. The Essential Course of the Sim FD Wales Programme has been well received and evaluated so far. Uptake has been high, with demand outstripping places available. Further evaluation is required to determine the effectiveness and impact of each course and the programme as a whole. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A34 Designing and implementing a National Simulation Faculty Development Programme for Wales (Sim FD Wales)","authors":"Clare Hawker, Cristina Diaz-Navarro, Sara-Catrin Cook, Bridie Jones, Suman Mita, Bethan Bartholomew","doi":"10.54531/bncx7773","DOIUrl":"https://doi.org/10.54531/bncx7773","url":null,"abstract":"Simulation faculty should be trained and competent [1, 2]. A strategic objective of the Health Education and Improvement Wales (HEIW) Simulation team is to provide equitable access to a standardized simulation faculty development programme across Wales. A consultation process involving meetings, focussed discussions and webinars with key stakeholders, educators and clinicians from a range of professional backgrounds was carried out. The following priority areas were identified: development of a tiered programme supporting a competency-based approach to develop educational skills, knowledge and behaviours required to deliver high quality simulation-based education and training (SBET) in safe learning environments to promote interprofessional SBET and offer flexible and accessible faculty training opportunities. A tiered programme framework consisting of 3 standalone courses (essential, advanced and expert) comprising 4 blended learning modules each, was designed collaboratively and informed by the literature [2,3]. Following content mapping and creation by experts, the Essential Course was launched in October 2022. It entails 5 hours of self-directed e- learning followed by a 5-hour facilitated (virtually or face to face) session, fully funded by HEIW. Advanced Course content is under development, due to commence in March 2024. Thirty-eight participants completed the essential course between October 2022 and February 2023, Learners were asked to rate the usefulness of each e-learning module on a Likert scale, with 1 equating to ‘not at all’ and 5 to ‘very much’. The number of participants that evaluated each module and reported them ≥4 is as follows: ‘Introduction to simulation’ Evaluation of the essential course e-learning modules Response rate to the evaluation of the face-to-face sessions was 24/28 (86%) and 8/10 (80%) for the virtual session. All responders 32/32 (100%) rated the face to face and virtual sessions ≥4 regarding relevance and usefulness, with 31/32 (97%) agreeing that the learning objectives were met. Common themes identified as ‘most useful’ were the ability to practise running a scenario and opportunity to practise debriefing and gain feedback. The Essential Course of the Sim FD Wales Programme has been well received and evaluated so far. Uptake has been high, with demand outstripping places available. Further evaluation is required to determine the effectiveness and impact of each course and the programme as a whole. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is increased availability and development of the advanced clinical practitioner (ACP) course to upskill allied health professionals in clinical, leadership and supervision areas [1]. Locally, ACPs and ACPs in training have not previously had simulation integrated into their training for this role despite this being considered an effective learning method for communication skills [2]. The simulation department was approached with funding to develop a course to add variation to their development programme and enhance learning in areas better targeted through simulation. A survey was sent to the ACP cohort to ascertain their desired learning objectives from simulation training. Then the team met a focus group of ACP trainees to further explore their varied roles and the expected changes moving to the ACP role. From this research, a 1-day course was developed to include scenarios with themes felt to be widely applicable across the umbrella of ‘advanced clinical practice’. Examples included; managing patient expectations, challenging hierarchy, safeguarding, learning disability, mental capacity assessment, difficult supervision. Two courses have been completed with a mix of ACP roles, and scenarios adapted to apply to the specific participants. The debriefs explored how the scenario theme could be applied cross discipline and gave an opportunity for these senior healthcare professionals to share experiences and their individual management strategies. This was a stimulating but challenging course to develop given the seniority and multidisciplinary background of the target group. This required significant creativity and adaptability from the organizing team and multiple scenarios to be designed for participants. The courses generated valuable discussion and all candidates reported the day to be a useful experience with specific learning and development taken from the day. Limitations included some allocated scenarios were felt to be outside the usual job remit of the allocated participant, which could impact on the authenticity and psychological safety of the scenario for that candidate. Despite this, useful discussion of the intended themes was still possible, and this was reinforced by the experience brought from the candidates present. Even though ACPs may have similar more complex learning needs in line with their required capabilities, this is challenging to translate into a transferable and valuable simulation course when targeting multiple disciplines with varying amounts of senior experience. We reflect on ways to approach this in the future and would be open to opinions from our esteemed education colleagues. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A115 Developing a simulation course for Advanced Clinical Practice-Challenges of designing for a diverse interprofessional group","authors":"Lisa Stevens, Sini John","doi":"10.54531/azri1037","DOIUrl":"https://doi.org/10.54531/azri1037","url":null,"abstract":"There is increased availability and development of the advanced clinical practitioner (ACP) course to upskill allied health professionals in clinical, leadership and supervision areas [1]. Locally, ACPs and ACPs in training have not previously had simulation integrated into their training for this role despite this being considered an effective learning method for communication skills [2]. The simulation department was approached with funding to develop a course to add variation to their development programme and enhance learning in areas better targeted through simulation. A survey was sent to the ACP cohort to ascertain their desired learning objectives from simulation training. Then the team met a focus group of ACP trainees to further explore their varied roles and the expected changes moving to the ACP role. From this research, a 1-day course was developed to include scenarios with themes felt to be widely applicable across the umbrella of ‘advanced clinical practice’. Examples included; managing patient expectations, challenging hierarchy, safeguarding, learning disability, mental capacity assessment, difficult supervision. Two courses have been completed with a mix of ACP roles, and scenarios adapted to apply to the specific participants. The debriefs explored how the scenario theme could be applied cross discipline and gave an opportunity for these senior healthcare professionals to share experiences and their individual management strategies. This was a stimulating but challenging course to develop given the seniority and multidisciplinary background of the target group. This required significant creativity and adaptability from the organizing team and multiple scenarios to be designed for participants. The courses generated valuable discussion and all candidates reported the day to be a useful experience with specific learning and development taken from the day. Limitations included some allocated scenarios were felt to be outside the usual job remit of the allocated participant, which could impact on the authenticity and psychological safety of the scenario for that candidate. Despite this, useful discussion of the intended themes was still possible, and this was reinforced by the experience brought from the candidates present. Even though ACPs may have similar more complex learning needs in line with their required capabilities, this is challenging to translate into a transferable and valuable simulation course when targeting multiple disciplines with varying amounts of senior experience. We reflect on ways to approach this in the future and would be open to opinions from our esteemed education colleagues. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"2 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autoethnography is an emerging category of qualitative research that seeks to connect the rigorous analysis of traditional science with the undeniable influence of human experience [1]. Despite remaining under-utilized within surgical and simulation-based education research [2], autoethnography has great potential for sharing systematic, personal reflections with the wider readership, particularly with surgical trainees who rely on experiential learning as a cornerstone of their training. This study examines the use of autoethnography to investigate virtual reality (VR) temporal bone (TB) drilling simulation as a learning tool for Ear, Nose and Throat (ENT) training from the perspective of a surgical novice. The primary researcher undertook 16 three-hour sessions learning to perform a virtual cortical mastoidectomy on the Voxel-Man TempoSurg (VMT) TB simulator from October 2021 to July 2022. Qualitative data including field notes and reflective journal logs were collected using a template. These data were coded using NVivo12 and analysed using inductive thematic analysis. Additional quantitative data on surgical simulation performance derived from the Modified Welling Scale and Modified Stanford Assessment were plotted using Microsoft Excel and statistically analysed using simple linear regression. Six themes were ultimately yielded relating to the learning experience: (1) VMT as a surgical learning tool, (2) internal and external causes of rushing leading to inaccuracy, (3) overcoming VMT technological issues, (4) reflecting on reflection and the importance of feedback, (5) the physical impact of surgery on the operator and (6) overcoming demotivation. The author’s reflections on each theme were subsequently discussed in detail and analysed in the context of the current literature to meet the study objectives. Statistical analysis of the quantitative data demonstrated statistically significant improvements in procedural skills and ability over the 16-session period ( This study demonstrates a novel application of autoethnography showing VR TB simulation to be an effective ENT training tool for learning anatomy and technical skills when used in combination with the regimented reflection and feedback of autoethnography. We found that rushing caused by assessment-driven behaviour and hunger led to errors. These errors led to demotivation and stress, emotions frequently experienced by operating surgeons [3]. Therefore, we have also demonstrated that VR TB simulation can successfully model several human factors commonly found in operating theatres which must be self-identified and prompt seeking senior support to prevent patient harm. This evidence should provide a springboard for future autoethnographic research in the field of surgical and simulation-based literature. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if
{"title":"A6 Virtual reality simulation as a tool for ENT training: an autoethnographic study","authors":"Thomas Binnersley, C. Lucy Dalton","doi":"10.54531/pvza8652","DOIUrl":"https://doi.org/10.54531/pvza8652","url":null,"abstract":"Autoethnography is an emerging category of qualitative research that seeks to connect the rigorous analysis of traditional science with the undeniable influence of human experience [1]. Despite remaining under-utilized within surgical and simulation-based education research [2], autoethnography has great potential for sharing systematic, personal reflections with the wider readership, particularly with surgical trainees who rely on experiential learning as a cornerstone of their training. This study examines the use of autoethnography to investigate virtual reality (VR) temporal bone (TB) drilling simulation as a learning tool for Ear, Nose and Throat (ENT) training from the perspective of a surgical novice. The primary researcher undertook 16 three-hour sessions learning to perform a virtual cortical mastoidectomy on the Voxel-Man TempoSurg (VMT) TB simulator from October 2021 to July 2022. Qualitative data including field notes and reflective journal logs were collected using a template. These data were coded using NVivo12 and analysed using inductive thematic analysis. Additional quantitative data on surgical simulation performance derived from the Modified Welling Scale and Modified Stanford Assessment were plotted using Microsoft Excel and statistically analysed using simple linear regression. Six themes were ultimately yielded relating to the learning experience: (1) VMT as a surgical learning tool, (2) internal and external causes of rushing leading to inaccuracy, (3) overcoming VMT technological issues, (4) reflecting on reflection and the importance of feedback, (5) the physical impact of surgery on the operator and (6) overcoming demotivation. The author’s reflections on each theme were subsequently discussed in detail and analysed in the context of the current literature to meet the study objectives. Statistical analysis of the quantitative data demonstrated statistically significant improvements in procedural skills and ability over the 16-session period ( This study demonstrates a novel application of autoethnography showing VR TB simulation to be an effective ENT training tool for learning anatomy and technical skills when used in combination with the regimented reflection and feedback of autoethnography. We found that rushing caused by assessment-driven behaviour and hunger led to errors. These errors led to demotivation and stress, emotions frequently experienced by operating surgeons [3]. Therefore, we have also demonstrated that VR TB simulation can successfully model several human factors commonly found in operating theatres which must be self-identified and prompt seeking senior support to prevent patient harm. This evidence should provide a springboard for future autoethnographic research in the field of surgical and simulation-based literature. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"2014 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sadie Rawlinson, HaEun Ji, Hannah Tierney, Beth Robbins
The Medical Support Worker (MSW) programme enables International Medical Graduates (IMG) and refugee doctors to support clinical teams, whilst General Medical Council registration is gained [1]. North Bristol NHS Trust, a large teaching hospital in South-West England, has designed and implemented a novel training programme for a second cohort of 30 MSWs. A comprehensive learning needs assessment informed the content of the programme. Learning needs were identified from two probing questionnaires and reflective pieces, completed by 22, 27 and 29 MSWs respectively; alongside Health Education England and General Medical Council guidance [2, 3]. Four principal areas were identified- (1) Communication, (2) Portfolio Development, (3) Career Development, (4) Preparation for work in the NHS. A subsequent teaching programme consisted of simulation, human factors, communication and ethics training, alongside community theatre delivered communication skills, interview preparation practice, portfolio training sessions and a specifically tailored lecture series. The programme was evaluated using two delayed surveys, formed largely of Likert scale questions, completed by 25 and 17 MSWs. Communication, social skills or cultural change were highlighted as the biggest challenges by 64% MSWs. Only 48% of MSWs felt confident working in the NHS. Confidence in managing emergencies, sensitive discussions, presenting cases, and updating relatives was low (0-35%). 75% requested teaching in assessing acutely unwell patients and decision-making. 60% wanted to improve teamworking skills. : Confidence working within the NHS rose from 48% to 92%. 100% of MSWs reported that the teaching programme helped them prepare for work as doctors in the NHS. There was a greater understanding of the structure and function of the NHS, the role of allied healthcare professionals, plus the portfolio and professional development requirements of doctors (92%). 100% of MSWs felt their communication skills had improved. 87.5% reported increased confidence with informal conversation and 100% reported increased confidence in voicing opinions and raising concerns. Additionally, 100% of MSWs reported increased confidence recognizing and assessing acutely unwell patients. Confidence in managing emergencies, sensitive discussions, presenting cases, and updating relatives improved (60-88%). This well-received, novel programme addresses some of the unique learning needs of MSWs and helps them prepare for work as doctors in the NHS. Collaborations with other trusts are taking place to establish whether the programme could be adapted for IMGs more broadly. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A61 A comprehensive training programme for Medical Support Workers at a large teaching hospital","authors":"Sadie Rawlinson, HaEun Ji, Hannah Tierney, Beth Robbins","doi":"10.54531/vrwy2398","DOIUrl":"https://doi.org/10.54531/vrwy2398","url":null,"abstract":"The Medical Support Worker (MSW) programme enables International Medical Graduates (IMG) and refugee doctors to support clinical teams, whilst General Medical Council registration is gained [1]. North Bristol NHS Trust, a large teaching hospital in South-West England, has designed and implemented a novel training programme for a second cohort of 30 MSWs. A comprehensive learning needs assessment informed the content of the programme. Learning needs were identified from two probing questionnaires and reflective pieces, completed by 22, 27 and 29 MSWs respectively; alongside Health Education England and General Medical Council guidance [2, 3]. Four principal areas were identified- (1) Communication, (2) Portfolio Development, (3) Career Development, (4) Preparation for work in the NHS. A subsequent teaching programme consisted of simulation, human factors, communication and ethics training, alongside community theatre delivered communication skills, interview preparation practice, portfolio training sessions and a specifically tailored lecture series. The programme was evaluated using two delayed surveys, formed largely of Likert scale questions, completed by 25 and 17 MSWs. Communication, social skills or cultural change were highlighted as the biggest challenges by 64% MSWs. Only 48% of MSWs felt confident working in the NHS. Confidence in managing emergencies, sensitive discussions, presenting cases, and updating relatives was low (0-35%). 75% requested teaching in assessing acutely unwell patients and decision-making. 60% wanted to improve teamworking skills. : Confidence working within the NHS rose from 48% to 92%. 100% of MSWs reported that the teaching programme helped them prepare for work as doctors in the NHS. There was a greater understanding of the structure and function of the NHS, the role of allied healthcare professionals, plus the portfolio and professional development requirements of doctors (92%). 100% of MSWs felt their communication skills had improved. 87.5% reported increased confidence with informal conversation and 100% reported increased confidence in voicing opinions and raising concerns. Additionally, 100% of MSWs reported increased confidence recognizing and assessing acutely unwell patients. Confidence in managing emergencies, sensitive discussions, presenting cases, and updating relatives improved (60-88%). This well-received, novel programme addresses some of the unique learning needs of MSWs and helps them prepare for work as doctors in the NHS. Collaborations with other trusts are taking place to establish whether the programme could be adapted for IMGs more broadly. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simulations can be important for wider learning and patient safety [1]. However, the delivery of traditional simulations is not always feasible [2]. We developed an alternative ‘Mini-Sim’ to deliver high quality teaching with a sustainable approach, aimed to save time and resources. The simulation team delivered traditional ward-based simulations every Wednesday. Where this was not possible, due to timing or staffing constraints, we delivered ‘Mini-Sims’. This involved participant verbalizing their assessments to a pre-written scenario with a facilitator asking follow-up questions as opposed to physically acting out. Data collected over 5 months included the type and duration of simulation, how many participants were involved, and resources required. Across the 5 months, between 0 to 16 participants were reached monthly using traditional simulations, whereas ‘Mini-Sims’ reached 4 to 14, Comparing participant numbers from ‘Traditional Sims’ with ‘Mini-Sims’ delivered between October 2022 to February 2023 Where resources and time are limited, the minimalistic approach of ‘Mini-Sims’ provide consistent teaching opportunities and promotes sustainability in man-power, time, and costs. Whilst humble in appearance, ‘Mini-Sims’ show sizeable potential for sustainable learning. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A62 Mini in Disruption, Major in Impact: The Use and Sustainability of ‘Mini-Sims’","authors":"Cary Tang, Mariam Tarhini, Esther Wilson, Benjamin Hester, Vanessa Redwood, Ashley Duzy","doi":"10.54531/qkwc6448","DOIUrl":"https://doi.org/10.54531/qkwc6448","url":null,"abstract":"Simulations can be important for wider learning and patient safety [1]. However, the delivery of traditional simulations is not always feasible [2]. We developed an alternative ‘Mini-Sim’ to deliver high quality teaching with a sustainable approach, aimed to save time and resources. The simulation team delivered traditional ward-based simulations every Wednesday. Where this was not possible, due to timing or staffing constraints, we delivered ‘Mini-Sims’. This involved participant verbalizing their assessments to a pre-written scenario with a facilitator asking follow-up questions as opposed to physically acting out. Data collected over 5 months included the type and duration of simulation, how many participants were involved, and resources required. Across the 5 months, between 0 to 16 participants were reached monthly using traditional simulations, whereas ‘Mini-Sims’ reached 4 to 14, Comparing participant numbers from ‘Traditional Sims’ with ‘Mini-Sims’ delivered between October 2022 to February 2023 Where resources and time are limited, the minimalistic approach of ‘Mini-Sims’ provide consistent teaching opportunities and promotes sustainability in man-power, time, and costs. Whilst humble in appearance, ‘Mini-Sims’ show sizeable potential for sustainable learning. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"97 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On-call respiratory physiotherapy is utilized when an acutely unwell patient could deteriorate without immediate assessment and treatment overnight. Education related to this topic varies greatly and is often of poor quality. Simulation-based education (SBE) has been increasingly used within other areas of healthcare yet, Gough et al. [1] completed a study in 2013, which found only 39% of acute trusts used simulation for respiratory on-call training. To determine from existing research, whether SBE can enhance the development of registered physiotherapists respiratory ‘on-call’ skills in order to impact future practice. A qualitative literature review was completed as part of a PgCert in Health Simulation at Coventry University, in March 2023. Ethical approval was gained from Coventry University (P149952). Studies included were found by searching AMED, CINAHL Embase and Medline databases. PRISMA flow diagram Eleven papers were selected to be reviewed after the removal of duplicates, screening and the exclusion criteria were applied. The main themes identified were the use of high-fidelity simulation, the measure of confidence and/or competence, and findings of positive implications for practice. SBE is widely used for other healthcare professions with positive outcomes; however, its use within respiratory physiotherapy is limited. Most studies chose to measure self-reported levels of competence and confidence, which is an example of Kirkpatrick level-one evaluation. These measures have only casual links to transfer of knowledge and behaviour change, which are key requirements when applying training to clinical settings. Interestingly, the review also demonstrates favourable use of high-fidelity manikins within this population. Although this was not discussed by the researchers, this may be a barrier for further implementation due to cost and technical knowledge required to use the equipment. The use of SBE has been beneficial in other healthcare professions and similar positives were found for its use with respiratory physiotherapists. However, much of the research is of low quality, and further research is required to review other confounding factors that may influence the outcomes and longitudinal staff behaviour. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
{"title":"A20 Does the use of simulation enhance the development of registered physiotherapist’s respiratory ‘on-call’ skills – a literature review","authors":"Emily Barnfield","doi":"10.54531/nnqb8682","DOIUrl":"https://doi.org/10.54531/nnqb8682","url":null,"abstract":"On-call respiratory physiotherapy is utilized when an acutely unwell patient could deteriorate without immediate assessment and treatment overnight. Education related to this topic varies greatly and is often of poor quality. Simulation-based education (SBE) has been increasingly used within other areas of healthcare yet, Gough et al. [1] completed a study in 2013, which found only 39% of acute trusts used simulation for respiratory on-call training. To determine from existing research, whether SBE can enhance the development of registered physiotherapists respiratory ‘on-call’ skills in order to impact future practice. A qualitative literature review was completed as part of a PgCert in Health Simulation at Coventry University, in March 2023. Ethical approval was gained from Coventry University (P149952). Studies included were found by searching AMED, CINAHL Embase and Medline databases. PRISMA flow diagram Eleven papers were selected to be reviewed after the removal of duplicates, screening and the exclusion criteria were applied. The main themes identified were the use of high-fidelity simulation, the measure of confidence and/or competence, and findings of positive implications for practice. SBE is widely used for other healthcare professions with positive outcomes; however, its use within respiratory physiotherapy is limited. Most studies chose to measure self-reported levels of competence and confidence, which is an example of Kirkpatrick level-one evaluation. These measures have only casual links to transfer of knowledge and behaviour change, which are key requirements when applying training to clinical settings. Interestingly, the review also demonstrates favourable use of high-fidelity manikins within this population. Although this was not discussed by the researchers, this may be a barrier for further implementation due to cost and technical knowledge required to use the equipment. The use of SBE has been beneficial in other healthcare professions and similar positives were found for its use with respiratory physiotherapists. However, much of the research is of low quality, and further research is required to review other confounding factors that may influence the outcomes and longitudinal staff behaviour. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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