Development and enrichment of the undergraduate simulation experience is needed due to its utility in developing the aspiring clinician and their ability to assess and manage acutely unwell patients. However, with its heavy resource demand, and the desire for technologically enhanced learning by ‘Generation Z’, novel simulation modalities must now be considered [1]. Mixed reality (MR) technology provides a platform to deliver such simulation training; however, it is yet to be studied in this context. To evaluate this, we conducted an observational cohort study to assess if MR simulation improves students’ perceived ability to assess and manage acutely unwell patients. We recruited 32 undergraduate medical students and asked them to rate their ability to assess and manage acutely unwell patients out of 10, before delivering a 2-hour MR simulation teaching session using the Microsoft HoloLens head-mounted device and HoloScenario software produced by GigXR [2]. They were then asked again to rate their assessment and management ability alongside their experience of the MR system and its usability. Data were analysed using paired Analysis of the MR teaching session showed a statistically significant improvement of student scores in their perceived ability in assessment ( MR shows promise in its ability to deliver simulation training and improve students’ perceived ability to assess and manage acutely unwell patients. Advances in software availability and simulation exercises are required for complete integration into undergraduate medical curricula. Further research is required to assess if MR simulation objectively improves student performance in this area. 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":"A13 Mixed reality simulation training in the assessment and management of acutely unwell patients in undergraduate medical education: a pilot study","authors":"Benjamin Rowlands, Dominic Proctor","doi":"10.54531/ujlt8117","DOIUrl":"https://doi.org/10.54531/ujlt8117","url":null,"abstract":"Development and enrichment of the undergraduate simulation experience is needed due to its utility in developing the aspiring clinician and their ability to assess and manage acutely unwell patients. However, with its heavy resource demand, and the desire for technologically enhanced learning by ‘Generation Z’, novel simulation modalities must now be considered [1]. Mixed reality (MR) technology provides a platform to deliver such simulation training; however, it is yet to be studied in this context. To evaluate this, we conducted an observational cohort study to assess if MR simulation improves students’ perceived ability to assess and manage acutely unwell patients. We recruited 32 undergraduate medical students and asked them to rate their ability to assess and manage acutely unwell patients out of 10, before delivering a 2-hour MR simulation teaching session using the Microsoft HoloLens head-mounted device and HoloScenario software produced by GigXR [2]. They were then asked again to rate their assessment and management ability alongside their experience of the MR system and its usability. Data were analysed using paired Analysis of the MR teaching session showed a statistically significant improvement of student scores in their perceived ability in assessment ( MR shows promise in its ability to deliver simulation training and improve students’ perceived ability to assess and manage acutely unwell patients. Advances in software availability and simulation exercises are required for complete integration into undergraduate medical curricula. Further research is required to assess if MR simulation objectively improves student performance in this area. 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 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":"135871657","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}
In the United Kingdom, trainee doctors rotate through different specialities during their training. They are often unfamiliar with systems, environments, and personnel. Working on a general paediatric ward in a district general hospital can be anxiety inducing for those new to paediatrics. Fortnightly low-fidelity simulation scenarios are embedded in our local teaching schedule to improve confidence amongst the medical and nursing team. These are performed on the ward addressing varied scenarios, aiming to increase confidence with clinical cases, improve local environment and systems awareness, and enhance communication between professionals. Fortnightly 30-minute simulation sessions are run by the paediatric simulation team on the paediatric ward at our trust. The wider multidisciplinary team are invited, including nurses and health care assistants. The emergency buzzer from a bed space is pulled, and those involved attend and a scenario is undertaken. The scenario is structured to involve the wider team to improve interdisciplinary working and non-technical skills, as well as address clinical outcomes. Equipment is provided using a grab bag. Once the scenario has ended, a debrief is performed involving candidates and observers of all disciplines, to discuss technical and non-technical skills. Post session feedback was collected on each occasion with quantitative data via Likert scales and qualitative data by free text questions. In-situ simulation has been part of the departmental paediatric teaching rota since 2009 but has been a regular fortnightly occurrence since 2018. This is because it has been rostered into our working hours before the medical team assume clinical duties. We have collected feedback since September 2018. We have had 616 participants and delivered 82 scenarios in the clinical environment. This includes during the Covid pandemic. The weighted average confidence recorded by candidates pre-scenario was 2.51 with confidence post-scenario recorded as 3.69. 83% reported improved confidence following the scenario. This is an important finding as 45% had never encountered the scenario before in their practice. Thematic analysis has highlighted key aspects including communication, escalation, teamwork and available resources. In-situ, low fidelity simulation is an effective tool to improve human factors amongst the multidisciplinary team on a paediatric ward. By regularly simulating clinical practice in their daily working environment, all candidates have demonstrated improved clinical confidence and better familiarity with the ward environment. Additionally, the fortnightly in-situ simulation has improved working relationships through recognition of the roles of the ward multidisciplinary team, communication skills and team and leaderships skills. 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 ap
{"title":"A49 Five Year Review of Paediatric Multidisciplinary In-Situ Simulation on a General Paediatric Ward","authors":"Shoshana Layman, Catherine Beatty, Chukwudumebi Mbeledogu, Lucine Nahabedian, Ashish Patel, Ash Holt, Annabel Copeman","doi":"10.54531/jnpi7905","DOIUrl":"https://doi.org/10.54531/jnpi7905","url":null,"abstract":"In the United Kingdom, trainee doctors rotate through different specialities during their training. They are often unfamiliar with systems, environments, and personnel. Working on a general paediatric ward in a district general hospital can be anxiety inducing for those new to paediatrics. Fortnightly low-fidelity simulation scenarios are embedded in our local teaching schedule to improve confidence amongst the medical and nursing team. These are performed on the ward addressing varied scenarios, aiming to increase confidence with clinical cases, improve local environment and systems awareness, and enhance communication between professionals. Fortnightly 30-minute simulation sessions are run by the paediatric simulation team on the paediatric ward at our trust. The wider multidisciplinary team are invited, including nurses and health care assistants. The emergency buzzer from a bed space is pulled, and those involved attend and a scenario is undertaken. The scenario is structured to involve the wider team to improve interdisciplinary working and non-technical skills, as well as address clinical outcomes. Equipment is provided using a grab bag. Once the scenario has ended, a debrief is performed involving candidates and observers of all disciplines, to discuss technical and non-technical skills. Post session feedback was collected on each occasion with quantitative data via Likert scales and qualitative data by free text questions. In-situ simulation has been part of the departmental paediatric teaching rota since 2009 but has been a regular fortnightly occurrence since 2018. This is because it has been rostered into our working hours before the medical team assume clinical duties. We have collected feedback since September 2018. We have had 616 participants and delivered 82 scenarios in the clinical environment. This includes during the Covid pandemic. The weighted average confidence recorded by candidates pre-scenario was 2.51 with confidence post-scenario recorded as 3.69. 83% reported improved confidence following the scenario. This is an important finding as 45% had never encountered the scenario before in their practice. Thematic analysis has highlighted key aspects including communication, escalation, teamwork and available resources. In-situ, low fidelity simulation is an effective tool to improve human factors amongst the multidisciplinary team on a paediatric ward. By regularly simulating clinical practice in their daily working environment, all candidates have demonstrated improved clinical confidence and better familiarity with the ward environment. Additionally, the fortnightly in-situ simulation has improved working relationships through recognition of the roles of the ward multidisciplinary team, communication skills and team and leaderships skills. 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 ap","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"45 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":"135870004","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}
Transitions from CAMHS services to adult mental health care present a challenge to patients, carers, and professionals alike and are often managed poorly by services, leading to avoidable anxiety and adverse experiences for service users [1]. For patients with autism, transitions can be extremely distressing and require careful consideration and planning to ensure continuity of care. There is a lack of clarity for professionals and services users about what resources are available and appropriate for people with autism. This course is designed to provide professionals working in both CAMHS and adult mental health with a better understanding of autism and introduce strategies to improve the management of transitions and care of individuals with autism. Maudsley Learning, in collaboration with the ESTIA Centre, offered an online simulation training program on two occasions. The course aimed to provide participants with a clinical understanding of autism and autistic persons’ lived experiences, to equip participants with person-centred strategies to support individuals with autism, address the challenges faced by autistic individuals during child-to-adult transitions, and implement strategies to improve the care of individuals with autism who have co-morbid mental and physical illnesses. The training began with group icebreakers and a didactic introduction to simulation training to establish psychological safety followed by five scenarios covering different aspects of ASD and the challenges faced by individuals with ASD during transition. To add higher fidelity and better learning experience, we involved actors with autism and intellectual disability. The Maudsley debrief model was used to provide constructive feedback to participants on their contributions and facilitate positive learning experiences. Participants completed a questionnaire before and after the course assessing their confidence in skills related to the course. They also provided qualitative feedback on their experience and their willingness to apply their learning. Paired samples t-tests did not find a significant difference in scores for course-specific questions between pre-course (M =16.75 SD = 2.50) and post-course (M = 20.25, SD =.50), t(2.64)=3 p >.0.05, 95% CI [-7.70,.70]. 100% of the participants reported that they would recommend the course. This course was co-produced and involved actors with autism and intellectual disability for better learning. The score improved slightly, but not significantly due to a small number of participants. All participants found the course helpful for their clinical practice and would recommend it. The course is best conducted in-person for optimal learning experiences. 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":"A39 Managing transitions from CAMHS for people with autism spectrum disorder (ASD) – interactive simulation training course","authors":"Naila Saleem, Megan Fisher, Ruwani Ampegama, Selena Galloway, Cristina Jianu, Marta Ortega Vega","doi":"10.54531/ottk6170","DOIUrl":"https://doi.org/10.54531/ottk6170","url":null,"abstract":"Transitions from CAMHS services to adult mental health care present a challenge to patients, carers, and professionals alike and are often managed poorly by services, leading to avoidable anxiety and adverse experiences for service users [1]. For patients with autism, transitions can be extremely distressing and require careful consideration and planning to ensure continuity of care. There is a lack of clarity for professionals and services users about what resources are available and appropriate for people with autism. This course is designed to provide professionals working in both CAMHS and adult mental health with a better understanding of autism and introduce strategies to improve the management of transitions and care of individuals with autism. Maudsley Learning, in collaboration with the ESTIA Centre, offered an online simulation training program on two occasions. The course aimed to provide participants with a clinical understanding of autism and autistic persons’ lived experiences, to equip participants with person-centred strategies to support individuals with autism, address the challenges faced by autistic individuals during child-to-adult transitions, and implement strategies to improve the care of individuals with autism who have co-morbid mental and physical illnesses. The training began with group icebreakers and a didactic introduction to simulation training to establish psychological safety followed by five scenarios covering different aspects of ASD and the challenges faced by individuals with ASD during transition. To add higher fidelity and better learning experience, we involved actors with autism and intellectual disability. The Maudsley debrief model was used to provide constructive feedback to participants on their contributions and facilitate positive learning experiences. Participants completed a questionnaire before and after the course assessing their confidence in skills related to the course. They also provided qualitative feedback on their experience and their willingness to apply their learning. Paired samples t-tests did not find a significant difference in scores for course-specific questions between pre-course (M =16.75 SD = 2.50) and post-course (M = 20.25, SD =.50), t(2.64)=3 p >.0.05, 95% CI [-7.70,.70]. 100% of the participants reported that they would recommend the course. This course was co-produced and involved actors with autism and intellectual disability for better learning. The score improved slightly, but not significantly due to a small number of participants. All participants found the course helpful for their clinical practice and would recommend it. The course is best conducted in-person for optimal learning experiences. 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":"108 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870116","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}
Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [1]. The campaign ‘For a Greener NHS’ launched in 2020 set a road map for the National Health Service (NHS) in the UK to reach net-zero emissions for patient care by 2040 [2]. However, to achieve this, staff must be carbon literate and start by understanding the impact of their own professional practice. It follows, therefore, that carbon literacy education must be a priority for healthcare educators. There is to date no research on educating student nurses on carbon literacy or the personal carbon footprints of their practice. Using simulation could provide an innovative solution providing a system-thinking environment that could connect carbon emissions theory to actual practice and develop carbon literacy. The aim of the study was to explore student nurses’ reflections on their carbon footprint of resources used in simulation and identify the potential role of simulation in developing carbon literacy. This study used qualitative phenomenographic methodology, underpinned by transformational learning theory to explore student nurses’ awareness and attitudes towards their carbon emissions from simulation. Ten participants were asked to log the clinical resources used during a venepuncture and cannulation simulation skills station. Carbon emissions were then calculated for each participant using the Centre for Sustainable Healthcare [3] carbon emissions calculation and were shown to students during one-to-one semi-structured interviews. Data analysis was conducted, discovering the different ways participants conceptualized their carbon footprint. Students were unaware and shocked by their carbon emissions from resource use in simulation and wanted to be better educated to enable them to make an informed choice to practise sustainably. Students highlighted the crucial role of simulation educators to educate students using simulation but to role model sustainable practice and design low resource-use simulation. Finally, students were able to connect the impact of their personal clinical practice to the global climate crisis. Simulation is a powerful teaching approach to develop carbon literacy, challenging students’ pre-existing knowledge, and enabling them to link their personal practice to the global climate-change crisis. The 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":"A3 ‘I have had an epiphany’ student nurses’ reflections on their carbon footprint in simulation","authors":"Hannah Ames, Lucy Spowart","doi":"10.54531/cfxc3308","DOIUrl":"https://doi.org/10.54531/cfxc3308","url":null,"abstract":"Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [1]. The campaign ‘For a Greener NHS’ launched in 2020 set a road map for the National Health Service (NHS) in the UK to reach net-zero emissions for patient care by 2040 [2]. However, to achieve this, staff must be carbon literate and start by understanding the impact of their own professional practice. It follows, therefore, that carbon literacy education must be a priority for healthcare educators. There is to date no research on educating student nurses on carbon literacy or the personal carbon footprints of their practice. Using simulation could provide an innovative solution providing a system-thinking environment that could connect carbon emissions theory to actual practice and develop carbon literacy. The aim of the study was to explore student nurses’ reflections on their carbon footprint of resources used in simulation and identify the potential role of simulation in developing carbon literacy. This study used qualitative phenomenographic methodology, underpinned by transformational learning theory to explore student nurses’ awareness and attitudes towards their carbon emissions from simulation. Ten participants were asked to log the clinical resources used during a venepuncture and cannulation simulation skills station. Carbon emissions were then calculated for each participant using the Centre for Sustainable Healthcare [3] carbon emissions calculation and were shown to students during one-to-one semi-structured interviews. Data analysis was conducted, discovering the different ways participants conceptualized their carbon footprint. Students were unaware and shocked by their carbon emissions from resource use in simulation and wanted to be better educated to enable them to make an informed choice to practise sustainably. Students highlighted the crucial role of simulation educators to educate students using simulation but to role model sustainable practice and design low resource-use simulation. Finally, students were able to connect the impact of their personal clinical practice to the global climate crisis. Simulation is a powerful teaching approach to develop carbon literacy, challenging students’ pre-existing knowledge, and enabling them to link their personal practice to the global climate-change crisis. The 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":"3 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":"135870305","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}
Conflict is a consistent and unavoidable issue within healthcare [1], both within interdisciplinary teams and during therapeutic interactions. Confidence to manage conflict and its resolution using effective communication are considered essential graduate skills [2]. Studies have shown that by integrating simulated scenarios into conflict resolution training allows students to improve academic practice in group settings and even demonstrate more positive views towards conflict [3]. Simulation can potentially provide a safe and supportive learning environment in which students can develop the necessary skills and confidence to manage conflict, through the use of realistic and challenging scenarios and structured debrief. The aim of this evaluation was to determine the effectiveness of using simulation for conflict resolution training in developing confidence prior to placement for pre-registration MSc and BSc Physiotherapy students. 22 Pre-Registration MSc and 42 BSc Physiotherapy students participated in a newly developed conflict resolution simulation as part of their first year Developing Values Based Professional Practice module. This consisted of three clinical scenarios; 1) Interdisciplinary team communication and scope of practice; 2) Maintaining confidentiality and managing challenging behaviour; and 3) Managing unrealistic expectations which align with Core Skills Training Framework (CSTF) [2]. Each scenario was followed by an interactive debrief period, led by a trained facilitator. The students were invited to complete an anonymous online post-session evaluation regarding their perceived level of confidence and competence in managing challenging scenarios in practice. There was an overall response rate of 77% (48 respondents in total; 13 MSc and 25 BSc students), 27% were pre-registration MSc students and 73% were BSc students. 98% were active in each of the three scenarios as either a Physiotherapy student in the scenario or as an active participant in the post scenario debrief. Following the simulation scenarios, 92% of students felt either ‘a little confident’ or ‘very confident’ in managing challenging behaviour on placement and 94% of students felt either ‘a little confident’ or ‘very confident’ having a conversation with a patient around managing their expectations. 96% of the students rated the session as 8/10 or above in terms of benefit for preparation for practice ( Graph to show student response that the overall conflict resolution experience was well received and considered to be an 8 out of 10 or higher Student satisfaction scores suggest that simulation is a useful tool to enhance pre-registration MSc and BSc Physiotherapy students’ conflict resolution skills required for clinical practice. Additional research into how the development of these skills carry over into placement is warranted. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirm
{"title":"A105 The use of simulation to develop conflict resolution skills in practice for pre-qualifying physiotherapy students","authors":"Lindsey Johnston, Jo Pierce","doi":"10.54531/bacb6962","DOIUrl":"https://doi.org/10.54531/bacb6962","url":null,"abstract":"Conflict is a consistent and unavoidable issue within healthcare [1], both within interdisciplinary teams and during therapeutic interactions. Confidence to manage conflict and its resolution using effective communication are considered essential graduate skills [2]. Studies have shown that by integrating simulated scenarios into conflict resolution training allows students to improve academic practice in group settings and even demonstrate more positive views towards conflict [3]. Simulation can potentially provide a safe and supportive learning environment in which students can develop the necessary skills and confidence to manage conflict, through the use of realistic and challenging scenarios and structured debrief. The aim of this evaluation was to determine the effectiveness of using simulation for conflict resolution training in developing confidence prior to placement for pre-registration MSc and BSc Physiotherapy students. 22 Pre-Registration MSc and 42 BSc Physiotherapy students participated in a newly developed conflict resolution simulation as part of their first year Developing Values Based Professional Practice module. This consisted of three clinical scenarios; 1) Interdisciplinary team communication and scope of practice; 2) Maintaining confidentiality and managing challenging behaviour; and 3) Managing unrealistic expectations which align with Core Skills Training Framework (CSTF) [2]. Each scenario was followed by an interactive debrief period, led by a trained facilitator. The students were invited to complete an anonymous online post-session evaluation regarding their perceived level of confidence and competence in managing challenging scenarios in practice. There was an overall response rate of 77% (48 respondents in total; 13 MSc and 25 BSc students), 27% were pre-registration MSc students and 73% were BSc students. 98% were active in each of the three scenarios as either a Physiotherapy student in the scenario or as an active participant in the post scenario debrief. Following the simulation scenarios, 92% of students felt either ‘a little confident’ or ‘very confident’ in managing challenging behaviour on placement and 94% of students felt either ‘a little confident’ or ‘very confident’ having a conversation with a patient around managing their expectations. 96% of the students rated the session as 8/10 or above in terms of benefit for preparation for practice ( Graph to show student response that the overall conflict resolution experience was well received and considered to be an 8 out of 10 or higher Student satisfaction scores suggest that simulation is a useful tool to enhance pre-registration MSc and BSc Physiotherapy students’ conflict resolution skills required for clinical practice. Additional research into how the development of these skills carry over into placement is warranted. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirm","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"88 20","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870310","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}
Ligature and death by hanging represent critical issues in nursing practice that necessitate ongoing vigilance and assessment from healthcare practitioners [1–3]. This study delves into the lived experiences of healthcare professionals participating in a simulated ligature training and management workshop at a London university. The phenomenological research aims to offer an in-depth comprehension of the benefits and challenges associated with employing a simulation-based approach to ligature management training for mental health care professionals. A purposive sample of 10 healthcare professionals working in in-patient settings were invited to partake in a 2-day simulation-based ligature management workshop. Participants were aged 18 years or older and were able to provide written informed consent. Qualitative data were gathered following the 2-day simulation workshop through audio recordings and verbatim transcriptions, which were subsequently thematically analysed and interpreted by the research team. Thematic analysis of in-depth interviews unveiled three principal themes: (1) transformative experience, (2) altered perspectives on ligature training, and (3) patient-centred risk management and empowerment. The study offers valuable insights into the lived experiences of healthcare professionals within a simulated learning environment, contributing to a more profound understanding of effective training strategies for handling ligature-related situations in clinical practice. The findings indicate that simulation-based training can bolster the competence, resilience and preparedness of mental health professionals in managing ligature-related situations. Moreover, involving patients in devising their own risk management plans and delivering individualized care can result in improved patient outcomes and diminished staff burnout. This study sheds light on effective training strategies for mental health professionals in tackling complex and challenging circumstances in mental health care. 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":"A8 Mental health professionals’ lived experiences of simulated ligature training: a phenomenological study","authors":"Aby Mitchell, Barry Hill","doi":"10.54531/kysw4642","DOIUrl":"https://doi.org/10.54531/kysw4642","url":null,"abstract":"Ligature and death by hanging represent critical issues in nursing practice that necessitate ongoing vigilance and assessment from healthcare practitioners [1–3]. This study delves into the lived experiences of healthcare professionals participating in a simulated ligature training and management workshop at a London university. The phenomenological research aims to offer an in-depth comprehension of the benefits and challenges associated with employing a simulation-based approach to ligature management training for mental health care professionals. A purposive sample of 10 healthcare professionals working in in-patient settings were invited to partake in a 2-day simulation-based ligature management workshop. Participants were aged 18 years or older and were able to provide written informed consent. Qualitative data were gathered following the 2-day simulation workshop through audio recordings and verbatim transcriptions, which were subsequently thematically analysed and interpreted by the research team. Thematic analysis of in-depth interviews unveiled three principal themes: (1) transformative experience, (2) altered perspectives on ligature training, and (3) patient-centred risk management and empowerment. The study offers valuable insights into the lived experiences of healthcare professionals within a simulated learning environment, contributing to a more profound understanding of effective training strategies for handling ligature-related situations in clinical practice. The findings indicate that simulation-based training can bolster the competence, resilience and preparedness of mental health professionals in managing ligature-related situations. Moreover, involving patients in devising their own risk management plans and delivering individualized care can result in improved patient outcomes and diminished staff burnout. This study sheds light on effective training strategies for mental health professionals in tackling complex and challenging circumstances in mental health care. 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":"63 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":"135870580","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}
Clinical placements are an essential part of physiotherapy education, providing students with the opportunity to gain practical experience in clinical settings. Due to the limited number of available placements [1], and the fact that simulated placements have emerged as an innovative approach to placement experience [2], we co-produced (HEI and simulation-based education provider) a placement programme for 80 BSc and 30 MSc undergraduate physiotherapy students. We describe the structure of the well evaluated and replicable large-scale simulated placement. Each student was provided with 40 simulated placement hours over one week, this was divided between hands on facilitated simulation, with follow-up synthesis and reflection of the learning outcomes. The facilitated sessions with actor role players centred around authentic scenarios which were level-matched and closely aligned with the HCPC Physiotherapy Standards of Proficiency [3]. The scenarios reflected the diverse society in which we live, with actors taking on roles of patients/relatives and colleagues, from a range of backgrounds, with differing demographics and characteristics, presenting in a broad range of situations. Students were able to reflect on their interactions, before, during and after the simulation; they received objective feedback from the actor, from the unique perspective of patient/relative or colleague, they received feedback from their peers and from the facilitator. The simulated placement, for both sets of students, was a resounding success. Both groups (BSc and MSc) worked through 10 scenarios. The larger BSc group required 20 separate facilitated sessions and 40 actors. For the MSc group, there were 5 facilitated sessions and 10 actors. As always, sustainability of programmes is linked to budget. Although a quantified analysis is yet to be completed, the time taken to organize the placement, write matched scenarios with clear learning outcomes, deliver the placement and evaluate, is time consuming. Continued co-production with shared facilitation (HEI and education provider) is a potential way forward, with re-use of scenarios and rotations; it is highly replicable, with a team of experienced facilitators and actors. Simulated clinical placements provide physiotherapy MSc and BSc students with a valuable, realistic learning experience, in a safe and supportive, facilitator-led environment. The placement was found to be effective in enhancing students’ communication skills, professionalism, empathy, and compassion. Involving actors was found to be an effective way of immersing students in realistic clinical scenarios. This is a reusable resource, so considering ‘return on investment’ would suggest repeating for future students. 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":"A48 Large-scale simulated placements for BSc and MSc physiotherapy students: consideration of sustainability","authors":"Jess Spencer, Carrie Hamilton, Tiffany Blackburn, Sarah-Jane Ryan, Cindy Gaimster, Channine Clarke","doi":"10.54531/vcdj9852","DOIUrl":"https://doi.org/10.54531/vcdj9852","url":null,"abstract":"Clinical placements are an essential part of physiotherapy education, providing students with the opportunity to gain practical experience in clinical settings. Due to the limited number of available placements [1], and the fact that simulated placements have emerged as an innovative approach to placement experience [2], we co-produced (HEI and simulation-based education provider) a placement programme for 80 BSc and 30 MSc undergraduate physiotherapy students. We describe the structure of the well evaluated and replicable large-scale simulated placement. Each student was provided with 40 simulated placement hours over one week, this was divided between hands on facilitated simulation, with follow-up synthesis and reflection of the learning outcomes. The facilitated sessions with actor role players centred around authentic scenarios which were level-matched and closely aligned with the HCPC Physiotherapy Standards of Proficiency [3]. The scenarios reflected the diverse society in which we live, with actors taking on roles of patients/relatives and colleagues, from a range of backgrounds, with differing demographics and characteristics, presenting in a broad range of situations. Students were able to reflect on their interactions, before, during and after the simulation; they received objective feedback from the actor, from the unique perspective of patient/relative or colleague, they received feedback from their peers and from the facilitator. The simulated placement, for both sets of students, was a resounding success. Both groups (BSc and MSc) worked through 10 scenarios. The larger BSc group required 20 separate facilitated sessions and 40 actors. For the MSc group, there were 5 facilitated sessions and 10 actors. As always, sustainability of programmes is linked to budget. Although a quantified analysis is yet to be completed, the time taken to organize the placement, write matched scenarios with clear learning outcomes, deliver the placement and evaluate, is time consuming. Continued co-production with shared facilitation (HEI and education provider) is a potential way forward, with re-use of scenarios and rotations; it is highly replicable, with a team of experienced facilitators and actors. Simulated clinical placements provide physiotherapy MSc and BSc students with a valuable, realistic learning experience, in a safe and supportive, facilitator-led environment. The placement was found to be effective in enhancing students’ communication skills, professionalism, empathy, and compassion. Involving actors was found to be an effective way of immersing students in realistic clinical scenarios. This is a reusable resource, so considering ‘return on investment’ would suggest repeating for future students. 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":"59 40","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870650","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}
Caroline Richardson, Caoimhe Madden, Dara Byrne, Sinead Lydon, Paul O’Connor
The effectiveness of simulation-based education (SBE) in improving healthcare education among practising healthcare professionals (HCPs) is well recognized [1–3]. However, there is limited research available that explores the facilitators and barriers to the use of these activities amongst this population. The aim of this study was to determine those barriers and facilitators that exist to the use of healthcare simulation amongst practising HCPs through the systematic review of existing qualitative literature. Searches were performed using Medline and CINAHL from February to May 2022 with an updated search performed in June 2022. Reference list searches of included studies were also conducted. English-language, peer-reviewed studies that used qualitative methodology to examine barriers and/or facilitators to the use of SBE activities amongst HCPs practising in a hospital setting were included. Data were extracted and a quality appraisal tool was applied by the primary author, with 30% of included studies independently extracted and appraised by a second author to examine the agreement. Barriers and facilitators were coded inductively using thematic analysis. Thirteen studies were included out of a total of 2109 screened. Four main themes related to facilitators and barriers were identified: (1) management and leadership; (2) resources; (3) perceived impact and (4) learning experience (see Thematic analysis of facilitators and barriers to the use and uptake of SBE activities This study identified common barriers and facilitators to the use of SBE activities. By anticipating and addressing these adequately, the use and uptake of SBE activities amongst practising HCPs can be further enhanced. 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":"A18 Barriers and facilitators to the use of healthcare simulation to support the professional development of healthcare professionals: a systematic review of qualitative research.","authors":"Caroline Richardson, Caoimhe Madden, Dara Byrne, Sinead Lydon, Paul O’Connor","doi":"10.54531/ebai6237","DOIUrl":"https://doi.org/10.54531/ebai6237","url":null,"abstract":"The effectiveness of simulation-based education (SBE) in improving healthcare education among practising healthcare professionals (HCPs) is well recognized [1–3]. However, there is limited research available that explores the facilitators and barriers to the use of these activities amongst this population. The aim of this study was to determine those barriers and facilitators that exist to the use of healthcare simulation amongst practising HCPs through the systematic review of existing qualitative literature. Searches were performed using Medline and CINAHL from February to May 2022 with an updated search performed in June 2022. Reference list searches of included studies were also conducted. English-language, peer-reviewed studies that used qualitative methodology to examine barriers and/or facilitators to the use of SBE activities amongst HCPs practising in a hospital setting were included. Data were extracted and a quality appraisal tool was applied by the primary author, with 30% of included studies independently extracted and appraised by a second author to examine the agreement. Barriers and facilitators were coded inductively using thematic analysis. Thirteen studies were included out of a total of 2109 screened. Four main themes related to facilitators and barriers were identified: (1) management and leadership; (2) resources; (3) perceived impact and (4) learning experience (see Thematic analysis of facilitators and barriers to the use and uptake of SBE activities This study identified common barriers and facilitators to the use of SBE activities. By anticipating and addressing these adequately, the use and uptake of SBE activities amongst practising HCPs can be further enhanced. 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":"34 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":"135870714","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}
Surgical chest drain insertion is indicated in pneumothorax or haemothorax secondary to thoracic trauma. It is a mandatory emergency procedure that is incorporated as a part of the core medical training curriculum [1]. However, sparse training opportunities result in low clinician competency and increased risk of complications. While simulation training can offer a solution, the affordability of commercial models and hygiene and ethical implications of animal carcasses are significant limiting factors. The aim of this project is to build a reusable, high-fidelity, low-cost human chest cavity model excluding animal use for simulation-based teaching of surgical chest drain insertion. To construct the model, plaster gauze, metal wires and u-channel rubber trims were used to build a ribcage. Soy-protein-based sausage casing was used to create the pleural layers, and the muscles and subcutaneous fat were represented with ADAMgel (Aqueous Dietary fibre Antifreeze Mix gel), a novel material with tactility and dissection sensation similar to human soft tissue [2]. Synthetic chamois leather was used to represent skin. The resulting model allowed locating the safe triangle using anatomical landmarks, blunt dissection of muscles, pleural puncturing and advancement and suturing of the chest tube. The model cost less than £130, and it could be repaired after over 20 uses with less than £15. Verbal consent on study participation was obtained from all participants who performed chest drain insertion on the model and evaluated its fidelity and educational value using an anonymized Likert scale questionnaire. All questionnaire responses were converted to numerical values for data quantification, as shown in Median and range of questionnaire responses collected from study participants Sixteen senior clinicians with multiple experience on chest drain insertion and 11 junior clinicians with limited experience took part in the study. Anatomical and haptic fidelity of the model was evaluated very highly amongst experienced clinicians. Junior doctors stated increased confidence in performing the procedure, overall assessing the model as an appropriate learning tool. Twenty participants with previous training experience compared the quality of this model to other commercial or animal-based models, and 18 rated this model to be of the same or superior quality. This chest cavity model is suitable for simulation training of chest drain insertion. Importantly, the model excluded the use of animals under the principle of replacing, refining and reducing animal use in research [3]. Further training opportunities that utilize this model can increase clinician competence in the procedure, which can improve clinical practice and reduce patient mortality. 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":"A4 Development and evaluation of a chest cavity simulation model for teaching surgical chest drain insertion","authors":"Ji Yun Bog","doi":"10.54531/hstp2405","DOIUrl":"https://doi.org/10.54531/hstp2405","url":null,"abstract":"Surgical chest drain insertion is indicated in pneumothorax or haemothorax secondary to thoracic trauma. It is a mandatory emergency procedure that is incorporated as a part of the core medical training curriculum [1]. However, sparse training opportunities result in low clinician competency and increased risk of complications. While simulation training can offer a solution, the affordability of commercial models and hygiene and ethical implications of animal carcasses are significant limiting factors. The aim of this project is to build a reusable, high-fidelity, low-cost human chest cavity model excluding animal use for simulation-based teaching of surgical chest drain insertion. To construct the model, plaster gauze, metal wires and u-channel rubber trims were used to build a ribcage. Soy-protein-based sausage casing was used to create the pleural layers, and the muscles and subcutaneous fat were represented with ADAMgel (Aqueous Dietary fibre Antifreeze Mix gel), a novel material with tactility and dissection sensation similar to human soft tissue [2]. Synthetic chamois leather was used to represent skin. The resulting model allowed locating the safe triangle using anatomical landmarks, blunt dissection of muscles, pleural puncturing and advancement and suturing of the chest tube. The model cost less than £130, and it could be repaired after over 20 uses with less than £15. Verbal consent on study participation was obtained from all participants who performed chest drain insertion on the model and evaluated its fidelity and educational value using an anonymized Likert scale questionnaire. All questionnaire responses were converted to numerical values for data quantification, as shown in Median and range of questionnaire responses collected from study participants Sixteen senior clinicians with multiple experience on chest drain insertion and 11 junior clinicians with limited experience took part in the study. Anatomical and haptic fidelity of the model was evaluated very highly amongst experienced clinicians. Junior doctors stated increased confidence in performing the procedure, overall assessing the model as an appropriate learning tool. Twenty participants with previous training experience compared the quality of this model to other commercial or animal-based models, and 18 rated this model to be of the same or superior quality. This chest cavity model is suitable for simulation training of chest drain insertion. Importantly, the model excluded the use of animals under the principle of replacing, refining and reducing animal use in research [3]. Further training opportunities that utilize this model can increase clinician competence in the procedure, which can improve clinical practice and reduce patient mortality. 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":"161 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871429","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}
The gap between imagined and realized healthcare practice is indisputable. For trainees who rotate between departments, the challenges of navigating complex healthcare systems are unmet by standard induction programmes [1,2]. Our simulation centre and orthopaedic department collaborated to create an enhanced departmental induction using immersive simulation. Following a thorough needs assessment for new trainees rotating to trauma and orthopaedics. We looked at previous trainee feedback, adverse event data from our safeguarding reporting system, and expert opinion from orthopaedic staff. It became clear that at times of transition, the process of accessing timely and appropriate support was challenging. Furthermore, there were a myriad of clinical duties and patient cohorts covered by the trauma team. Working within this dynamic and complex structure was difficult for new trainees. We used team-informed process mapping to define the escalation systems in place, and the distinct roles within the team. We identified key learning objectives for a simulation induction session. We used a case vignette of an unwell trauma patient and aligned the scenario design to the required learning objectives on clear escalation pathways and whole team working within a complex environment. Following a successful pilot run, this enhanced induction is routinely delivered four monthly for junior doctors rotating to the orthopaedic department. Current trainees, orthopaedic consultants, and senior managers also attend this trainee induction as an open forum for dialogue on service improvements. All participants have rated these sessions as good or excellent; they value the whole team approach and repeatedly ask for further simulation sessions. Feedback from other members of the trauma team following these sessions commented on increased connection within the team, which included junior trainees attending departmental meetings. The orthopaedic team also felt that, following the induction programme, new trainees had demonstrated improved handover skills when escalating unwell patients. This whole team simulation-enhanced approach to orthopaedic induction is novel, and in contrast to the majority of standardized induction programmes [3]. This work provides a template that can be applied to different healthcare systems. By delivering constructively aligned simulation sessions, we can improve team training and enable new trainees to flourish during periods of transition. 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":"A77 Translational simulation in practice: an enhanced orthopaedic induction for new trainees","authors":"Osama Alsawada, Amrita Brara, Terence Savaridas, Julie Mardon","doi":"10.54531/vyiu1170","DOIUrl":"https://doi.org/10.54531/vyiu1170","url":null,"abstract":"The gap between imagined and realized healthcare practice is indisputable. For trainees who rotate between departments, the challenges of navigating complex healthcare systems are unmet by standard induction programmes [1,2]. Our simulation centre and orthopaedic department collaborated to create an enhanced departmental induction using immersive simulation.\u0000 Following a thorough needs assessment for new trainees rotating to trauma and orthopaedics. We looked at previous trainee feedback, adverse event data from our safeguarding reporting system, and expert opinion from orthopaedic staff. It became clear that at times of transition, the process of accessing timely and appropriate support was challenging. Furthermore, there were a myriad of clinical duties and patient cohorts covered by the trauma team. Working within this dynamic and complex structure was difficult for new trainees. We used team-informed process mapping to define the escalation systems in place, and the distinct roles within the team.\u0000 We identified key learning objectives for a simulation induction session. We used a case vignette of an unwell trauma patient and aligned the scenario design to the required learning objectives on clear escalation pathways and whole team working within a complex environment.\u0000 Following a successful pilot run, this enhanced induction is routinely delivered four monthly for junior doctors rotating to the orthopaedic department. Current trainees, orthopaedic consultants, and senior managers also attend this trainee induction as an open forum for dialogue on service improvements. All participants have rated these sessions as good or excellent; they value the whole team approach and repeatedly ask for further simulation sessions. Feedback from other members of the trauma team following these sessions commented on increased connection within the team, which included junior trainees attending departmental meetings. The orthopaedic team also felt that, following the induction programme, new trainees had demonstrated improved handover skills when escalating unwell patients.\u0000 This whole team simulation-enhanced approach to orthopaedic induction is novel, and in contrast to the majority of standardized induction programmes [3]. This work provides a template that can be applied to different healthcare systems. By delivering constructively aligned simulation sessions, we can improve team training and enable new trainees to flourish during periods of transition.\u0000 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":"2005 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813386","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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