Debbie Suggitt, David Baxter, Jeanette Baxter, Matthew Sharman, Jodie Murdoch, Aoife Colgan
Delayed airway management was identified in 70% (9 of 13) of Insitu simulation (ISS) with an average time of 3.42 minutes from identification of the problem to management. The resuscitation council UK suggest that in most patients presenting with a compromised airway, simple actions are sufficient to stabilize them, failing to do so increases the risk of hypoxia and multi-organ failure [1]. To address this trust wide training was initiated through the ‘skills2u’ programme, where toolbox teaching was taken to the wards. Across a two-week period, a multiprofessional team comprising of the simulation faculty, anaesthetists, and advanced clinical practitioners, visited all clinical areas and delivered a short 10–15-minute practical ward-based interactive session to the interprofessional team. The session covered airway assessment, airway opening manoeuvres and opportunity to practice inserting basic airway adjuncts. 412 clinical staff, of all grades and disciplines, were taught in basic airway management of the deteriorating and arrested patient. Evaluation of the teaching revealed 95.5% of staff agreed it was relevant to their role and 98% agreed they now felt better prepared to respond to changes in a patient’s condition. In the subsequent three months, technical skills performance errors for airway management were identified in 15% of 10 ISS completed. In these simulations the average time taken to manage the airway from identification of the problem reduced to 1.39 minutes. Using ISS to identify technical skills performance errors followed by a trust wide ward-based education programme is an effective way to enhance patient safety. 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":"A31 Skills2u – using ward-based toolkit training to address frequently identified technical skills performance errors during <i>in situ</i> simulation","authors":"Debbie Suggitt, David Baxter, Jeanette Baxter, Matthew Sharman, Jodie Murdoch, Aoife Colgan","doi":"10.54531/eods9506","DOIUrl":"https://doi.org/10.54531/eods9506","url":null,"abstract":"Delayed airway management was identified in 70% (9 of 13) of Insitu simulation (ISS) with an average time of 3.42 minutes from identification of the problem to management. The resuscitation council UK suggest that in most patients presenting with a compromised airway, simple actions are sufficient to stabilize them, failing to do so increases the risk of hypoxia and multi-organ failure [1]. To address this trust wide training was initiated through the ‘skills2u’ programme, where toolbox teaching was taken to the wards. Across a two-week period, a multiprofessional team comprising of the simulation faculty, anaesthetists, and advanced clinical practitioners, visited all clinical areas and delivered a short 10–15-minute practical ward-based interactive session to the interprofessional team. The session covered airway assessment, airway opening manoeuvres and opportunity to practice inserting basic airway adjuncts. 412 clinical staff, of all grades and disciplines, were taught in basic airway management of the deteriorating and arrested patient. Evaluation of the teaching revealed 95.5% of staff agreed it was relevant to their role and 98% agreed they now felt better prepared to respond to changes in a patient’s condition. In the subsequent three months, technical skills performance errors for airway management were identified in 15% of 10 ISS completed. In these simulations the average time taken to manage the airway from identification of the problem reduced to 1.39 minutes. Using ISS to identify technical skills performance errors followed by a trust wide ward-based education programme is an effective way to enhance patient safety. 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":"2004 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":"135813527","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}
Mia Paget, Aisha Choksi, Ciara Quigley, Michael Williams, Anna Stevenson
It is well established that simulation is a powerful tool for developing empathy in healthcare students [1]. Previous simulation designs surrounding the ‘patient experience’ have focused on putting the learner into the patient’s position and mimicking health conditions [2]. Empathic Simulation (ES) is a novel simulation design which focuses on healthcare students thinking of ways to improve the patient experience whilst a simulated patient (SP) wears an audio-visual headset recording device. This allows for an immersive video-assisted debrief session where students see how they are perceived through the eyes of the patient, promoting self-reflection and behavioural awareness to a higher degree compared to previous techniques [3]. In March 2023, ES was trialled by 36 3rd year medical students during a ‘Patient Experience Week’ whilst on placement at a District General Hospital. The simulation focused on an SP wanting to self-discharge due to an accumulation of poor experiences during their hospital stay. Students were encouraged to determine and resolve these issues using the resources available to them in a simulation suite. Throughout the simulation, the SP wore a Microsoft HoloLens to record the scenario from their viewpoint. Afterwards, the recording was used to stimulate discussion during an immersive debrief session. Students provided pre and post-simulation feedback using an online polling software. This included rating their confidence with various scenarios, e.g. discussing with patients who wish to self-discharge the reasoning behind their thoughts. Further feedback was also collected via a follow-up survey. 28/36 students provided feedback at the end of their ‘Patient Experience Week’. There was an average of 24% increase in confidence across all scenarios (average rating of 3.1 vs 4.3) and a 16% increase in confidence in the ability to empathize with patients experiencing long-term health conditions (see Average confidence ratings reflecting various scenarios were gathered from students before and after the ‘Patient Experience Week’ in March 2023. This figure demonstrates the average confidence ratings for scenarios related to Empathic Simulation before vs after the session. Empathic Simulation may be an effective simulation design to improve empathy and insight into the patient experience as well as situational and self-awareness in healthcare students. Research into the effectiveness of this novel simulation will be explored in the future. 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":"A26 Empathic simulation: a novel simulation design to develop empathy in healthcare students","authors":"Mia Paget, Aisha Choksi, Ciara Quigley, Michael Williams, Anna Stevenson","doi":"10.54531/xjck3778","DOIUrl":"https://doi.org/10.54531/xjck3778","url":null,"abstract":"It is well established that simulation is a powerful tool for developing empathy in healthcare students [1]. Previous simulation designs surrounding the ‘patient experience’ have focused on putting the learner into the patient’s position and mimicking health conditions [2]. Empathic Simulation (ES) is a novel simulation design which focuses on healthcare students thinking of ways to improve the patient experience whilst a simulated patient (SP) wears an audio-visual headset recording device. This allows for an immersive video-assisted debrief session where students see how they are perceived through the eyes of the patient, promoting self-reflection and behavioural awareness to a higher degree compared to previous techniques [3]. In March 2023, ES was trialled by 36 3rd year medical students during a ‘Patient Experience Week’ whilst on placement at a District General Hospital. The simulation focused on an SP wanting to self-discharge due to an accumulation of poor experiences during their hospital stay. Students were encouraged to determine and resolve these issues using the resources available to them in a simulation suite. Throughout the simulation, the SP wore a Microsoft HoloLens to record the scenario from their viewpoint. Afterwards, the recording was used to stimulate discussion during an immersive debrief session. Students provided pre and post-simulation feedback using an online polling software. This included rating their confidence with various scenarios, e.g. discussing with patients who wish to self-discharge the reasoning behind their thoughts. Further feedback was also collected via a follow-up survey. 28/36 students provided feedback at the end of their ‘Patient Experience Week’. There was an average of 24% increase in confidence across all scenarios (average rating of 3.1 vs 4.3) and a 16% increase in confidence in the ability to empathize with patients experiencing long-term health conditions (see Average confidence ratings reflecting various scenarios were gathered from students before and after the ‘Patient Experience Week’ in March 2023. This figure demonstrates the average confidence ratings for scenarios related to Empathic Simulation before vs after the session. Empathic Simulation may be an effective simulation design to improve empathy and insight into the patient experience as well as situational and self-awareness in healthcare students. Research into the effectiveness of this novel simulation will be explored in the future. 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":"2007 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":"135813780","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}
Luke Hunt, Samantha Farrow, Cariad Evans, Anne Tunbridge, Joby Cole, Brian Crook, Paul Johnson
High-consequence infectious diseases (HCID) are pathogens which spread easily between people, have high mortality rates, and lack effective treatment [1]. Examples include Ebola and Lassa fever. Most emerging pandemics, including COVID-19, are initially classified as HCID. Assessment of patients with suspected HCID infection is an advanced procedural skill requiring application of enhanced infection control measures including patient isolation, personal protective equipment, and decontamination. There is a risk of healthcare worker infection if procedures are not followed [2]. HCID often present in non-specialist centres; there is a need for an accessible, educationally effective HCID course for NHS staff. We developed a course for clinicians in infectious disease and emergency medicine, in collaboration with the Health & Safety Executive and clinicians in the UK-HCID network. The course uses a blended approach; theoretical components are taught with online learning. Practical components are taught with high-fidelity, multidisciplinary simulation using VIOLET, a mannequin which coughs, vomits and sweats ultraviolet markers ( Ultraviolet tracers are used to replicate contact and airborne transmission of infectious pathogens in simulation scenarios Between 01/12/22 and 01/04/23, 57 specialized clinicians participated. All participants passed post-course competency-based practical assessments. Participants demonstrated significant gains in knowledge between pre- and post-course tests (mean score 61% vs. 83%, This is the first HCID simulation course internationally using ultraviolet markers to allow visualization of contamination. The course appears to be an effective educational intervention and improves learner confidence in PPE use. 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":"A51 Educational effectiveness of a high-consequence infectious disease training course using ultraviolet simulation","authors":"Luke Hunt, Samantha Farrow, Cariad Evans, Anne Tunbridge, Joby Cole, Brian Crook, Paul Johnson","doi":"10.54531/xvsb4567","DOIUrl":"https://doi.org/10.54531/xvsb4567","url":null,"abstract":"High-consequence infectious diseases (HCID) are pathogens which spread easily between people, have high mortality rates, and lack effective treatment [1]. Examples include Ebola and Lassa fever. Most emerging pandemics, including COVID-19, are initially classified as HCID. Assessment of patients with suspected HCID infection is an advanced procedural skill requiring application of enhanced infection control measures including patient isolation, personal protective equipment, and decontamination. There is a risk of healthcare worker infection if procedures are not followed [2]. HCID often present in non-specialist centres; there is a need for an accessible, educationally effective HCID course for NHS staff. We developed a course for clinicians in infectious disease and emergency medicine, in collaboration with the Health & Safety Executive and clinicians in the UK-HCID network. The course uses a blended approach; theoretical components are taught with online learning. Practical components are taught with high-fidelity, multidisciplinary simulation using VIOLET, a mannequin which coughs, vomits and sweats ultraviolet markers ( Ultraviolet tracers are used to replicate contact and airborne transmission of infectious pathogens in simulation scenarios Between 01/12/22 and 01/04/23, 57 specialized clinicians participated. All participants passed post-course competency-based practical assessments. Participants demonstrated significant gains in knowledge between pre- and post-course tests (mean score 61% vs. 83%, This is the first HCID simulation course internationally using ultraviolet markers to allow visualization of contamination. The course appears to be an effective educational intervention and improves learner confidence in PPE use. 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":"2012 33","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135814119","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 cost of developing simulation-based education (SBE) facilities is high. However, the cost of sustaining SBE activities is often not considered in the initial outlay and facilities and centres can find themselves in financial difficulty early on. In addition to the cost of the initial capital and technology costs, there are many other costs incurred when running and sustaining SBE programmes. These are often not apparent or considered by simulationists when establishing new programmes. Research to date has focused on cost effectiveness and a return on investment [1]. However, the sustainability of a SBE programme is related to the ability to meet these costs. The aim of this work is to develop a simulation cost calculator that considered all costs incurred in skills programme development. Following consultation with experienced simulation faculty, the finance office, human resources and buildings office and equipment providers, a cost calculator template was devised to categorize the items required for SBE. The template allows for the calculation of the cost of teaching a procedural skill per person based on the total cost of all of the items in the template plus the number of attempts required for teaching and/or assessment. The cost calculator categories for procedural skills teaching in a simulated environment included recurrent costs such as heating, light and cleaning of the simulation space/facility, consumables, single use simulators, fixed equipment/initial outlay, waste disposal, depreciation costs and staff costs. To illustrate, the calculated cost for a bowel anastomosis workshop using biological materials is approx. €235 per person while the equipment cost for a basic skill such as venepuncture is €161.17. Adequate resourcing is critical to establish, run and sustain SBE programmes. A cost calculator template will help new facilities to project their budget requirements and to decide what skills education they can support and sustain long term. 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":"A24 Calculating the cost of simulation based education. What to include?","authors":"Dara Byrne, Laura Fitzgerald, Angela O’Dea","doi":"10.54531/njtn6089","DOIUrl":"https://doi.org/10.54531/njtn6089","url":null,"abstract":"The cost of developing simulation-based education (SBE) facilities is high. However, the cost of sustaining SBE activities is often not considered in the initial outlay and facilities and centres can find themselves in financial difficulty early on. In addition to the cost of the initial capital and technology costs, there are many other costs incurred when running and sustaining SBE programmes. These are often not apparent or considered by simulationists when establishing new programmes. Research to date has focused on cost effectiveness and a return on investment [1]. However, the sustainability of a SBE programme is related to the ability to meet these costs. The aim of this work is to develop a simulation cost calculator that considered all costs incurred in skills programme development. Following consultation with experienced simulation faculty, the finance office, human resources and buildings office and equipment providers, a cost calculator template was devised to categorize the items required for SBE. The template allows for the calculation of the cost of teaching a procedural skill per person based on the total cost of all of the items in the template plus the number of attempts required for teaching and/or assessment. The cost calculator categories for procedural skills teaching in a simulated environment included recurrent costs such as heating, light and cleaning of the simulation space/facility, consumables, single use simulators, fixed equipment/initial outlay, waste disposal, depreciation costs and staff costs. To illustrate, the calculated cost for a bowel anastomosis workshop using biological materials is approx. €235 per person while the equipment cost for a basic skill such as venepuncture is €161.17. Adequate resourcing is critical to establish, run and sustain SBE programmes. A cost calculator template will help new facilities to project their budget requirements and to decide what skills education they can support and sustain long term. 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":"2004 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813398","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 World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice (2010), states ‘Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes’ [1]. When healthcare students enter the practice workplace, they are required to work in an interprofessional team and make collaborative decisions to provide safe and effective patient care. With the increasing complexity of patient presentation, increase in life expectancy and disability years coupled with the challenges of resource and delivery within the healthcare system it is vital that practitioners have solid foundational skills in interprofessional working. To facilitate this healthcare educators are being required to think of innovative, authentic and contemptuous pedagogical tools to demonstrate interprofessional working, collaboration and interdisciplinary role awareness. To provide healthcare students with meaningful exposure to interpersonal working educators at Birmingham City University embarked on the design and delivery of a live simulated patient case conference. To promote authenticity the case conference was designed (with consent) around a living patient (Jake) with complex medical and social needs. A team of healthcare educators each took the roles of clinicians from both health, social and tertiary care service. A round table discussion was held related to Jakes’s inpatient care and decisions regarding hospital discharge. Jake has quadriplegic cerebral palsy and substantial medical, social and occupational needs. Jake’s mum is also present, demonstrating the need to have patient and carer collaboration. The session was observed live by students but also filmed and edited into an ongoing simulation learning resource with both clinical and non-clinical learning objectives. A facilitated debrief was held after the session. Feedback and anecdotal analysis of the session showed greater student engagement and understanding of the needs for interprofessional collaboration when discussing patient care and decision-making. The use of a real and living patient meant students could immerse themselves in Jake’s story and feel true empathy with his clinical case. For some students’ knowledge of interprofessional working and the roles of other disciplines proves a challenging concept to master. It is feasible and effective to utilize simulation (live and virtual) as a method of teaching hard to grasp but vital concepts of healthcare practice including interprofessional working and interdisciplinary role awareness. 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":"A85 Jake’s story: Teaching interprofessional working through the delivery of a live patient multi-disciplinary team meeting","authors":"Jodie Bryant","doi":"10.54531/ndkh4990","DOIUrl":"https://doi.org/10.54531/ndkh4990","url":null,"abstract":"The World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice (2010), states ‘Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes’ [1]. When healthcare students enter the practice workplace, they are required to work in an interprofessional team and make collaborative decisions to provide safe and effective patient care. With the increasing complexity of patient presentation, increase in life expectancy and disability years coupled with the challenges of resource and delivery within the healthcare system it is vital that practitioners have solid foundational skills in interprofessional working. To facilitate this healthcare educators are being required to think of innovative, authentic and contemptuous pedagogical tools to demonstrate interprofessional working, collaboration and interdisciplinary role awareness. To provide healthcare students with meaningful exposure to interpersonal working educators at Birmingham City University embarked on the design and delivery of a live simulated patient case conference. To promote authenticity the case conference was designed (with consent) around a living patient (Jake) with complex medical and social needs. A team of healthcare educators each took the roles of clinicians from both health, social and tertiary care service. A round table discussion was held related to Jakes’s inpatient care and decisions regarding hospital discharge. Jake has quadriplegic cerebral palsy and substantial medical, social and occupational needs. Jake’s mum is also present, demonstrating the need to have patient and carer collaboration. The session was observed live by students but also filmed and edited into an ongoing simulation learning resource with both clinical and non-clinical learning objectives. A facilitated debrief was held after the session. Feedback and anecdotal analysis of the session showed greater student engagement and understanding of the needs for interprofessional collaboration when discussing patient care and decision-making. The use of a real and living patient meant students could immerse themselves in Jake’s story and feel true empathy with his clinical case. For some students’ knowledge of interprofessional working and the roles of other disciplines proves a challenging concept to master. It is feasible and effective to utilize simulation (live and virtual) as a method of teaching hard to grasp but vital concepts of healthcare practice including interprofessional working and interdisciplinary role awareness. 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":"2004 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813528","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 debriefing plays an important role in knowledge synthesis [1]. Although there is evidence to suggest that video-assisted debriefing improves outcomes, at least in nursing simulations, there is a wide variability in the practice and perceived effectiveness of video-assisted debriefing [2,3]. There is a paucity of literature about participants’ perspectives on the use of video review for simulation debriefing. The aim of this study is to explore participants’ perceptions and experience of the use of video review post-simulation. The study received ethical approval from the ethics committee at Anglia Ruskin University. We used qualitative research methodology to answer our research question. Foundation year trainees attending simulation as part of the curriculum were included in the study. This study involved focus group interviews with simulation participants prior to their simulation-based education. Post-simulation training, participants reviewed their simulation video clip in their own time and filled in a structured qualitative questionnaire about their video review experience. This is an ongoing research and initial results are presented here. Data were collected from 13 participants over a period of 3 months from February 2023 to April 2023 in the simulation centre of a tertiary teaching hospital in the UK. The audio recording and the questionnaire were pseudonymized and analysed using inductive thematic content analysis. Important themes identified were the emotional aspects of watching their video, the learning opportunities available with video review, level of support needed for video review and ideal time to review the video. Unexpected emergent themes included foundation doctors’ views about simulation education, reflective practice post-simulation and peer pressure during simulation. This study explored foundation trainees’ perceptions (cognitive, kinetic and affective) about video review after simulation and several interesting themes were identified. We believe this study adds value to simulation-based medical education in helping to understand foundation doctors’ views about simulation and video-assisted debriefing. 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":"A15 Video review after simulation-based education – perception of participants","authors":"Mohammed Batcha, Ratna Makker, Georgia Winnett","doi":"10.54531/sync1715","DOIUrl":"https://doi.org/10.54531/sync1715","url":null,"abstract":"Simulation debriefing plays an important role in knowledge synthesis [1]. Although there is evidence to suggest that video-assisted debriefing improves outcomes, at least in nursing simulations, there is a wide variability in the practice and perceived effectiveness of video-assisted debriefing [2,3]. There is a paucity of literature about participants’ perspectives on the use of video review for simulation debriefing. The aim of this study is to explore participants’ perceptions and experience of the use of video review post-simulation. The study received ethical approval from the ethics committee at Anglia Ruskin University. We used qualitative research methodology to answer our research question. Foundation year trainees attending simulation as part of the curriculum were included in the study. This study involved focus group interviews with simulation participants prior to their simulation-based education. Post-simulation training, participants reviewed their simulation video clip in their own time and filled in a structured qualitative questionnaire about their video review experience. This is an ongoing research and initial results are presented here. Data were collected from 13 participants over a period of 3 months from February 2023 to April 2023 in the simulation centre of a tertiary teaching hospital in the UK. The audio recording and the questionnaire were pseudonymized and analysed using inductive thematic content analysis. Important themes identified were the emotional aspects of watching their video, the learning opportunities available with video review, level of support needed for video review and ideal time to review the video. Unexpected emergent themes included foundation doctors’ views about simulation education, reflective practice post-simulation and peer pressure during simulation. This study explored foundation trainees’ perceptions (cognitive, kinetic and affective) about video review after simulation and several interesting themes were identified. We believe this study adds value to simulation-based medical education in helping to understand foundation doctors’ views about simulation and video-assisted debriefing. 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":"2000 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813781","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}
Due to the nature of simulation-based education, large amounts of blank paperwork are used and disposed of in any given scenario. As many trusts are now moving towards e-noting, including e-obs and e-prescribing, the use of these in simulation can be extremely beneficial for the learners. These were highlighted by the author as areas for sustainability and increased realism throughout the simulation sessions run by the team at Dartford and Gravesham NHS Trust [1]. This initiative was developed to cut down on the amount of paper waste used during scenarios and increase the realism for the learners taking part. E-obs, e-prescribing and e-noting templates were created using Microsoft Excel and Microsoft Word that mirrored the programmes used throughout the trust, and were made readily available for the learners taking part in the simulation scenarios. These were then saved as templates, and a new version created for each existing patient throughout the scenarios. On top of this, each new scenario created also required a new set of e-noting, including a NEWS, prescription and the relevant paperwork. ‘Patients’ who had progressed through ED, for example, had a completed CAS card, and their NEWS chart reflected the several sets of observations already taken. The NEWS chart template was also adapted for patients with COPD, and PEWS charts for each paediatric age group were also created, alongside separate e-prescribing to mirror the paediatric version of the drug charts throughout the trust. Learners who participated in the scenarios using e-noting provided positive feedback, highlighting the realism and relevance to practice. 43 learners were asked to complete a short survey after taking part in 1 or more scenarios using the new e-noting system. 79% of learners reported that they found the system easy to use, 90% reported the relevance to clinical practice, 81% reported that it was realistic and 95% were happy that this is a feasible and sustainable way to utilize prescribing, observations measurement and note writing/history taking throughout the simulation sessions. 4% reported not using the e-noting system during their scenario. Although the creation of the e-noting system required additional time and resources at the start, they quickly became easy to implement and adapt to each new patient or scenario. The use of this system leads to much less paperwork being destroyed and increased the realism for the participants who use e-noting throughout the trust. 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":"A99 Designing and implementing e-noting for use in simulation scenarios for sustainability and realism","authors":"Lauren Philpott","doi":"10.54531/ohuc4497","DOIUrl":"https://doi.org/10.54531/ohuc4497","url":null,"abstract":"Due to the nature of simulation-based education, large amounts of blank paperwork are used and disposed of in any given scenario. As many trusts are now moving towards e-noting, including e-obs and e-prescribing, the use of these in simulation can be extremely beneficial for the learners. These were highlighted by the author as areas for sustainability and increased realism throughout the simulation sessions run by the team at Dartford and Gravesham NHS Trust [1]. This initiative was developed to cut down on the amount of paper waste used during scenarios and increase the realism for the learners taking part. E-obs, e-prescribing and e-noting templates were created using Microsoft Excel and Microsoft Word that mirrored the programmes used throughout the trust, and were made readily available for the learners taking part in the simulation scenarios. These were then saved as templates, and a new version created for each existing patient throughout the scenarios. On top of this, each new scenario created also required a new set of e-noting, including a NEWS, prescription and the relevant paperwork. ‘Patients’ who had progressed through ED, for example, had a completed CAS card, and their NEWS chart reflected the several sets of observations already taken. The NEWS chart template was also adapted for patients with COPD, and PEWS charts for each paediatric age group were also created, alongside separate e-prescribing to mirror the paediatric version of the drug charts throughout the trust. Learners who participated in the scenarios using e-noting provided positive feedback, highlighting the realism and relevance to practice. 43 learners were asked to complete a short survey after taking part in 1 or more scenarios using the new e-noting system. 79% of learners reported that they found the system easy to use, 90% reported the relevance to clinical practice, 81% reported that it was realistic and 95% were happy that this is a feasible and sustainable way to utilize prescribing, observations measurement and note writing/history taking throughout the simulation sessions. 4% reported not using the e-noting system during their scenario. Although the creation of the e-noting system required additional time and resources at the start, they quickly became easy to implement and adapt to each new patient or scenario. The use of this system leads to much less paperwork being destroyed and increased the realism for the participants who use e-noting throughout the trust. 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":"11 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":"135869899","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}
While the use of simulation-based education (SBE) is embedded within clinical courses delivered in higher education, it’s use within further education is extremely limited, leading to a perception that students may be at a disadvantage, particularly those from a neurodiverse background, where kinesthetic learning is their preferred style [1]. The same principles also apply to assessment. Supported through funding from the NCFE (originally known as the Northern Council for Further Education), a pilot project was developed with the following objectives: To transform the assessment methodology within further education (FE) via the use of immersive technologies To facilitate collaborative development of bespoke virtual reality (VR) scenarios incorporating course learning outcomes (T level and Care Certificate) For digital technology students to work jointly with industry in VR development To gain feedback from students, employers and other key stakeholders with regards to using immersive technology as a method of assessment. Three prototype scenarios were developed in the iRIS platform to aid adherence to ASPiH and INACSL standards as well as collaboration across the development and project teams. The VR development was undertaken in Unity by digital students led by industry experts. The University of Huddersfield led on the evaluation of the project using a qualitative approach encompassing the three degrees of validity [2], using student and employer/stakeholder focus groups and 1:1 interviews both pre and post scenario testing. Discussions were transcribed and template analysis [3] applied. While final evaluation is still ongoing, initial findings are as follows: iRIS proved to be an invaluable platform for scenario development across organizations greatly aiding communication and decision-making Both students and faculty need have reached a minimum competency with the VR equipment and environment prior to assessment Course learning outcomes can be readily incorporated into bespoke VR scenarios VR would be a suitable mode for assessment for some learning outcomes but not all The prototype scenarios provided adequate realism, face and construct validity for assessing the identified learning outcomes VR simulation has the potential to be suitable and acceptable mode of delivery for assessment in health and social care. Funding applications have been submitted for phase two of the project which would include an impact study. 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.
虽然基于模拟的教育(SBE)的使用嵌入到高等教育的临床课程中，但它在继续教育中的使用非常有限，导致学生可能处于不利地位，特别是那些来自神经多样性背景的学生，他们的首选学习方式是动觉学习[1]。同样的原则也适用于评估。在NCFE(最初称为北方继续教育委员会)的资助下，开展了一个试点项目，目标如下:通过使用沉浸式技术来改变继续教育(FE)中的评估方法促进定制虚拟现实(VR)场景的协作开发，结合课程学习成果(T级和护理证书)，使数字技术专业的学生与VR开发行业合作，以获取学生，雇主和其他主要利益相关者关于使用沉浸式技术作为评估方法的反馈。在iRIS平台中开发了三个原型场景，以帮助遵守ASPiH和INACSL标准，以及跨开发和项目团队的协作。VR开发是由行业专家领导的数字学生在Unity中进行的。哈德斯菲尔德大学(University of Huddersfield)领导了该项目的评估，使用了包括三个效度的定性方法[2]，使用了学生和雇主/利益相关者焦点小组，以及场景测试前后的1:1访谈。对讨论进行转录并应用模板分析[3]。虽然最后评价仍在进行中，但初步调查结果如下:iRIS被证明是跨组织场景开发的宝贵平台，极大地帮助沟通和决策。在评估之前，学生和教师都需要达到对VR设备和环境的最低能力。课程学习成果可以很容易地纳入定制的VR场景。VR将是评估某些学习成果的合适模式，但不是所有的原型场景提供了足够的真实感。虚拟现实模拟有可能成为健康和社会护理评估的合适和可接受的交付模式。该项目第二阶段的拨款申请已提交，其中包括一项影响研究。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
{"title":"A72 Using Simulation as a Method of Assessment in Further Education","authors":"Ann Sunderland, Rebecca Weeks","doi":"10.54531/uina3995","DOIUrl":"https://doi.org/10.54531/uina3995","url":null,"abstract":"While the use of simulation-based education (SBE) is embedded within clinical courses delivered in higher education, it’s use within further education is extremely limited, leading to a perception that students may be at a disadvantage, particularly those from a neurodiverse background, where kinesthetic learning is their preferred style [1]. The same principles also apply to assessment. Supported through funding from the NCFE (originally known as the Northern Council for Further Education), a pilot project was developed with the following objectives: To transform the assessment methodology within further education (FE) via the use of immersive technologies To facilitate collaborative development of bespoke virtual reality (VR) scenarios incorporating course learning outcomes (T level and Care Certificate) For digital technology students to work jointly with industry in VR development To gain feedback from students, employers and other key stakeholders with regards to using immersive technology as a method of assessment. Three prototype scenarios were developed in the iRIS platform to aid adherence to ASPiH and INACSL standards as well as collaboration across the development and project teams. The VR development was undertaken in Unity by digital students led by industry experts. The University of Huddersfield led on the evaluation of the project using a qualitative approach encompassing the three degrees of validity [2], using student and employer/stakeholder focus groups and 1:1 interviews both pre and post scenario testing. Discussions were transcribed and template analysis [3] applied. While final evaluation is still ongoing, initial findings are as follows: iRIS proved to be an invaluable platform for scenario development across organizations greatly aiding communication and decision-making Both students and faculty need have reached a minimum competency with the VR equipment and environment prior to assessment Course learning outcomes can be readily incorporated into bespoke VR scenarios VR would be a suitable mode for assessment for some learning outcomes but not all The prototype scenarios provided adequate realism, face and construct validity for assessing the identified learning outcomes VR simulation has the potential to be suitable and acceptable mode of delivery for assessment in health and social care. Funding applications have been submitted for phase two of the project which would include an impact study. 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":"12 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":"135870436","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 recent years we have seen an exponential increase in the use of simulation-based education (SBE) within surgical training. Early evidence supported initial integration of simulation to Trauma & Orthopaedic (T&O) training [1] with more contemporary evidence focused on refining training methods and technology usage [2,3]. We aim to assess the integration of established as well as novel SBE components within our T&O training programme in Northern Ireland. Simulation sessions were introduced to the Northern Ireland (NI) T&O Core Curriculum in academic year 2022/23: Trauma Simulation Scenario Training: Pelvic trauma scenarios were delivered to all T&O specialist trainees as part of Core Curriculum teaching in a regional simulation centre. Multi-professional input was sought and delivered by Blood Transfusion Service (Major Haemorrhage Protocol training) and Urological micro-teaching session (traumatic urological injuries in setting of pelvic trauma). Arthroscopy Simulation Course: A knee arthroscopy course was developed in conjunction with industry for all T&O trainees in NI utilizing passive haptic feedback arthroscopy simulators. Pre + post simulation surveys were completed assessing educational value, engagement with SBE as method of teaching, desire for further SBE content and suggestions for topics of same. Focus groups of lead educators were set up to plan development of further SBE training within T&O curriculum. Trainees reported increased confidence in management of pelvic trauma. Overwhelmingly positive response to integration of SBE sessions to core curriculum with 89% in favour of further multi-specialty simulation training sessions. There was a preference seen within feedback for a variety of SBE iterations with in-situ and operative/ procedural simulation being slightly preferred to scenario-based training. With majority of trainees requesting procedural SBE training as topic for future sessions, Knee Arthroscopy Simulation Course was subsequently developed (to be delivered as part of Core Curriculum in May 2023). From lead educator focus groups further simulation-based training sessions are planned for development in 2023/24 including shoulder arthroscopy simulation course, rare approaches simulation and advanced supracondylar simulation sessions. Feedback will be sought throughout to ensure training is tailored to needs of trainees as well as curriculum requirements. Recognition of benefits and scope of SBE training within T&O has prompted development of formal simulation trainee role as result of initial regional experience. Our experience of integrating SBE training methods to T&O core curriculum has been hugely positive with demand amongst trainees high for a wide range of further sessions and courses. 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":"A91 Integrating Simulation Based Education to Trauma &amp; Orthopaedic Training: A Regional Experience","authors":"Ryan Moffatt, Richard Napier","doi":"10.54531/sasq1430","DOIUrl":"https://doi.org/10.54531/sasq1430","url":null,"abstract":"In recent years we have seen an exponential increase in the use of simulation-based education (SBE) within surgical training. Early evidence supported initial integration of simulation to Trauma & Orthopaedic (T&O) training [1] with more contemporary evidence focused on refining training methods and technology usage [2,3]. We aim to assess the integration of established as well as novel SBE components within our T&O training programme in Northern Ireland. Simulation sessions were introduced to the Northern Ireland (NI) T&O Core Curriculum in academic year 2022/23: Trauma Simulation Scenario Training: Pelvic trauma scenarios were delivered to all T&O specialist trainees as part of Core Curriculum teaching in a regional simulation centre. Multi-professional input was sought and delivered by Blood Transfusion Service (Major Haemorrhage Protocol training) and Urological micro-teaching session (traumatic urological injuries in setting of pelvic trauma). Arthroscopy Simulation Course: A knee arthroscopy course was developed in conjunction with industry for all T&O trainees in NI utilizing passive haptic feedback arthroscopy simulators. Pre + post simulation surveys were completed assessing educational value, engagement with SBE as method of teaching, desire for further SBE content and suggestions for topics of same. Focus groups of lead educators were set up to plan development of further SBE training within T&O curriculum. Trainees reported increased confidence in management of pelvic trauma. Overwhelmingly positive response to integration of SBE sessions to core curriculum with 89% in favour of further multi-specialty simulation training sessions. There was a preference seen within feedback for a variety of SBE iterations with in-situ and operative/ procedural simulation being slightly preferred to scenario-based training. With majority of trainees requesting procedural SBE training as topic for future sessions, Knee Arthroscopy Simulation Course was subsequently developed (to be delivered as part of Core Curriculum in May 2023). From lead educator focus groups further simulation-based training sessions are planned for development in 2023/24 including shoulder arthroscopy simulation course, rare approaches simulation and advanced supracondylar simulation sessions. Feedback will be sought throughout to ensure training is tailored to needs of trainees as well as curriculum requirements. Recognition of benefits and scope of SBE training within T&O has prompted development of formal simulation trainee role as result of initial regional experience. Our experience of integrating SBE training methods to T&O core curriculum has been hugely positive with demand amongst trainees high for a wide range of further sessions and courses. 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":"64 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":"135871243","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}
To address the existing workforce deficit within Physiotherapy an extra 500 Physiotherapists need to be trained every year - an additional 15% of current student numbers. The biggest barrier to expansion of student numbers is placement capacity. Novel and innovative models of placement are being trialled, with a strong emphasis on the four pillars of clinical practice. Simulation, and virtual based placements offer alternative models of placement provision [1]. Current literature has detailed successful simulated clinical placement within Physiotherapy using full or partial substitution of clinical placement. It has been shown that switching up to 25% of practice learning to a simulated model does not compromise student attainment or competency [2]. However, these studies tend to involve small student numbers. For simulated placements to be a practical alternative they need to be delivered at scale. The aim of this pilot project was to develop, deliver and evaluate an on campus simulated placement experience for 140 first year Physiotherapy students at a large UK university. A four-week program of activities was designed to simulate the core learning that occurs on a typical physiotherapy clinical placement. Including case scenarios with standardized patients, virtual case discussions with clinicians, expert patient panel, day in the life of videos, note writing workshops and live streaming of patient sessions. Students attended two observational days in practice with structured debriefing on campus. Themes for the placement included communication, risk assessment, patient journeys, wellness and effective learning on placement. The development of the learning activities was research and stakeholder informed. Clinical scenarios were co-designed with level 5 Physiotherapy students. Placement evaluation was collected via a questionnaire including open ended questions and Likert scales (0-5). Students agreed that that placement was engaging and interesting (mean score of 3.45), with the greatest agreement that the placement had improved note writing, communication and understanding of professionalism. Students ranked simulated clinical scenarios and observation as their preference for activity, with peer learning to support these activities to be ranked the lowest. A review of placement attainment data noted a correlation with previous clinical placement data. There was an increase in a student’s perception of their preparedness to go on a clinical placement pre and post simulated placement. Large scale, simulated on campus placements are workable and a useful learning experience for first year Physiotherapy 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":"A110 Simulated Physiotherapy Placement: An alternative to clinical placement for first year undergraduate Physiotherapy students","authors":"Karen Stevens, Helen Batty, Ross Mallett","doi":"10.54531/rwgo6841","DOIUrl":"https://doi.org/10.54531/rwgo6841","url":null,"abstract":"To address the existing workforce deficit within Physiotherapy an extra 500 Physiotherapists need to be trained every year - an additional 15% of current student numbers. The biggest barrier to expansion of student numbers is placement capacity. Novel and innovative models of placement are being trialled, with a strong emphasis on the four pillars of clinical practice. Simulation, and virtual based placements offer alternative models of placement provision [1]. Current literature has detailed successful simulated clinical placement within Physiotherapy using full or partial substitution of clinical placement. It has been shown that switching up to 25% of practice learning to a simulated model does not compromise student attainment or competency [2]. However, these studies tend to involve small student numbers. For simulated placements to be a practical alternative they need to be delivered at scale. The aim of this pilot project was to develop, deliver and evaluate an on campus simulated placement experience for 140 first year Physiotherapy students at a large UK university. A four-week program of activities was designed to simulate the core learning that occurs on a typical physiotherapy clinical placement. Including case scenarios with standardized patients, virtual case discussions with clinicians, expert patient panel, day in the life of videos, note writing workshops and live streaming of patient sessions. Students attended two observational days in practice with structured debriefing on campus. Themes for the placement included communication, risk assessment, patient journeys, wellness and effective learning on placement. The development of the learning activities was research and stakeholder informed. Clinical scenarios were co-designed with level 5 Physiotherapy students. Placement evaluation was collected via a questionnaire including open ended questions and Likert scales (0-5). Students agreed that that placement was engaging and interesting (mean score of 3.45), with the greatest agreement that the placement had improved note writing, communication and understanding of professionalism. Students ranked simulated clinical scenarios and observation as their preference for activity, with peer learning to support these activities to be ranked the lowest. A review of placement attainment data noted a correlation with previous clinical placement data. There was an increase in a student’s perception of their preparedness to go on a clinical placement pre and post simulated placement. Large scale, simulated on campus placements are workable and a useful learning experience for first year Physiotherapy 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 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":"135871418","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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