Jess Spencer, Mike Evison, Carrie Hamilton, Sophie Macadie, Frances Haig
Between April and September 2022, 11,496 internationally educated nurses (IENs) registered with the NMC for the first time, which is 606 less than those domestically educated within the same timeframe [1]. To register, IENs must pass OSCEs and although globally assessed, there is no specific communication skills assessment [2]. A literature review identified challenges associated with integration into culturally different healthcare systems, most notably communication barriers; however, it found that with good support it is possible for IENs to achieve their full career potential [3]. To support local healthcare trusts and IENs, our organization designed a simulation-based educational programme to address the aforementioned barriers. To ensure a non-paternalistic approach, IENs lived experiences allowed the development of authentic, co-produced simulated scenarios. Actors were trained for the roles, and learning outcomes and debriefing processes were shared in advance. To assist participants with their skills, a model of communication was introduced, enabling them reference to a framework whilst participating and observing. Eight groups of six IENs have participated over eight months. Thematic analysis identified themes in which IENs wanted to be upskilled, these were integrated into multi-faceted simulated scenarios: Distressed relatives – IENs reported struggling setting appropriate boundaries and dealing with conflict with emotive relatives. Difficult conversations with patients – IENs felt ill equipped to communicate with challenging patients due to anxiety through language and cultural barriers leading to avoidance of engagement, further exacerbating the issues. Differing patient agenda – IENs struggled to manage patients who were not engaging with recommended multi-disciplinary interventions, due to a poor understanding of the MDT agenda. Hierarchical adjustment – IENs typically came from countries with a more established hierarchy and did not feel confident clarifying doctor’s decisions even if concerned. Evaluation linked to the learning outcomes; a rating scale from 1 (no ability/confidence) to 5 (excellent ability/confidence). 48 IENs have undertaken this training and all report progression in ability and confidence, with ongoing applicability of their learning within the workplace. The number of IENs is increasing within the NHS with recent records indicating NMC registrations being equal between domestic and internationally educated nursing staff. A repeatable simulation-based communication skills workshop has been developed based upon the lived experiences reported by IENs. Further deliveries are planned with subsequent quantitative and qualitative analysis. 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":"A47 Supporting internationally educated nurses reach their full career potential and deliver safe and effective patient care through simulation-based communication skills training","authors":"Jess Spencer, Mike Evison, Carrie Hamilton, Sophie Macadie, Frances Haig","doi":"10.54531/wcim6042","DOIUrl":"https://doi.org/10.54531/wcim6042","url":null,"abstract":"Between April and September 2022, 11,496 internationally educated nurses (IENs) registered with the NMC for the first time, which is 606 less than those domestically educated within the same timeframe [1]. To register, IENs must pass OSCEs and although globally assessed, there is no specific communication skills assessment [2]. A literature review identified challenges associated with integration into culturally different healthcare systems, most notably communication barriers; however, it found that with good support it is possible for IENs to achieve their full career potential [3]. To support local healthcare trusts and IENs, our organization designed a simulation-based educational programme to address the aforementioned barriers. To ensure a non-paternalistic approach, IENs lived experiences allowed the development of authentic, co-produced simulated scenarios. Actors were trained for the roles, and learning outcomes and debriefing processes were shared in advance. To assist participants with their skills, a model of communication was introduced, enabling them reference to a framework whilst participating and observing. Eight groups of six IENs have participated over eight months. Thematic analysis identified themes in which IENs wanted to be upskilled, these were integrated into multi-faceted simulated scenarios: Distressed relatives – IENs reported struggling setting appropriate boundaries and dealing with conflict with emotive relatives. Difficult conversations with patients – IENs felt ill equipped to communicate with challenging patients due to anxiety through language and cultural barriers leading to avoidance of engagement, further exacerbating the issues. Differing patient agenda – IENs struggled to manage patients who were not engaging with recommended multi-disciplinary interventions, due to a poor understanding of the MDT agenda. Hierarchical adjustment – IENs typically came from countries with a more established hierarchy and did not feel confident clarifying doctor’s decisions even if concerned. Evaluation linked to the learning outcomes; a rating scale from 1 (no ability/confidence) to 5 (excellent ability/confidence). 48 IENs have undertaken this training and all report progression in ability and confidence, with ongoing applicability of their learning within the workplace. The number of IENs is increasing within the NHS with recent records indicating NMC registrations being equal between domestic and internationally educated nursing staff. A repeatable simulation-based communication skills workshop has been developed based upon the lived experiences reported by IENs. Further deliveries are planned with subsequent quantitative and qualitative analysis. 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":"2008 29","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813142","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}
Buddug Eckley, Richard Cooper, Lucia Buratti, Linda Brayshay, Jack Barrington, David Purchase
Simulated sessions are widely used within medical education. Despite the potential benefits of simulated learning, it suffers from a narrow scope of practice; acute, emergency presentations and procedural skills. There is less research for its utility in sub-acute and chronic disease management. To develop expertise in medical practice, learners require sufficient foundational knowledge to facilitate more complex behaviours [1]. Within ward environments, lack of foundational knowledge in both ‘hard’ (knowledge) skills, and ‘soft’ (organizational) skills can limit learners’ potential for development. Considering legitimate peripheral participation theory, learners require ‘enculturing’ into an institution to develop ‘soft’ skills. Examples of ‘soft’ skills include understanding problem solving approaches, language, values and norms of the profession [2]. To design and assess the educational impact of simulated ward round teaching sessions on medical students in semi-acute settings, focussing on ‘enculturing’ skills. This was a prospective study. We created a ward round-based simulation session, with six simulated patient scenarios, designed for clinical placement level medical students. Ten students were included in the study. We utilized an induction exercise to familiarize students with medical documentation, a simulated ward round, and a consolidation exercise reviewing discharge paperwork and prescriptions. A simulated patient was present in each scenario, with a member of faculty facilitating. Simulated ward round entries, nursing handover queries and investigations were provided to students. Scenarios were 20 minutes; with objectives to produce ward round documentation and generate holistic clinical management decisions. Students participated in a ‘board round’, which served as a forum for station specific feedback. Enculturing values were assessed via a 40-point, knowledge based formative assessment, covering the main themes of the session: appropriate documentation, medical abbreviations, and clinical decision-making. Assessment was administered both pre- and post-session. Qualitative feedback of the session was obtained from learners to identify themes for further development. There was a significant improvement in knowledge following the session (see Results of pre- and post-intervention knowledge assessment Our results demonstrate an increased sense of empowerment in the study population. Simulated practice can be used effectively to enhance learning in sub-acute medical situations. Enculturing skills were particularly enhanced; promoting future learning through orientation within zones of legitimate peripheral participation. 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":"A57 Simulated Practice as a Method to Promote Legitimate Peripheral Participation","authors":"Buddug Eckley, Richard Cooper, Lucia Buratti, Linda Brayshay, Jack Barrington, David Purchase","doi":"10.54531/flhm6632","DOIUrl":"https://doi.org/10.54531/flhm6632","url":null,"abstract":"Simulated sessions are widely used within medical education. Despite the potential benefits of simulated learning, it suffers from a narrow scope of practice; acute, emergency presentations and procedural skills. There is less research for its utility in sub-acute and chronic disease management. To develop expertise in medical practice, learners require sufficient foundational knowledge to facilitate more complex behaviours [1]. Within ward environments, lack of foundational knowledge in both ‘hard’ (knowledge) skills, and ‘soft’ (organizational) skills can limit learners’ potential for development. Considering legitimate peripheral participation theory, learners require ‘enculturing’ into an institution to develop ‘soft’ skills. Examples of ‘soft’ skills include understanding problem solving approaches, language, values and norms of the profession [2]. To design and assess the educational impact of simulated ward round teaching sessions on medical students in semi-acute settings, focussing on ‘enculturing’ skills. This was a prospective study. We created a ward round-based simulation session, with six simulated patient scenarios, designed for clinical placement level medical students. Ten students were included in the study. We utilized an induction exercise to familiarize students with medical documentation, a simulated ward round, and a consolidation exercise reviewing discharge paperwork and prescriptions. A simulated patient was present in each scenario, with a member of faculty facilitating. Simulated ward round entries, nursing handover queries and investigations were provided to students. Scenarios were 20 minutes; with objectives to produce ward round documentation and generate holistic clinical management decisions. Students participated in a ‘board round’, which served as a forum for station specific feedback. Enculturing values were assessed via a 40-point, knowledge based formative assessment, covering the main themes of the session: appropriate documentation, medical abbreviations, and clinical decision-making. Assessment was administered both pre- and post-session. Qualitative feedback of the session was obtained from learners to identify themes for further development. There was a significant improvement in knowledge following the session (see Results of pre- and post-intervention knowledge assessment Our results demonstrate an increased sense of empowerment in the study population. Simulated practice can be used effectively to enhance learning in sub-acute medical situations. Enculturing skills were particularly enhanced; promoting future learning through orientation within zones of legitimate peripheral participation. 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":"2008 34","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813275","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}
Collaborative learning is recognized as essential in ensuring the delivery of safe and effective healthcare. It is fundamental to creating the healthcare teams of the future [1,3]. Central to this, is the early exposure of healthcare students to multiple, healthcare professions to begin the process of thinking and practising in a more interprofessional way. Importantly, how the interprofessional experience is assessed is crucial to the success of collaborative learning. This was the background to the development of an interprofessional module within the School of Nursing & Midwifery at Queens’ University Belfast. (1) To collaborate on the development of additional IPE workshops to supplement an established interprofessional simulation model. (2) To develop an assessment component for the interprofessional activities, including interprofessional simulation. (3) To evaluate the process. Drawing upon the expertise associated with the implementation of a highly successful interprofessional simulation programme, an interprofessional education (IPE) group was established with representation across the Faculty. From the outset, there was a need to have a shared understanding of the module and its complexities, and to work together to collectively support the pedagogy, shaping student learning and assessment, and providing the best educational experience [2]. The team collaborated on sourcing and establishing IPE workshops, developing reflective questions, as well as working on designing and integrating an online video within a digital platform, and streaming all students to one interprofessional workshop. An evaluation questionnaire was created using Microsoft Forms. The 17-item questionnaire incorporated three Likert scales, plus two either/or answers and two questions on digital device/browser. The questionnaire had 10 qualitative ‘free response’ questions to allow candidates to elaborate, expand, clarify or illustrate their answers. The collaboration with staff across the Faculty of Medicine Health & Life Sciences resulted in the establishment of four additional IPE workshops to complement an established six. Total number of IPE workshops, Interprofessional opportunities that utilize a reflective video-based assessment contribute positively to the student experience and are a welcome addition to the undergraduate nursing curriculum. 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":"A12 Development of a summative assessment method for interprofessional simulation and other interprofessional education (IPE) activities","authors":"Billiejoan Rice, Marian Traynor","doi":"10.54531/mlvt9074","DOIUrl":"https://doi.org/10.54531/mlvt9074","url":null,"abstract":"Collaborative learning is recognized as essential in ensuring the delivery of safe and effective healthcare. It is fundamental to creating the healthcare teams of the future [1,3]. Central to this, is the early exposure of healthcare students to multiple, healthcare professions to begin the process of thinking and practising in a more interprofessional way. Importantly, how the interprofessional experience is assessed is crucial to the success of collaborative learning. This was the background to the development of an interprofessional module within the School of Nursing & Midwifery at Queens’ University Belfast. (1) To collaborate on the development of additional IPE workshops to supplement an established interprofessional simulation model. (2) To develop an assessment component for the interprofessional activities, including interprofessional simulation. (3) To evaluate the process. Drawing upon the expertise associated with the implementation of a highly successful interprofessional simulation programme, an interprofessional education (IPE) group was established with representation across the Faculty. From the outset, there was a need to have a shared understanding of the module and its complexities, and to work together to collectively support the pedagogy, shaping student learning and assessment, and providing the best educational experience [2]. The team collaborated on sourcing and establishing IPE workshops, developing reflective questions, as well as working on designing and integrating an online video within a digital platform, and streaming all students to one interprofessional workshop. An evaluation questionnaire was created using Microsoft Forms. The 17-item questionnaire incorporated three Likert scales, plus two either/or answers and two questions on digital device/browser. The questionnaire had 10 qualitative ‘free response’ questions to allow candidates to elaborate, expand, clarify or illustrate their answers. The collaboration with staff across the Faculty of Medicine Health & Life Sciences resulted in the establishment of four additional IPE workshops to complement an established six. Total number of IPE workshops, Interprofessional opportunities that utilize a reflective video-based assessment contribute positively to the student experience and are a welcome addition to the undergraduate nursing curriculum. 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":"2014 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813408","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}
As international migration continues to shape the healthcare workforce globally, the United Kingdom (UK) has seen a significant increase in internationally educated (IE) nurses, midwives and allied health professionals (AHPs) [1]. These healthcare workers are vital to maintaining healthcare services, yet they face multiple challenges including language pronunciation, culture shock, and lack of social support [2]. The aim of this NHSE funded project was to identify the experiences of IE registrants, then develop and deliver a sustainable set of simulation-based workshops equipping established nurses, midwives and AHPs with the necessary skills to be allies [3]. The project design involved a mixed-method approach. Qualitative data was collected from across the region through focus group discussions and semi-structured interviews with IE registrants and with Trust leads for inclusivity and diversity. The findings were analysed and authentic story boards and scripts for scenarios were developed, cross checking back to source. These then became the core of a ‘re-usable’ workshop with skilled actor role players and facilitators. Allyship is introduced, advantage and privilege discussed, pre-recorded films analysed, and simulation is through live face to face encounters and forum theatre. The workshop centres on cultural allyship and the four pillars of allyship, which include awareness, empathy, action, and sustainability. Face to face simulation-based experiential learning has enabled participants to explore different scenarios and gain insights into the challenges faced by IE registrants. Workshops have been delivered on 20 occasions to groups of around 20, predominantly UK educated, nurses, midwives and AHPs. The impact has been significant; over 400 participants have benefitted, with evaluations of the workshop comprehensively positive. The participants reported increased awareness of their own biases and privilege, improved empathy towards IE registrants, and increased confidence in taking action to support them. The workshop ends with each participant making a pledge, showing their commitment to being an ally to IE registrants. Equipping UK educated nurses, midwives and AHPs with the skills to be allies to IE registrants is essential, not least because this is about being respectful and compassionate to one another, but also retaining our recruited workforce helps us all deliver safe healthcare. These repeated workshops, adaptable for different professional groups, are an effective way to achieve the goal of being active as an ally. The workshops have the potential to be replicated in other healthcare settings to promote cultural allyship, and improve healthcare outcomes for all. 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":"A25 Guiding UK educated nurses, midwives and allied health professionals with the skills to be allies to internationally educated registrants","authors":"Nicky Sinden, Carrie Hamilton, Jess Spencer, Caroline Tomkins","doi":"10.54531/rxmn5350","DOIUrl":"https://doi.org/10.54531/rxmn5350","url":null,"abstract":"As international migration continues to shape the healthcare workforce globally, the United Kingdom (UK) has seen a significant increase in internationally educated (IE) nurses, midwives and allied health professionals (AHPs) [1]. These healthcare workers are vital to maintaining healthcare services, yet they face multiple challenges including language pronunciation, culture shock, and lack of social support [2]. The aim of this NHSE funded project was to identify the experiences of IE registrants, then develop and deliver a sustainable set of simulation-based workshops equipping established nurses, midwives and AHPs with the necessary skills to be allies [3]. The project design involved a mixed-method approach. Qualitative data was collected from across the region through focus group discussions and semi-structured interviews with IE registrants and with Trust leads for inclusivity and diversity. The findings were analysed and authentic story boards and scripts for scenarios were developed, cross checking back to source. These then became the core of a ‘re-usable’ workshop with skilled actor role players and facilitators. Allyship is introduced, advantage and privilege discussed, pre-recorded films analysed, and simulation is through live face to face encounters and forum theatre. The workshop centres on cultural allyship and the four pillars of allyship, which include awareness, empathy, action, and sustainability. Face to face simulation-based experiential learning has enabled participants to explore different scenarios and gain insights into the challenges faced by IE registrants. Workshops have been delivered on 20 occasions to groups of around 20, predominantly UK educated, nurses, midwives and AHPs. The impact has been significant; over 400 participants have benefitted, with evaluations of the workshop comprehensively positive. The participants reported increased awareness of their own biases and privilege, improved empathy towards IE registrants, and increased confidence in taking action to support them. The workshop ends with each participant making a pledge, showing their commitment to being an ally to IE registrants. Equipping UK educated nurses, midwives and AHPs with the skills to be allies to IE registrants is essential, not least because this is about being respectful and compassionate to one another, but also retaining our recruited workforce helps us all deliver safe healthcare. These repeated workshops, adaptable for different professional groups, are an effective way to achieve the goal of being active as an ally. The workshops have the potential to be replicated in other healthcare settings to promote cultural allyship, and improve healthcare outcomes for all. 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":"2015 24","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813148","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}
Uncertainty is a prevalent concept within medicine, intrinsic to clinical decision-making. Managing uncertainty can be challenging, especially in specialties (i.e. General Practice) where unclear diagnoses are common. This has resulted in curriculums for such specialities introducing teaching on managing uncertainty [1]. With poor tolerance of uncertainty associated with negative outcomes in medical students [2], there is a strong argument that medical schools need to prepare students to manage uncertainty. Uncertainty simulation cases have been utilized to achieve immersive teaching on uncertainty [3], however this is limited by the resources made available by simulation departments, restricting the potential reach of this transformative learning. Aim: To deliver an immersive teaching programme for medical students that develops skills in managing uncertainty within a minimal resource environment. 8 teaching sessions with 46 students were facilitated, which involved students rotating through a circuit of 5 simulated General Practice consultation stations. Students firstly performed the station and then acted as the patient for the next candidate in a continuous cycle ( Circuit Rotation Design – Students started the circuit acting as either the doctor or patient for stations 1-5. After each 10-minute station, there were two minutes for feedback. Students then rotated in a clockwise direction becoming the patient for the station they had previously performed or performing a new station. The students continued to rotate according to this carousel circuit design until they had performed and examined all five stations Students responded positively to the teaching programme, rating its provision of confidence in managing uncertainty and managing GP scenarios (real and OSCE) as >95%. Enjoyment of the sessions was rated at 97% with main aspects being: variety of stations and interactivity. Usefulness of the sessions was rated at 98% with main aspects being: chance to practice, range of cases, receiving feedback. Simulations of GP consultations were rated as highly representative; this was achieved with minimal resources. This teaching programme developed medical students’ confidence and skills in managing uncertainty. They also felt better prepared for managing patients in a GP setting. Critical to the success of this programme was the enjoyment and perceived usefulness of the teaching, as this improved engagement with the learning outcomes. With the cohort being final year students that were integrating knowledge from previous clinical years, we hypothesize that the usefulness was due to students wanting to focus more on revision and opportunities to develop skills in managing less commonly taught but clinically important abstract concepts, such as managing uncertainty. Further programmes should expand on the simulated environments (ED, medical/surgical on-calls) and managing other clinically important abstract concepts (confrontations, prioritizati
{"title":"A73 Using simulated general practice consultation circuits to develop medical students’ skills in managing uncertainty","authors":"Lucy Porter, James Speed","doi":"10.54531/iolf7810","DOIUrl":"https://doi.org/10.54531/iolf7810","url":null,"abstract":"Uncertainty is a prevalent concept within medicine, intrinsic to clinical decision-making. Managing uncertainty can be challenging, especially in specialties (i.e. General Practice) where unclear diagnoses are common. This has resulted in curriculums for such specialities introducing teaching on managing uncertainty [1]. With poor tolerance of uncertainty associated with negative outcomes in medical students [2], there is a strong argument that medical schools need to prepare students to manage uncertainty. Uncertainty simulation cases have been utilized to achieve immersive teaching on uncertainty [3], however this is limited by the resources made available by simulation departments, restricting the potential reach of this transformative learning. Aim: To deliver an immersive teaching programme for medical students that develops skills in managing uncertainty within a minimal resource environment. 8 teaching sessions with 46 students were facilitated, which involved students rotating through a circuit of 5 simulated General Practice consultation stations. Students firstly performed the station and then acted as the patient for the next candidate in a continuous cycle ( Circuit Rotation Design – Students started the circuit acting as either the doctor or patient for stations 1-5. After each 10-minute station, there were two minutes for feedback. Students then rotated in a clockwise direction becoming the patient for the station they had previously performed or performing a new station. The students continued to rotate according to this carousel circuit design until they had performed and examined all five stations Students responded positively to the teaching programme, rating its provision of confidence in managing uncertainty and managing GP scenarios (real and OSCE) as >95%. Enjoyment of the sessions was rated at 97% with main aspects being: variety of stations and interactivity. Usefulness of the sessions was rated at 98% with main aspects being: chance to practice, range of cases, receiving feedback. Simulations of GP consultations were rated as highly representative; this was achieved with minimal resources. This teaching programme developed medical students’ confidence and skills in managing uncertainty. They also felt better prepared for managing patients in a GP setting. Critical to the success of this programme was the enjoyment and perceived usefulness of the teaching, as this improved engagement with the learning outcomes. With the cohort being final year students that were integrating knowledge from previous clinical years, we hypothesize that the usefulness was due to students wanting to focus more on revision and opportunities to develop skills in managing less commonly taught but clinically important abstract concepts, such as managing uncertainty. Further programmes should expand on the simulated environments (ED, medical/surgical on-calls) and managing other clinically important abstract concepts (confrontations, prioritizati","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"2004 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":"135813387","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}
Climate change is considered one of the most pressing global concerns for the future and the single biggest health threat [1]. Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [2]. One of the largest contributors to NHS carbon emissions is the use of equipment, consumables and clinical care itself [2]. Therefore, clinical staff have a significant part to play in reducing carbon emissions and achieving national carbon reduction targets. However, they must be carbon literate and understand the impact of personal practice on global carbon emissions and be able to identify ways to deliver low carbon models of care [3]. Simulation could play a significant role in educating and developing sustainable practice in healthcare students through a system thinking approach. Allowing students to examine the environmental impact of healthcare delivery and support innovative solutions to reduce carbon emissions without compromising care. The aim was to firstly increase nursing students’ awareness of the carbon emissions from the delivery of patient care. Secondly to improve clinical decision-making in the selection and implementation of interventions to enable the delivery of low carbon care. Undergraduate nursing students took part in a specifically designed simulation scenario. Students completed the scenario of a patient presenting to the Emergency Department with exacerbation of Chronic Obstructive Pulmonary Disease (COPD), implementing care and interventions as clinically indicated. After completion of the simulation students then calculated the carbon emissions from the clinical resources they used, using the Centre for Sustainable Healthcare carbon emissions calculation. Debriefing identified that students did not consider sustainability and carbon emissions in their current clinical decision-making. Students were shocked by the amount of carbon emissions generated from interventions. Students identified areas where they could reduce carbon emissions without compromising care such as inappropriate use of gloves, using dry powdered inhalers, and reducing unnecessary cannulation. Simulation could play a pivotal role in developing sustainable clinical decision-making skills in healthcare students and staff. Actively calculating carbon emissions allows students to directly see the environmental impact of their practice, increasing carbon literacy and stimulating low carbon care practice. This use of simulation should be explored further by educators across professions to support both national and global climate change policies. 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":"A45 Developing low carbon care – using simulation to calculate and reduce carbon emissions","authors":"Hannah Ames","doi":"10.54531/hisc7520","DOIUrl":"https://doi.org/10.54531/hisc7520","url":null,"abstract":"Climate change is considered one of the most pressing global concerns for the future and the single biggest health threat [1]. Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [2]. One of the largest contributors to NHS carbon emissions is the use of equipment, consumables and clinical care itself [2]. Therefore, clinical staff have a significant part to play in reducing carbon emissions and achieving national carbon reduction targets. However, they must be carbon literate and understand the impact of personal practice on global carbon emissions and be able to identify ways to deliver low carbon models of care [3]. Simulation could play a significant role in educating and developing sustainable practice in healthcare students through a system thinking approach. Allowing students to examine the environmental impact of healthcare delivery and support innovative solutions to reduce carbon emissions without compromising care. The aim was to firstly increase nursing students’ awareness of the carbon emissions from the delivery of patient care. Secondly to improve clinical decision-making in the selection and implementation of interventions to enable the delivery of low carbon care. Undergraduate nursing students took part in a specifically designed simulation scenario. Students completed the scenario of a patient presenting to the Emergency Department with exacerbation of Chronic Obstructive Pulmonary Disease (COPD), implementing care and interventions as clinically indicated. After completion of the simulation students then calculated the carbon emissions from the clinical resources they used, using the Centre for Sustainable Healthcare carbon emissions calculation. Debriefing identified that students did not consider sustainability and carbon emissions in their current clinical decision-making. Students were shocked by the amount of carbon emissions generated from interventions. Students identified areas where they could reduce carbon emissions without compromising care such as inappropriate use of gloves, using dry powdered inhalers, and reducing unnecessary cannulation. Simulation could play a pivotal role in developing sustainable clinical decision-making skills in healthcare students and staff. Actively calculating carbon emissions allows students to directly see the environmental impact of their practice, increasing carbon literacy and stimulating low carbon care practice. This use of simulation should be explored further by educators across professions to support both national and global climate change policies. 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 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":"135813634","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}
Research suggests that interprofessional training wards (ITW) enhance student learning and patient satisfaction [1] but are resource intensive from governance and faculty training points of view. Given NHS pressures, we developed a simulated ITW to meet training needs of healthcare undergraduates and improve attitudes and confidence regarding interprofessional working prior to qualification. The session simulated a typical ward day, with nursing handover, ward-round, board-round, communication scenarios, and an acutely deteriorating patient. Final year medical, nursing and physiotherapy students attended, and formed interprofessional teams. After each scenario an interprofessional debrief took place. Students completed the readiness for interprofessional learning scale (RIPLS) [2] pre and post, also providing feedback using Likert scales and qualitative comments. 35 students participated, all completing RIPLS, and 32 completing Likert and qualitative feedback. Despite the small dataset, we demonstrated significant change (p<0.05) in 9 of the RIPLS statements, indicating a positive change in attitudes toward interprofessional learning. All students felt the session met their learning requirements. Likert feedback across professions demonstrated increased understanding and valuing of multi-disciplinary teams (MDT) (97%); appreciation of the relevance of multi-disciplinary working to their training (91%); belief that it would change their approach to MDT work (84%); and increased confidence prior to transitioning to a working role (81%). Profession-specific breakdown demonstrated highest confidence and increased understanding for physiotherapists, however they (alongside nurses) found the content more challenging. Summary of infographic for SUIT ward Thematic analysis highlighted several key themes: Interprofessional teamworking, patient-centred care, communication, professional readiness, technical skills, and satisfaction with session format and delivery. Interprofessional teamworking, patient-centred care, and communication bridged the categories of ‘valued aspects’ and ‘take-home messages’, demonstrating uptake of key learning points, and reinforcing the changes in the RIPLS data. While the feedback regarding the ‘suggested improvements’ category reiterated the challenges of catering to all learners, this category’s comments were overwhelmingly positive, with appreciation and importance of this learning event appearing frequently. One wrote, ‘I feel incredibly lucky to have had the opportunity to take part… and strongly believe every single healthcare student should have the chance to attend a similar session’. Our pilot program suggests that using simulated ITWs offers multiple benefits to students. The simulated ITW environment improved confidence and understanding of interprofessional roles in clinical practice; and was valuable and relevant to learners with early signs of improving attitudes towards interprofessional learning. A full study i
{"title":"A35 Simulated Undergraduate Interprofessional Training Ward – improving self-confidence and attitudes to interprofessional working prior to transition to clinical practice","authors":"Steve McLaren, Alexandra Muston, Sophie Page","doi":"10.54531/ewpo5556","DOIUrl":"https://doi.org/10.54531/ewpo5556","url":null,"abstract":"Research suggests that interprofessional training wards (ITW) enhance student learning and patient satisfaction [1] but are resource intensive from governance and faculty training points of view. Given NHS pressures, we developed a simulated ITW to meet training needs of healthcare undergraduates and improve attitudes and confidence regarding interprofessional working prior to qualification. The session simulated a typical ward day, with nursing handover, ward-round, board-round, communication scenarios, and an acutely deteriorating patient. Final year medical, nursing and physiotherapy students attended, and formed interprofessional teams. After each scenario an interprofessional debrief took place. Students completed the readiness for interprofessional learning scale (RIPLS) [2] pre and post, also providing feedback using Likert scales and qualitative comments. 35 students participated, all completing RIPLS, and 32 completing Likert and qualitative feedback. Despite the small dataset, we demonstrated significant change (p<0.05) in 9 of the RIPLS statements, indicating a positive change in attitudes toward interprofessional learning. All students felt the session met their learning requirements. Likert feedback across professions demonstrated increased understanding and valuing of multi-disciplinary teams (MDT) (97%); appreciation of the relevance of multi-disciplinary working to their training (91%); belief that it would change their approach to MDT work (84%); and increased confidence prior to transitioning to a working role (81%). Profession-specific breakdown demonstrated highest confidence and increased understanding for physiotherapists, however they (alongside nurses) found the content more challenging. Summary of infographic for SUIT ward Thematic analysis highlighted several key themes: Interprofessional teamworking, patient-centred care, communication, professional readiness, technical skills, and satisfaction with session format and delivery. Interprofessional teamworking, patient-centred care, and communication bridged the categories of ‘valued aspects’ and ‘take-home messages’, demonstrating uptake of key learning points, and reinforcing the changes in the RIPLS data. While the feedback regarding the ‘suggested improvements’ category reiterated the challenges of catering to all learners, this category’s comments were overwhelmingly positive, with appreciation and importance of this learning event appearing frequently. One wrote, ‘I feel incredibly lucky to have had the opportunity to take part… and strongly believe every single healthcare student should have the chance to attend a similar session’. Our pilot program suggests that using simulated ITWs offers multiple benefits to students. The simulated ITW environment improved confidence and understanding of interprofessional roles in clinical practice; and was valuable and relevant to learners with early signs of improving attitudes towards interprofessional learning. A full study i","PeriodicalId":93766,"journal":{"name":"International journal of healthcare simulation : advances in theory and practice","volume":"2007 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813776","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 can immerse learners in scenarios that mimic clinical situations, simultaneously mitigating safety risks and increasing standardization in healthcare education [1]. Through simulation, learners can get the chance to develop clinical reasoning with focused learning opportunities [2]. Clinical reasoning is multidimensional in nature, and underdeveloped clinical reasoning skills and the risk of cognitive overload can potentially threaten patient safety and delay care, so it is important to systematize, optimize and structure clinical reasoning for simulation-based education [3]. That can be achieved through using valid clinical reasoning models but with careful consideration to the contributing and influencing factors of case complexity, staff seniority, competence, scope of practice, specialty and subspecialty. A scoping review was undertaken to answer the questions: what are the best available valid and reliable clinical reasoning models for simulation-based education? We searched Medline, Scopus, Education Research Complete and Google Scholar to identify relevant recent primary research conducted on this topic from 2000 onwards. The search included MeSH topics of ‘Clinical reasoning’, ‘Simulation-based education’ and ‘Clinical Reasoning models’. The inclusion criteria were primary studies describing the clinical reasoning models developed for simulation-based courses. Two independent researchers agreed on the inclusion of the identified articles for full-text review. This review followed the review guidelines of Joanne Briggs Institute. Five valid and reliable models to structure the clinical reasoning process while attending simulation-based training were identified and are reported in Identified clinical reasoning models based on the scoping review There is an adequate number of clinical reasoning models to be used while taking part in simulation-based training; however, there is a significant basis to test the reliability and validity of these models against different competence and seniority levels, and applicability to other healthcare professions. The authors are presently working on the development of a new model using an innovative and rigorous approach. 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.
模拟可以让学习者沉浸在模拟临床情况的场景中，同时降低安全风险，提高医疗保健教育的标准化[1]。通过模拟，学习者可以获得发展临床推理的机会，并有集中的学习机会[2]。临床推理是多维度的，临床推理能力的不发达和认知超载的风险可能会威胁患者的安全并延误护理，因此对临床推理进行系统化、优化和结构化的模拟教育非常重要[3]。这可以通过使用有效的临床推理模型来实现，但要仔细考虑病例复杂性、工作人员资历、能力、业务范围、专科和亚专科等因素的促成和影响因素。进行了范围审查，以回答以下问题:什么是基于模拟的教育的最佳有效和可靠的临床推理模型?我们检索了Medline, Scopus, Education Research Complete和Google Scholar，以确定自2000年以来有关该主题的最新主要研究。搜索的MeSH主题包括“临床推理”、“基于模拟的教育”和“临床推理模型”。纳入标准是描述为模拟课程开发的临床推理模型的初步研究。两名独立研究人员同意将确定的文章纳入全文审查。本综述遵循乔安妮布里格斯研究所的综述指南。在基于范围审查的识别临床推理模型中，确定并报告了参加基于模拟的培训时结构临床推理过程的五个有效可靠的模型。参加基于模拟的培训时可以使用足够数量的临床推理模型;然而，有一个重要的基础来测试这些模型的信度和效度针对不同的能力和资历水平，并适用于其他医疗保健专业。作者目前正在开发一种使用创新和严格方法的新模型。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":"A19 Identification of clinical reasoning models commonly used in simulation-based education","authors":"Emad Almomani, Jacqueline Sullivan, Natalie Pattison, Guillaume Alinier","doi":"10.54531/hbed6197","DOIUrl":"https://doi.org/10.54531/hbed6197","url":null,"abstract":"Simulation can immerse learners in scenarios that mimic clinical situations, simultaneously mitigating safety risks and increasing standardization in healthcare education [1]. Through simulation, learners can get the chance to develop clinical reasoning with focused learning opportunities [2]. Clinical reasoning is multidimensional in nature, and underdeveloped clinical reasoning skills and the risk of cognitive overload can potentially threaten patient safety and delay care, so it is important to systematize, optimize and structure clinical reasoning for simulation-based education [3]. That can be achieved through using valid clinical reasoning models but with careful consideration to the contributing and influencing factors of case complexity, staff seniority, competence, scope of practice, specialty and subspecialty. A scoping review was undertaken to answer the questions: what are the best available valid and reliable clinical reasoning models for simulation-based education? We searched Medline, Scopus, Education Research Complete and Google Scholar to identify relevant recent primary research conducted on this topic from 2000 onwards. The search included MeSH topics of ‘Clinical reasoning’, ‘Simulation-based education’ and ‘Clinical Reasoning models’. The inclusion criteria were primary studies describing the clinical reasoning models developed for simulation-based courses. Two independent researchers agreed on the inclusion of the identified articles for full-text review. This review followed the review guidelines of Joanne Briggs Institute. Five valid and reliable models to structure the clinical reasoning process while attending simulation-based training were identified and are reported in Identified clinical reasoning models based on the scoping review There is an adequate number of clinical reasoning models to be used while taking part in simulation-based training; however, there is a significant basis to test the reliability and validity of these models against different competence and seniority levels, and applicability to other healthcare professions. The authors are presently working on the development of a new model using an innovative and rigorous approach. 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":"9 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":"135870128","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}
Shona Hill, Ben Hester, Ashley Duzy, Lenny Kistler, Racheal Bolton
In recent years many Higher Education Institutions (HEIs) have recognized the benefits of Simulation Based Education (SBE) and incorporated it into their teaching programs, in some cases utilizing it to replace traditional ‘clinical placement’ hours [1]. This has been catalysed by the COVID-19 pandemic whereby there has been unprecedented demands on NHS services, forcing the industry to offer alternative placement models [2]. To contribute to placement expansion by offering a simulation-based student placement. We created a six week non-clinical, simulation placement designed to host two Physiotherapy students. The overarching objective of this placement was to enable students to create and run their own simulation training session by their final week. They were based in the simulation team and networked with other students and clinicians to guide their research and planning. We collated feedback from the students at the end of their six-week placement via anonymous, online Microsoft feedback forms. Throughout 2022 we ran this placement twice and collated data from the 4 Physiotherapy students, all who were in their second year of study. Thematic analysis suggested the most common skills students felt they gained were soft skills (i.e. organization and prioritization) and development of varied communication styles. Additional themes that were mentioned included simulation specific skills. There were two areas where students felt they were unable to develop due to the placement communicating with ‘real’ patients and clinical note writing. Students were asked to score their clinical knowledge relating to their chosen simulation topic area at the beginning and end of the placement. Scores increased from ‘Good’ (2 students) and ‘Average’ (2 students) at the beginning of the placement to ‘Good’ (1 student) and ‘Very Good’ (3 Students) at the end of the placement. Qualitative themes suggested the students felt the overall variety of activities and exposure to clinical scenarios/teams they may not have seen before was unique to this placement and both enjoyable and valuable. Previous studies have identified misconceptions relating to the purpose of simulation and its aims [1]. Our data reflected this concept as students rated their knowledge of simulation at the beginning of the placement as ‘Very Minimal’. However, our placement offering has proven to successfully increase this awareness and offer the opportunity to develop transferable skills and clinical knowledge in a way that is both exciting and aids placement expansion whilst incurring minimal cost. 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":"A103 The Future of Aiding Student Placement Expansion: is it simulation, is it sustainable?","authors":"Shona Hill, Ben Hester, Ashley Duzy, Lenny Kistler, Racheal Bolton","doi":"10.54531/zzal2905","DOIUrl":"https://doi.org/10.54531/zzal2905","url":null,"abstract":"In recent years many Higher Education Institutions (HEIs) have recognized the benefits of Simulation Based Education (SBE) and incorporated it into their teaching programs, in some cases utilizing it to replace traditional ‘clinical placement’ hours [1]. This has been catalysed by the COVID-19 pandemic whereby there has been unprecedented demands on NHS services, forcing the industry to offer alternative placement models [2]. To contribute to placement expansion by offering a simulation-based student placement. We created a six week non-clinical, simulation placement designed to host two Physiotherapy students. The overarching objective of this placement was to enable students to create and run their own simulation training session by their final week. They were based in the simulation team and networked with other students and clinicians to guide their research and planning. We collated feedback from the students at the end of their six-week placement via anonymous, online Microsoft feedback forms. Throughout 2022 we ran this placement twice and collated data from the 4 Physiotherapy students, all who were in their second year of study. Thematic analysis suggested the most common skills students felt they gained were soft skills (i.e. organization and prioritization) and development of varied communication styles. Additional themes that were mentioned included simulation specific skills. There were two areas where students felt they were unable to develop due to the placement communicating with ‘real’ patients and clinical note writing. Students were asked to score their clinical knowledge relating to their chosen simulation topic area at the beginning and end of the placement. Scores increased from ‘Good’ (2 students) and ‘Average’ (2 students) at the beginning of the placement to ‘Good’ (1 student) and ‘Very Good’ (3 Students) at the end of the placement. Qualitative themes suggested the students felt the overall variety of activities and exposure to clinical scenarios/teams they may not have seen before was unique to this placement and both enjoyable and valuable. Previous studies have identified misconceptions relating to the purpose of simulation and its aims [1]. Our data reflected this concept as students rated their knowledge of simulation at the beginning of the placement as ‘Very Minimal’. However, our placement offering has proven to successfully increase this awareness and offer the opportunity to develop transferable skills and clinical knowledge in a way that is both exciting and aids placement expansion whilst incurring minimal cost. 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":"1 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870174","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}
Owen Vale, Andrew Hadfield, Catrin Maidment, Danielle Huckle, Cristina Diaz-Navarro
Simulation training sessions were designed at the University Hospital of Wales in order to implement the new national guidelines for the management of suspected haematoma following thyroid surgery [1]. Opportunities included on site portable training with a part task trainer and high-fidelity scenarios simulating patient deterioration following thyroid surgery in an immersive environment. Our initial design for the high-fidelity set-up included a simulated neck haematoma achieved by using a second generation supraglottic airway device (SAD) with an inflatable cuff placed in the manikin’s neck with the laryngeal opening outwards and tubing inside the chest. The opening was filled with red jelly, covered by simulated strap muscles (made from simulated small bowel with interrupted sutures) and simulated neck skin (which presented a sutured incision complete with steri-strips). Ongoing bleeding was simulated by injecting liquid jelly through the SAD’s gastric port via a long connecting tube in the manikin’s thorax. This simulation training increased confidence and familiarity with the steps required to manage post thyroid surgery haematomas in 100% (15/15) of candidates, with 73% grading the mannikin ≥4/5 for realism. However, it was costly to provide and time-consuming to set up. It was decided to try to make the set-up cheaper and easier to reproduce without impairing quality. Equipment costs were reviewed and alternative options identified. Expensive components included the SAD and bowel material, which were replaced with a cheaper SAD and a disposable tourniquet fashioned as shown in Making the simulation larynx and strap muscles. A step by step guide The cost of disposable props used in each session was reduced from £133.04 to £8.52 with the new equipment. The designers also felt it was significantly more robust and easier to reproduce. This approach could also be easily adapted for mobile part-task training, improving multi-disciplinary access to training. Feedback showed 47% of candidates felt the new set-up to be better, and 47% reported non-inferiority. Changing to new equipment resulted in a design that was significantly cheaper, easier to source and set-up, while being at least as realistic and offering training opportunities outside the high-fidelity environment. 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":"A100 Simulating to manage post thyroidectomy haematoma safely: Improving fidelity whilst reducing cost","authors":"Owen Vale, Andrew Hadfield, Catrin Maidment, Danielle Huckle, Cristina Diaz-Navarro","doi":"10.54531/kjch7399","DOIUrl":"https://doi.org/10.54531/kjch7399","url":null,"abstract":"Simulation training sessions were designed at the University Hospital of Wales in order to implement the new national guidelines for the management of suspected haematoma following thyroid surgery [1]. Opportunities included on site portable training with a part task trainer and high-fidelity scenarios simulating patient deterioration following thyroid surgery in an immersive environment. Our initial design for the high-fidelity set-up included a simulated neck haematoma achieved by using a second generation supraglottic airway device (SAD) with an inflatable cuff placed in the manikin’s neck with the laryngeal opening outwards and tubing inside the chest. The opening was filled with red jelly, covered by simulated strap muscles (made from simulated small bowel with interrupted sutures) and simulated neck skin (which presented a sutured incision complete with steri-strips). Ongoing bleeding was simulated by injecting liquid jelly through the SAD’s gastric port via a long connecting tube in the manikin’s thorax. This simulation training increased confidence and familiarity with the steps required to manage post thyroid surgery haematomas in 100% (15/15) of candidates, with 73% grading the mannikin ≥4/5 for realism. However, it was costly to provide and time-consuming to set up. It was decided to try to make the set-up cheaper and easier to reproduce without impairing quality. Equipment costs were reviewed and alternative options identified. Expensive components included the SAD and bowel material, which were replaced with a cheaper SAD and a disposable tourniquet fashioned as shown in Making the simulation larynx and strap muscles. A step by step guide The cost of disposable props used in each session was reduced from £133.04 to £8.52 with the new equipment. The designers also felt it was significantly more robust and easier to reproduce. This approach could also be easily adapted for mobile part-task training, improving multi-disciplinary access to training. Feedback showed 47% of candidates felt the new set-up to be better, and 47% reported non-inferiority. Changing to new equipment resulted in a design that was significantly cheaper, easier to source and set-up, while being at least as realistic and offering training opportunities outside the high-fidelity environment. 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":"1 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":"135870200","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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