4 Departmental Paediatric Simulation Teaching: How Can we Best Involve Adolescents as Simulated Patients?

Abstract

Paediatrics requires diverse, adaptable, age and developmentally appropriate communication and clinical skills which HCPs can find challenging, negatively impacting paediatric care. The involvement of simulated patients (SPs) could be used to bridge this gap and bring patient perspectives. To create authentic, high-fidelity paediatric simulations it makes sense that young people should have a role. As a paediatric registrar in a district general hospital, I considered how to involve adolescent SPs in teaching by performing a literature review.On 2 February 2021, an advanced title and abstract search on PubMed: ‘paediatric’/’children’/’adolescent’ AND ‘simulated patient’/’simulated patients’/’standardized patient’/’standardized patients’. In total, 196 results returned which I filtered as per the inclusion and exclusion criteria (Table 1) leaving five articles.Inclusion/exclusion criteriaFindings Recruitment: SPs were recruited from theatre groups Training: some authors ran didactic teaching about conditions, rehearsals or video training Scenarios: standards of best practice state that simulated patients should be involved in resource writing and evaluation. However, while one group personalized scenarios Feedback: honest feedback from SPs is central to optimizing learning which SPs found challenging. Training to feedback with ‘I’ statements or using ‘the character’ to feedback was useful Positive impact: SPs felt the experience was positive and would be involved again. Positive impacts include: increased trust in HCPs Negative impact: exhaustion, boredom and potential for exploitation (missed schooling) Student learning: real children challenged students’ interpersonal skills and rendered encounters realistic.Implications for practice ‘Do no harm’ remains paramount in medical education. The benefit to society must be weighed against the risks to the child and their best interests must be kept central in educational processes.When planning teaching I will:Run monthly simulation sessions consolidating weekly didactic teachingLimit sessions to 1 hourRecruit young people within the hospital to minimize school absenceInvite collaboration between SPs and students to create scenarios around self-identified learning needs while maintaining psychological safety, allowing for complexity and fidelity that would be impossible if written by facultyTrain SPs to feedback using ‘I’ statementsCollaborate with the Child and Adolescent Mental Health Team prior to mental health scenarios to consider training and debriefingKeep the SPs voice central to the debrief and feedback