P27 Bringing the manikin to you: piloting in-situ simulation training for the multidisciplinary theatre recovery team

Abstract

Introduction The theatre environment is fast-paced and we identified it is logistically challenging for many theatre staff to access centre-based simulation training during normal hours. Therefore we designed a short recurrent, in-situ, multi-professional simulation programme. Simulation-based training is a valuable learning tool and there is a growing body of evidence supporting its integration into everyday healthcare education. Aim Our aim is to provide in-situ simulation training to a multidisciplinary theatre team during normal working hours, with minimal interruptions to theatre flow, in a familiar and safe environment, using a high-fidelity manikin from our dedicated Simulation Centre. The scenarios were selected based on common emergencies that manifest in recovery. Method We liaised with department managers to facilitate this in-situ recovery simulation. The anaesthetic secretary allocated an anaesthetist for the day we chose, the theatre co-ordinator nominated an operating department practitioner (ODP), the recovery nurse in charge selected 2 available recovery nurses and a South West Elective Orthopaedic Centre (SWELEOC) nurse. Pre-course material and an online survey was emailed out in advance to provide us with a baseline level of participant information. On the day we transferred the manikin on a trolley, with all necessary equipment and relevant hospital guidelines to the theatre recovery room for a 9 am start. Following a brief introduction to set psychological safety and introduce human factors, we ran through a single 15 min scenario e.g. management of anaphylaxis. After the simulation, participants re-convened to the simulation centre for a 30 min diamond debrief whilst we provided refreshments. Finally we collected instant post-course feedback. Results 30 members of staff have participated in six sessions over a nine month period from 2017–2018. The emphasis on a small multidisciplinary group meant that there was minimal disruption to the running of theatre, for 1.5 hours of teaching and learning centred on individual concerns in a safe environment. The feedback also highlighted that many felt more comfortable within the familiar theatre environment compared to the simulation centre. Comparing pre- and post-course survey results candidate’s confidence increased by 25%. Individual feedback was overwhelmingly positive with a senior nurse suggesting, ‘Theatre staff need more opportunities to do sim,’ and one anaesthetic trainee emphasised, ‘I’m more leading in real life after practicing in-situ sim.’ We continually develop our in-situ simulation course at Epsom based on real-life incidents and aim to expand by including our sister site St Helier’s Hospital recovery staff in 2018. References Issenberg SB, Mcgaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher2005;27:1:10–28. doi:10.1080/01421590500046924 Jaye P, Thomas L, Reedy G. The diamond: A structure for simulation debrief. Clin Teach2015;12:171–5.