P32 Can you improve knowledge and confidence in common paediatric emergencies using simulation teaching as part of a foundation year teaching program?

Abstract

Background All foundation trainees based within Cardiff and Vale Health Board follow a generic teaching curriculum. Paediatric emergencies are not often encountered within this group of trainees and trainees told us that they had never been involved in a paediatric resuscitation or had any simulation training on paediatric resus scenarios. Summary of work We built simulation teaching into the generic teaching program offered to Foundation Year doctors within our health board. We aimed to increase their knowledge and confidence of common Paediatric emergencies in a safe and supportive environment. We delivered an interactive afternoon session using simulation to focus on four common paediatric emergencies. The session focused on key skills that would translate into their existing foundation year post such as leadership and human factors. But also exposed them to common emergencies that they may have to handle if they became General Practitioners or had an Emergency Department post. We tested their knowledge of the emergencies pre and post simulation, using open questions with a specific answer. As well as self-reported confidence levels pre and post simulation on a Likert scale. Summary of results Results were analysed in XLStat 2018, using the Wilcoxon signed-rank test for comparison of 2 non-parametric sets of data. We demonstrated a significant increase in confidence post simulation. (Paediatric Cardiac Arrest p≤0.0001, Sepsis p≤0.0001, Acute Asthma p≤0.0001, Status p≤0.0001.) 2 of the 4 simulations also demonstrated a significant increase in knowledge. (Sepsis p≤0.001, Acute Asthma p=0.009) Foundation doctors also told us that they found the course useful and their confidence had increased. ‘I now feel more confident with treating an unwell child and what to do differently’ ‘Good teaching covering important topics’ ‘Fantastic facilitators, useful style of teaching’ Discussion and conclusions We have demonstrated that the use of a simulation program within the Foundation Training program results in an increase in confidence and knowledge amongst the trainees. The Foundation doctors found it useful to gain exposure to an area which they would commonly have very little exposure to. Recommendations We will continue to use simulation training to address identified learning needs, increasing their experience and knowledge. Improvements in confidence and knowledge have been shown to enable an improvement in patient safety and experience, however this is still being evaluated. Reference Zendejas B, Brydges R, Wang AT, Cook D. Patient outcomes in simulation-based medical education: A systematic review. Journal of General Internal Medicine 2013.