P6 In-situ simulation in the emergency department – are we doing it right?

Abstract

Background Simulation, particularly in-situ simulation, has been shown to be effective at teaching non-technical skills and clinical management of patients (as featured heavily in the Royal College of Emergency Medicine curriculum1) as well as improving patient safety.2 Our aim is to review if our established departmental in-situ programme is effective in developing clinical and non-technical skills based on feedback forms from our participants. Summary Multi-disciplinary in-situ simulation occurs weekly in our two major Emergency Departments at Leeds Teaching Hospitals Trust. Our programme includes adult and paediatric simulations as well as multi-speciality trauma, anaesthetic and neonatal sessions. The simulations last approximately 30 min followed by a robust, structured debrief. Feedback forms are then collected from participants to help us understand strengths and weaknesses of the programme. Feedback forms include 9 statements that our participants rank from 1 (entirely disagree) to 10 (entirely agree) with a not applicable option – see table 1. There are also three white space questions asking about their main learning points, suggestions for improvements and suggestions for future cases to cover. We’ve received feedback from 262 respondents from February 2017-February 2018, recorded by profession and grade as in figure 1. Results See table 1. Discussion/conclusion/recommendations The feedback is positive in all areas suggesting that the in-situ programme is a valuable and enjoyable educational experience for whole team development of clinical and non-clinical skills. The lowest scoring statement relates to leadership skills – likely to reflect that there’s usually only one team leader per session. Focusing our debrief skills onto the adaptation of leadership skills that is relevant to all participants may improve this. Figure 1 shows that we mostly have senior trainee doctors and nurses taking part – perhaps we should consider attempting to involve more of the other groups. We have already started nursing assessment simulations to empower nursing decision making. References Royal College of Emergency Medicine. Curriculum and Assessment Systems for Training in Emergency Medicine 2016. Available from: http://www.rcem.ac.uk/docs/Training/RCEM_2015_Curriculum___Applicable_from_August_2016__approved_23_Nov_2015_ATCF_RTT_DRE-EM_additions_July2017.pdf Fent G, Blythe J, Farooq O, Purva M. In situ simulation as a tool for patient safety: A systematic review identifying how it is used and its effectiveness. BMJ Simul Technol Enhanc Learn 2015;1:103–10. Available from: http://dx.doi.org/10.1136/