Multidisciplinary Simulation Course Research Articles

A88Designing a Multidisciplinary Chest Drain Course

In 2008 the National Patient Safety Agency reported 12 patient deaths directly related to chest drain insertion over a 3-year period. Since then there have been calls from publications highlighting the need for better education for clinicians [1]. Simulation has been shown to improve chest drain insertion technique [2], and multi-disciplinary simulation can encourage teamwork and communication skills [3]. Given that this procedure is an essential requirement for anaesthetic, intensive care, emergency medicine and internal medicine trainees, we decided to introduce a multi-disciplinary simulation course for the insertion of chest drains. A basic needs analysis was carried out with stakeholders. Initially the course was designed to run for half a day, with a maximum of 12 candidates and a minimum of 3 faculty. A course timetable, course manual, equipment list and pre- and post-course feedback questionnaires were created. The course begins with a lecture, followed by three simulation-based workshops, which the candidates rotate between. These cover seldinger and surgical chest drain insertion, and the basics of chest ultrasound, using ultrasoundable chest drain manikins. Feedback from the first course in July 2022 suggested that there should be a designated faculty team leader and healthy volunteers for the ultrasound workshop. We implemented this feedback and ran the course again in December 2022. Candidates were asked to rate their post course confidence at performing the procedure, with a score ranging between 1 and 7 (each number was assigned a qualitative value with 1 being unable to perform the procedure and 7 being extremely confident in performing the procedure). After the first course, the average score was 5 points. After the second, the average increased to 5.5. The course ran for a third time in April 2023, during which the duration of the workshops was increased and a lecture on aftercare was added. The average post course confidence score was 5.7. All candidates felt that the session fully met the learning objectives and would recommend the course to others. After implementing changes to our course including assigning a faculty team leader, recruiting healthy volunteers, increasing the time spent in workshops and adding a session on aftercare, there has been an improvement in the candidates’ average post course confidence at performing chest drains and qualitative candidate feedback was positive. We would recommend our course structure to others designing a chest drain course. 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.

Use of High-fidelity simulation training for radiology healthcare professionals in the management of acute medical emergencies.

Life-threatening emergencies are relatively uncommon in the radiology department, but when encountered, require timely intervention. With an increasing number of critically unwell patients visiting the radiology department each year for both diagnostic and interventional procedures, it is vital that radiology staff are trained to provide basic resuscitation before further assistance arrives. Simulation training is a well-validated, effective method for rehearsing low-frequency, high-acuity events in a supportive and safe environment. The aim of our study was to investigate whether the introduction of a focussed, multidisciplinary simulation course would improve healthcare professional's knowledge and confidence when managing common medical emergencies; including cardiac arrest, anaphylaxis and airway obstruction. A multidisciplinary group of radiology staff attended a dedicated simulation teaching course. Participants completed a pre- and post-test questionnaire which assessed a range of knowledge domains and their perceived confidence with dealing with the clinical scenarios. The delegates were then asked to repeat this questionnaire 6 months after taking part in the course to assess their retention of skills and knowledge. Knowledge scores increased by a mean difference of 4 points (p < 0.001). The mean pre- and post-course perceived confidence scores were 4.4/10 and 8/10, respectively. This study suggests that embedding simulation training into the radiology curriculum improves healthcare professional's knowledge and perceived confidence when dealing with common medical emergencies. Although previous studies have looked at the use of simulation training for radiology trainees in the management of selected medical emergencies, to the authors' knowledge, this is the first study to demonstrate these benefits across a range of clinical scenarios, within an interprofessional environment.

Developing a Multidisciplinary Simulation Course to Address the Physical Health Agenda in Mental Health: Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS)

Introduction There’s a renewed focus on physical health for people with mental health conditions. In Yorkshire & Humber, a team were tasked with improving patient safety, outcomes and experiences through training and simulation. Objectives Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS) provides opportunities to assess and manage deteriorations in physical health in a safe environment, where learner needs are paramount. It reflects the way situations unfold in real life with Health Care Assistants, Nurses and Psychiatric Trainees working together. Aims RAMPPS aims to improve effective communication, clinical, safety and collaborative skills. Scenarios test technical competencies around measurement and interpretation of observations, communication, handover of information and team dynamics. Methods Scenarios are based upon real-life incidents from psychiatric inpatient wards. Using high-fidelity manikins, part-task trainers, remote simulation technology and standardised patient-actors, we produced simulations akin to real-life. The RAMPPS course can be run in various ways: • Large simulation centres with scenarios running concurrently • Smaller simulation centres with live video • In-situ with equipment taken to a ward Confidence in competencies forms the core of paired pre- and post-course questionnaires; delegates act as their own control. Results Chi-square analysis of results shows a significant increase in confidence for doctors, nurses and health care assistants in core competency areas including communication, collaboration, clinical skills and organisational aspects of care. Conclusions RAMPPS is an effective and new way to incorporate effective simulation training in psychiatry. It can be adapted to the arrangement of the localities whilst retaining its core principles.

Developing a Multidisciplinary Simulation Course to Address the Physical Health Agenda in Mental Health: Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS)

Developing a Multidisciplinary Simulation Course to Address the Physical Health Agenda in Mental Health: Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS)

Interprofessional, simulation-based technology-enhanced learning to improve physical healthcare in psychiatry: The RAMPPS course.

People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time, as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve.

Interprofessional, simulation-based technology-enhanced learning to improve physical health care in psychiatry: The recognition and assessment of medical problems in psychiatric settings course.

People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings course, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve.