Non-clinical Skills Research Articles

Supporting best practice in the management of chronic diseases in primary health care settings: a scoping review of training programs for Indigenous Health Workers and Practitioners.

Background To improve diabetes management in primary health care for the Aboriginal and Torres Strait Islander peoples population, training programs that are culturally and contextually relevant to the local context are required. Using a scoping review methodology, the aim of this review was to describe the characteristics of chronic disease management training programs for Aboriginal Health Workers and Practitioners, their effectiveness on knowledge and skills, and client-related outcomes, and the enablers, barriers to delivery and participation. Methods Following protocol parameters, a systematic search was conducted in relevant databases and grey literature. Two independent reviewers screened the title and abstract of each paper to determine if the study met the inclusion criteria. Results Of the 23 included studies, most were developed with stakeholders, profession facilitated and delivered by cultural facilitators. All training programs included content knowledge, two included a professional support network, four provided on-the-job support and six had follow-up support post-training. Modes of delivery ranged from didactic, storytelling and hands-on learning. Two studies reported significant improvement in participants' knowledge and confidence; one reported improvement in knowledge (12.7% increase pre-post training), and an increase in confidence in both clinical and non-clinical skills. Enablers (relevance, modes of learning, power of networking, improved knowledge, confidence and clinical practice) and barriers (adult learning capabilities, competing work-family commitments) were reported. Few studies reported on knowledge transfer into clinical practice and client-related outcomes. Conclusions Multifaceted training programs for Aboriginal health workers are well received and may improve workforce capability.

This is why we are staying: Job satisfaction among Physiotherapists in the Kimberley region of Western Australia.

The Kimberley region of Western Australia (WA) is classified by the Modified Monash Model as MM6 & 7 ('Remote/Very Remote'). Many physiotherapists in the Kimberley are considered 'rural generalists' and require a diverse set of clinical and non-clinical skills to work successfully within this setting. To understand physiotherapists' perspectives regarding job satisfaction within the Kimberley region a 'rural and remote' areas of Australia. An exploratory case study approach examined physiotherapists' job satisfaction in the Kimberley. Each participant completed a demographic survey and a one-on-one face-to-face interview lasting for approximately 60 minutes. Transcriptions were analysed and presented thematically. Eleven physiotherapists (nine women, two men, median age = 32 [27-60] years) participated in the study. Participants' median time working in the Kimberley was 2 (1-15) years; eight participants completed a rural placement, and eight participants had a rural background. Two overarching themes relating to job satisfaction emerged: 'personal factors' and 'workplace factors'. Furthermore, several sub-themes illustrated high levels of job satisfaction. Positive sub-themes relating to personal factors included 'belonging to the community and a rural lifestyle'. 'Diversity in caseloads' and 'workplace culture' were examples of positive workplace sub-themes. Subthemes that challenged the participants personally were 'family arrangements' including schooling, 'spousal employment and family separation' and the 'transiency and social issues' within these remote communities. Workplace challenges comprised of 'barriers to providing best practice' and the 'workforce and clinical experience' found within the Kimberley physiotherapy community and the wider health care workforce. The primary challenge of job satisfaction that encompassed both personal and workplace factors was 'accommodation', with 'cost', 'lack of availability', and 'perceived unsafe location' challenging physiotherapists' decisions to remain in the Kimberley. This study describes the many factors impacting job satisfaction among physiotherapists in a rural and remote location in WA Australia. These factors warrant consideration by organisations interested in improving recruitment and retention in this context. Improving recruitment and retention in physiotherapists in rural and remote Australia has the potential to positively influence health service provision, and therefore improve health outcomes for those living in rural and remote communities.

New UK palliative medicine consultants: clinical and non-clinical preparedness after higher specialty training

ObjectivesHigher specialty trainees are expected to achieve clinical and non-clinical skills during training in preparation for a consultant role. However, evidence from many specialties from different countries suggests that new...

Development of a Transition to Residency Course Using a Design Thinking Framework.

Transition to residency (TTR) courses help alleviate medical students' concerns about preparing for residency; however, existing TTR courses are often limited to teaching clinical or procedural skills without addressing the nonclinical skills necessary for transitioning to practice. This report describes the use of design thinking (DT) to develop a learner-centered TTR course at the State University of New York Downstate Health Sciences University. DT consists of 5 steps: discovery, interpretation, ideation, experimentation, and evolution. The first 3 steps were used for needs assessments and course design. During the discovery step, empathetic, semistructured interviews of interns, program directors, and graduating medical students were conducted to identify concerns about starting residency. During the interpretation step, thematic analysis of interviews was performed to identify areas of concerning attitudes and deficient skills and to inform content. In the ideation step, a 2-week curriculum was designed, including didactic lectures, small group discussions and workshops, simulation, and procedure labs, to address the defined content areas. During the fourth step, implementation, a 2-week pilot elective course of the designed curriculum was conducted in spring 2021 with 6 students. Participant feedback from 2 students collected 6 months into internship found the procedures and simulated clinical skills cases high yield, appropriate, relevant to intern practice, and valuable. The course size in spring 2022 increased to 19 students, and the curriculum was refined based on the feedback of the previous pilot course (from 2 students and 4 faculty members) and from a precourse student survey (5 students). The last step of DT, evolution, included determining larger-scale feasibility while maintaining learner-centeredness and conducting a programmatic evaluation. The iterative, adaptable approach of DT is suitable for TTR design and is generalizable. Other institutions can adapt the DT approach to develop their own institutional TTR programs.

Essential non-clinical skills and training required by dentists in South Africa

Dentists possess clinical experience garnered within supervised clinical settings, primarily aimed at diagnosing, treating and preventing oral cavity related diseases.1 Undergraduate dentistry training mostly focuses on the scientific underpinnings of this discipline and building clinical experience, not allowing adequate time for additional coursework.1 According to Haslach et al.2, dentists choose dental careers because they want to help and work with people, as well as desire job and financial security. The current economic downturn has led to a revenue plunge for many independent dental practices, attributed partially to less per capita patient expenditure.3 In response, patients have increasingly embraced preventative measures over more costly procedures, seeking to minimise expenses.4 The global financial crisis further underscores the value of leadership development, given its potential impact on the efficacy of clinic leaders.

A84Medical Escape Rooms as a novel approach to simulation

Medical escape rooms have risen in popularity for their ability to teach various skills to medical students in a gamified context [1]. We designed two simulation-based medical escape rooms in which students could enhance their clinical and non-clinical skills, and learn about human factors. The escape room mimicked the complexity of a real patient with multiple pathologies, unlike traditional simulation, which usually focuses on one. This created a fun, realistic approach to experiential learning whilst enhancing psychological safety, collaboration, teamwork and communication. Learning outcomes for the escape room incorporated clinical reasoning, prescribing, data interpretation, synthesis of management plans, practicing effective communication, teamworking, leadership and situational awareness skills. These were mapped to the General Medical Council’s outcomes for graduates. The aim of creating the escape room was to create a realistic complex scenario, incorporate teamworking and clinical and non-clinical aspects of patient care, whilst maximizing engagement and easing the stress of traditional simulation. The escape room simulations were themed for Christmas and Valentine’s day with an underlying non-medical mission. The simulation was designed to ensure students practiced their A-E assessments. When students made the correct assessments and requested the correct investigations and management, clues would reveal answers to complete a puzzle or unlock a box that would slowly allow them to solve their non-medical mission. Feedback was collected from all 40 students who participated in the two escape rooms, using Likert scales and open answer text. 97% of students agreed or strongly agreed that the Escape Room enhanced their clinical reasoning skills. 98% agreed or strongly agreed that the session addressed nonclinical skills e.g. leadership, communication and teamworking and that the session will benefit patient care in future clinical practice. 95% agreed or strongly agreed that the debrief enhanced their clinical knowledge. Students enjoyed treating realistic multiple pathologies and completing several tasks, allowing for prolonged, in depth simulated practice. Students appreciated the teamworking opportunities, quizzes, puzzles and lateral thinking opportunities. They found the Escape Room simulation more fun and relaxing than traditional simulation, yet just as relevant. The positive feedback validates the potential of medical escape rooms as a unique teaching modality, and the scope to promote teamworking within a complex simulation scenario beyond that of traditional simulation. There is the potential to diversify and use escape rooms to promote interprofessional learning. 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.

More is not better: A scoping review of simulation in transition to residency programs

BackgroundTransition to residency programs frequently use simulation to promote clinical skills but place limited emphasis on non-clinical skills. We conducted a scoping review to determine how simulation is being used in transition to residency programs and the key non-clinical skills addressed by simulation activities and tools in these programs. MethodsWe searched PubMed, Scopus, and Embase to identify articles addressing transition to residency, simulation, and non-clinical skills/attributes. Two authors independently screened all abstracts and full-text articles and identified non-clinical attributes elicited in each study. Using descriptive statistics, we characterized the simulation activities and tools and the number and type of non-clinical attributes captured in the programs. Using analysis of variance, we compared the number of non-clinical attributes elicited based on the number of simulation activities used and compared the number of non-clinical attributes elicited based on the number of simulation tools used. ResultsWe identified 38 articles that met the study criteria. We characterized simulation activities as mock paging (37%), case-based scenarios (74%), and/or procedural skills training (39%). We found that the most common simulation tools were standardized patients (64.8%), and the most elicited non-clinical attributes were communication skills, critical thinking, and teamwork. Using more simulation activity categories or simulation tools did not increase the number of non-clinical skills elicited. ConclusionSimulation is used broadly in transition to residency programs but provides training in a few of the non-clinical skills required for a successful transition. Incorporating more simulation activities or tools does not increase the number of non-clinical attributes elicited, illustrating the importance of developing more targeted simulation activities to promote non-clinical skills more effectively.

28 Training future leaders in geriatrics—an executive leadership academy

Abstract Background Medical training has continued to move towards a competency-based framework of education. Leadership, management, and non-clinical skills are core competencies included in the Geriatrics HST training programme however formal training opportunities in this area are often limited. We designed a novel geriatric medicine registrar executive leadership academy with the following aims: (1) Enhance registrar leadership and management skills; (2) Explore non-clinical career interests e.g. research, education and (3) Develop non-clinical skills essential for consultant posts e.g. conflict resolution, service development. Methods We organised a consultant led executive leadership academy held once per month November–May. Consultant of the month provided a brief overview of their career and taught on a leadership and management topic. We created an educational needs assessment survey prior to commencement to rank leadership/management topics and assess the baseline level of knowledge and exposure thus far to training/experience in leadership and management. Pre and post-test surveys were conducted to assess for improvements in self-efficacy and knowledge in areas of leadership and management skills following this educational intervention. Results 12 registrars took part in the program with a range of registrar experience from one to six years. 10/12 completed a pre-program survey with three of these stating they felt ‘very confident’ in their leadership/management skills. Ranking of a list of topics allowed the program to be tailored to the registrars preferences. At the end of the program there was an increase in the registrars’ ability to identify personal areas in need of improvement. Conclusion The program was very successful with increased knowledge in non-clinical areas of medicine, increased confidence among trainees in applying for consultant posts and an enhanced relationship with consultants within the department.

701 Designing a Transition Programme: From Higher Surgical Training to Consultant Practice

Abstract Background Higher surgical training (HST) in the UK focuses on delivery of clinical knowledge to pass FRCS exams, technical skills to fulfil CCT requirements, and clinical preparedness for a day-one consultants. Aim To identify specific professional capabilities deficient in HST which may inform new training objectives to aid transition between HST and T&O consultant practice. Study Design PRISMA Scoping Review. Review of existing courses and interviews with course directors. Semi-structured interviews with newly appointed consultants (< 5 years) exploring non-clinical attributes necessary for new consultants. Interactive questionnaire with senior trainers and with post-FRCS trainees exploring timeframe for current trainees to gain non-clinical experience compared to the ideal timing of developing these skills. Results PRISMA-ScR papers identified n = 434, screened n = 276, eligible n = 105, included n = 50, of which surgical = 7, T&O = 0; demonstrating limited literature characterising the gap in preparedness during this specific surgical transition-point. Specialities with dedicated courses include paediatrics and ophthalmology; programmes reviewed demonstrated a wide array of topics. Interviews identified strong themes of lack of understanding of NHS structure, job planning, procuring specialist equipment, handling complaints and human factors. The interactive survey undertaken by both senior trainers and post-FRCS trainees demonstrated a similar trend with a clear shift towards pre-FRCS delivery of skills. Conclusions Differences in trainees’ perceived needs and those identified by consultants pose a potential challenge in HST. Across all groups involved, deficiencies were identified in acquiring non-clinical skills and knowledge. This mixed methods approach identified key topics to cover in transition to consultant course to improve challenges during transition.

The radiology job market in the Netherlands: which subspecialties and other skills are in demand?

ObjectivesTo evaluate the current job market for medical specialists in radiology and nuclear medicine (NM) in the Netherlands.MethodsVacancies posted for radiologists and nuclear medicine physicians in the Netherlands between December 2020 and February 2022 were collected and analyzed.ResultsA total of 157 vacancies (146 for radiologist and 11 for nuclear medicine physicians) were included. The most sought-after subspecialties were all-round (22%), abdominal (19%), and interventional radiology (14%), and 30% of vacancies preferred applicants with additional non-clinical skills (research, teaching, management, information and communications technology (ICT)/artificial intelligence (AI)). Non-academic hospitals significantly more frequently requested all-round radiologists (n = 31) than academic hospitals (n = 1) (p = 0.001), while the distribution of other requested subspecialties was not significantly different between non-academic and academic vacancies. Non-academic hospitals also significantly more frequently requested additional research tasks in their vacancies (n = 35) compared to academic hospitals (n = 4) (p = 0.011). There were non-significant trends for non-academic hospitals more frequently requesting teaching tasks in their vacancies (n =18) than academic hospitals (n = 1) (p = 0.051), and for non-academic hospitals more frequently asking for management skills (n = 11) than academic hospitals (n = 0) (p = 0.075).ConclusionAll-round, abdominal, and interventional radiologists are most in demand on the job market in the Netherlands. All-round radiologists are particularly sought after by non-academic hospitals, whereas nuclear radiologists who completed the Dutch integrated NM and radiology residency seem to be welcomed by hospitals searching for a nuclear medicine specialist. Finally, non-clinical skills (research, teaching, management, ICT/AI) are commonly requested. These data can be useful for residents and developers of training curricula.Clinical relevance statementAn overview of the radiology job market and the requested skills is important for residents, for those who seek work as a radiologist, and for those who are involved in the design and revision of residency programs.Key PointsReview of job vacancies over an extended period of time provides valuable information to residents and feedback to potentially improve radiology and nuclear medicine (NM) residency programs.All-round radiologists are wanted in non-academic hospitals and nuclear radiologists (those who have completed an integrated NM-radiology curriculum) are welcomed by hospitals searching for nuclear medicine specialists in the Netherlands.There is a need to train residents in important non-clinical skills, such as research and teaching, but also management and communications technology/artificial intelligence.

Pediatric Orthopaedic Observerships in North America for International Surgeons: A Qualitative Study Exploring Motivations, Relevance, and Alternate Learning Platforms.

Given the growing interest among international surgeons to participate in North American clinical observerships, it is essential to incorporate international surgeons' views to further enhance the program's applicability, value, and accessibility. In this qualitative follow-up study, we explored the motivations, relevance, and opinions about alternate learning platforms among the international surgeons who had participated in a pediatric orthopaedic clinical observership in North America. Using a semistructured interview guide, international surgeons who had participated in a North American pediatric orthopaedic observership during 2009 to 2019 were interviewed until data saturation and inductive thematic saturation were reached. Twenty-one international surgeons representing 15 different countries (1 from a low-income country, 10 from a lower middle-income country, 8 from an upper middle-income country, and 2 from a high-income country) were interviewed. The most commonly cited motivations for doing a clinical observership were to advance clinical training and learn specific skills. The clinical and nonclinical skills gained during the observership, such as utilizing an integrated team approach and open communication style, were helpful to most interviewees; however, several respondents highlighted the critical need to adapt and modify surgical indications, techniques, and skills to suit their local environment and limited resource availability. Although respondents were interested in exploring virtual learning models to save time and expense, several preferred a hybrid model, including access to remote learning opportunities and sharing their own clinical experiences with the North American hosts. Identifying the visiting surgeon's motivation for participation can allow North American hosts to align their clinical exposure more closely with the unique needs and aspirations of the international surgeons and enable a more relevant exchange of clinical and nonclinical skills. Use of a blended learning model, including in-person and virtual learning platforms, and the missed opportunity of having the international surgeons share their clinical experiences and skills with their North American counterparts should be explored further.

Some Pertinent Solutions to the Challenges Faced by the Pakistani Healthcare Systems

Health systems worldwide face various challenges. Disparities are evident among different geographic locations. There are several hurdles in providing high-quality professional education, especially in low- and Lower-Middle-Income Countries (LMICs), including insufficient basic infrastructure and a shortage of professionally trained staff. This issue presents a particular risk in LMICs that are ill-equipped to deal with complex and expensive treatments [1, 2]. Although developing and enhancing educational programs to yield more healthcare professionals is constructive, these efforts need to be accompanied by educational structuring that will provide postgraduates with the necessary competencies [3]. It is not uncommon for the patients in LMICs with a potentially curable disease to receive sub-optimal treatment because of a lack of competencies and a caring attitude. This prompts some interesting challenges around the speciality training of postgraduates. In particular, what we are trying to achieve in modern oncology training programmes? Are current examination systems an effective test of knowledge, skills, and safety to practice? And, if so, are they sufficient to prepare for independent practice? Or should training programmes incorporate non-clinical skills related to issues? Interestingly, according to World Health Organization (W.H.O.), there are six elements or system building blocks of the health system that includes (i) service delivery, (ii) health workforce, (iii) health information systems, (iv) access to essential medicines, (v) financing, and (vi) leadership/governance [4]. We believe that these elements overlap with our proposal of inclusion of non-clinical leadership skills during their early years so that they are aware of the gaps and develop a mindset to improve the healthcare system by themselves. In this paper, we propose these five concepts to be inducted into our postgraduate training that will pave the way to improve our healthcare system.

Implementation and assessment of a novel non-clinical skills curriculum for urology residents

BackgroundUrology is an increasingly competitive specialty that procures a highly selected and clinically excellent cohort of residents. However, other training needs such as leadership and professional development go underrecognized despite an identified need for formal training in these areas. The aim of this study was to implement, evaluate, and pilot a non-clinical skills curriculum, a novel individualized professional development workshop series, at a single institution.MethodsEighteen urology residents (15/year, 3 graduates/year) participated in this study over the course of two academic years. A pre-curriculum needs assessment was completed by 15 residents in Year 1 for purposes of curriculum design. The curriculum itself was a series of 1-hour monthly workshops given by an expert speaker on topics relevant to healthcare delivery, leadership and career promotion across various contexts. Survey-based assessments tracked gains in subject knowledge and satisfaction via a pre-post test design.ResultsThe pre-curriculum needs assessment indicated that trainees desired additional instruction in non-clinical skills (ps>0.1) and endorsed formal teaching to ensure success in their future careers (p<0.001). Trainees reported pre- to post-curriculum gains across each individual learning topic (Mean=20%, p<0.001) with an aggregate increase in subject knowledge of 17% for senior residents and 21% for junior residents (p<0.001).ConclusionA non-clinical skills curriculum implemented as a pilot ‘Hidden Curriculum’ for urology trainees was feasible and resulted in significant gains in non-clinical subject knowledge. Workshops were highly rated and trainees reported high satisfaction with the curriculum.

The review of Aboriginal and Torres Strait Islander content within an undergraduate paramedicine degree curriculum

A review of Aboriginal and Torres Strait Islander content within an accredited paramedicine degree curriculum was undertaken as part of major course review and ongoing evaluation of the program. The aim of which was to ensure the course content was appropriate and relevant to Aboriginal and Torres Strait Islander communities. All content and teaching activities were audited where specific content was explored and noted. Findings were presented to a review team where good practice was highlighted and areas for development were addressed. This has encouraged staff to seek opportunities to embed content in both clinical and non-clinical skills, knowledge teaching and experiences. In addition to encouraging further review of other diverse communities.

Virtual objective structured clinical examinations — a novel approach to teaching and evaluating leadership skills in medical students

The objective structured clinical examination (OSCE) is a simulation-based method of learning and assessment that allows for mistakes and feedback. Its uniformity, objectivity, and reproducibility are among its greatest strengths. Unfortunately, OSCEs rarely directly assess non-clinical skills or focus on leadership skills, such as conflict management. Leadership training is an underrepresented component of the medical school curriculum. Although OSCEs cannot evaluate leadership in its entirety, we have demonstrated the feasibility of using OSCEs to simulate realistic scenarios for students to apply and practise communication, collaboration and professional skills associated with leadership.

"I Need to Be the First One with a Different Approach and to Make a Difference to the People": A Mixed Methods Pilot Study on Non-Physician Clinicians Training in Malawi.

To improve child health care depends on the availability of sufficient numbers of skilled healthcare workers. To achieve this, the German Society of Tropical Paediatrics & International Child Health supported the existing three-year Bachelor of Science in Paediatrics and Child Health training for Clinical Officers, a non-physician clinician cadre, from 09/2017 to 08/2019. This study aims to evaluate the project to inform forthcoming training. All 17 students who were in training took part in this study. Quantitative data collection took place between 01/2018 to 06/2019 using the post-self-assessment bloc course survey, Research Self-Efficacy Scale (RSES), and Stages of Change (SOC) model. Students and key informants participated in three focus group discussions and five in-depth interviews during April 1-10, 2019. Students mostly perceived bloc course contents "At their level" (92%) and "Very important/relevant" (61%) with "Good quality" teaching (70.5%). The mean (SD) score for RSES (10-point scale) was 9.10 (0.91). The SOC (4-point scale) scores were higher for "Attitude" and "Intention" statements than "Action". Students found the program well-paced, felt that their clinical knowledge and skills had improved, and valued the acquired holistic disease management approach. They reported increased confidence and being more prepared for leadership roles in their future work. The involvement of international teachers and supervisors enriched their global perspectives. Students improved their clinical and non-clinical skills, developed self-efficacy and attitudes toward research, and were confident to build and utilize their networks. These transformative experiences could facilitate the development of change agents among current and future trainees.

Second-year undergraduate nursing students’ experiences with clinical simulation training in mental health clinical practice: A focus group study

AimThe aim of this focus group study was to investigate second-year undergraduate nursing students’ experiences with clinical simulation training as part of their clinical practice in acute mental health care. BackgroundThe quality of bachelor programmes in nursing has been criticised for lacking theoretical and experiential learning in the mental health modules. Novice nurses feel unprepared to care for patients with mental health challenges and graduate nurses are reported to lack the necessary knowledge and skills to manage patients with mental health issues confidently and competently. Clinical simulation training can facilitate the teaching of clinical and non-clinical skills simultaneously and is a highly suitable method within mental health care for addressing gaps in knowledge and skills in communicating with patients. Clinical simulation training may enhance nursing students' competence and thereby reduce the risk of adverse events and increase safety. However, we know little about undergraduate nursing students’ experiences with clinical simulation training as an integrated part of nursing students’ clinical practice in acute mental health wards. DesignExplorative qualitative focus group study. MethodThree focus group interviews were conducted using a semi-structured interview guide with second-year undergraduate nursing students from a university in Norway during spring 2020. In total, 14 students who had experienced clinical simulation training as part of their mental health clinical practice participated in the study. The collected data were analysed using systematic text condensation. ResultsClinical simulation training as part of the clinical practice increased the students’ preparedness, coping and self-awareness. Most of the participants had positive perceptions of the use of high-fidelity simulation-based learning. Furthermore, they highlighted three elements that increased the value of the training. First, the simulation felt authentic and increased their professional skills. Second, the standardised patient had clinical qualifications, which made the simulation feel authentic and close to realistic situations. Third, not having a former relationship with the person acting as the standardised patient enhanced authenticity. ConclusionClinical simulation training as part of clinical practice contributed to increasing the students’ self-awareness and in-depth reflection and to broadening their nursing competence. The present study lays the groundwork for future studies on clinical simulation training in mental health clinical practice for nursing students.

The Need for Contextual Intelligence in Athletic Training

Athletic training and the environment in which it is practiced is constantly changing. The emergent environment is volatile, uncertain, complex, and ambiguous. This new environment necessitates an adjustment to athletic training education particularly as it pertains to the instruction and development of the nonclinical skills (meta-skills) needed for clinical settings. One such meta-skill is contextual intelligence. Contextual intelligence is the capacity to recognize the convergence of different variables and respond to the emerging context as it is developing. Practicing contextual intelligence includes integrating 12 specific behaviors and the 3D thinking framework of hindsight, insight, and foresight into clinical decision making.

Mind the 'GAPP': a pre-graduation assessment of preparedness for practice amid a pandemic.

Introduction 'Preparedness for practice' refers to a multifaceted concept, encompassing not only clinical skills, but also broader, non-clinical skills, such as communication and professionalism. Previous graduates have reported feeling less prepared for complex procedures, such as molar endodontics and surgical extractions. Dental students typically utilise their final year to refine their clinical skills, however, the COVID-19 pandemic has meant that newly qualified dentists will have had around six months where they have not performed clinical dentistry before beginning dental foundation training (DFT).Aims This study aimed to explore final year students' self-reported preparedness for practice, identify areas of relative weakness that may influence future training needs and to highlight any perceived impact of the pandemic on final year experience and potential impact on DFT.Materials and methods The current Graduate Assessment of Preparedness for Practice (GAPP) questionnaire was adapted for our specific research aims and piloted and the PreGAPP questionnaire distributed via the social media channels of dental school student societies. Analysis was carried out using IBM Statistical Package for the Social Sciences software using descriptive statistics and the Mann-Whitney U test for two unrelated variables.Results Responses were received from final year students across all 16 UK dental schools. Students reported increased preparedness across domains in which they had the most experience; for example, providing preventative advice and administering local anaesthesia. Male students reported feeling significantly more prepared than female students, mature students significantly more than younger students, and students on four-year courses significantly more than traditional five-year courses. The COVID-19 pandemic was expected to have a major-to-severe impact on undergraduate experience and future DFT prospects.Conclusion Dental graduates in the COVID-19 era may have significantly different training needs to those before them. Complex clinical procedures remain the areas where students feel they are least prepared for practice. The importance of a clinical passport to highlight current experience level to trainers, alongside the creation of a personal development plan at the beginning of DFT, will ensure that targeted and personalised training can be implemented where required.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-022-4154-5 für autorisierte Leser zusätzliche Dateien abrufbar.

194 Implementing a Simulation Training Programme for Physician Associates

The physician associate (PAs) profession is a relatively new profession to the NHS. As such, there is no official national or regionally agreed further training to support PAs transitioning from PA school into clinical practice once they have graduated. Simulation training has proved to be an effective tool for developing clinical and non-clinical skills in other groups of clinicians We aimed to describe the development and implementation of a novel PA-specific simulation training programme and present the evaluation of our initial work.We designed and implemented a bespoke simulation training programme based on existing training for junior doctors. This model has three separate simulation sessions, spaced over 2 years, each session has three different clinical scenarios. Seventeen PAs have undergone the first two sessions. The first session contained three scenarios that highlighted important local protocols such as the major haemorrhage protocol and the sepsis At this point in time, we have feedback from 16 candidates from session 1 and 11 from session 2. The results are overwhelmingly positive showing improved confidence, better team-working skills and a perceived perception of improved patient safety following the simulation training, as shown in graphs 1 and 2. The majority of candidates partaking in the session found the simulation training beneficial to their practise. The main negative feedback given was the lack of ‘senior support’ (i.e. from a senior doctor) in the scenarios that were unrealistic to actual practice.The introduction of a novel PA simulation training programme has demonstrated improvements in clinical and non-clinical skills. This supports our aim of improving post-graduate PA training. Work continues to further develop our PA simulation programme and further evaluate its effectiveness with the aim of making this as a regional simulation programme that PAs can undertake when joining the healthcare workforce.