SC12 An evaluation of the transference of procedural days for CMT's across the east of england region. (November 2018) - Derrick, Jonathan
Abstract : Background: Simulation training for procedural skills is increasing; reasons have been stipulated as concern for patient safety, exposure to perform the skills and ability to be supervised. Having the ability to practice a set of procedures under safe supervision can convey multiple benefits for the learner and patients which can then be developed in clinical practice. 1 Therefore procedural days are now common for junior doctors but are rarely critically appraised. Summary of education programme or project: To evaluate procedural days across the region. We sent out a survey monkey questionnaire to all 200 CMTs trained in the East of England deanery in the last two years. Our primary aim was to assess transference of skills covered at procedural days into clinical practice. Our secondary aim was to establish whether trainee's felt there was benefit in procedural training days at ST3 +level. Summary of results: We had 41 respondents, with a response rate amongst all trainee's being 20.5%. The majority of training occurred at Basildon University Hospital (49%) and University of Hertfordshire (39%). The most frequently performed sessions were; Lumbar Puncture (98%), Central Line Insertion (95%), Chest Drain Insertion (93%) and Ascitic Drain Insertion (85%). All of the below figures are for respondents 'Strongly Agreed' or 'Agreed'. 'The procedures day was useful' and 'Improved Knowledge' (95%) 'Useful as an ST3 +trainee' (90%) 20% had performed all of the skills since under supervision, 41% most of the skills under supervision, 37% some of them and 2% had not. 39% of respondents stated that they had changed how they performed the skill in practice 'a great deal', 54% 'a small change' and 7% 'not at all'. Discussion: Trainees reported that procedural days improved confidence and ability at performing skills in clinical practice. The majority of trainees subsequently performed the skills under supervision. This aligns well with the educational theory of skills training at this level. Importantly self-reported behaviour change was significant with the majority of trainees changing how they performed the skills after the course. There was substantial demand for procedural training at ST3+. Conclusions: Evidence of transference of skills from the course was significant and addressed Kirkpatrick level 3, behaviour change. 2 Limitations were response rate and the validity of self-reported skills although this is supported by Bandura self-efficacy theory. Recommendations: This work supports evidence of the efficacy of transference into clinical practice from simulation procedural training at a regional level. References: Kneebone R. Evaluating clinical simulations for learning procedural skills: A theory-based approach. Academic Medicine2005;80(6):549–53. Kirkpatrick DL, Kirkpatrick JD. Evaluating training programs: The four levels (3rd ed.) 2006. San Francisco: Berrett-Koehler.