PP22 Developing digital simulation: faculty reflections on actor development. (10th November 2020)

• Record Type: Journal Article
• Authors: Bignell, Anita; Virk, Kiran; Evans, Gareth; O'Sullivan, Owen; Parish, Sandra; Powell, Jennifer
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 6(2020)Supplement 1
• Page Start: A25
• Page End: A25
• Publication Date: 2020-11-10
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2020-aspihconf.41
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: Mental health Simulation has an important role to play in improving clinical outcomes for patients. Transitioning to digital simulation presents facilitators, actors and technicians with several challenges to maintain high fidelity simulations. Methods: During the Coronavirus pandemic, Maudsley Simulation took a full-day simulation course and made adaptations for online delivery over a half day, testing in-house during a piloting phase. At the Simulation Centre, the sole focus for our simulated patients is acting, as technicians stage manage and dress scenes for them. The actors are experienced in playing these roles and have attended a Quality Assurance Course. Trial sessions were passively observed by other faculty members. Following each session, observations and reflections were logged and organised thematically. Results: Initially, platform instability was challenging for the team and actors, and was felt to undermine the fidelity of scenarios. We started by trialling teleconference type scenarios that were static in nature and set in the community but developed this over subsequent trials. Actors are well versed in acting to camera and adapted quickly to this aspect of online simulation. Transitions to scenarios proved challenging and distracting in the early stages but were improved upon with audio-visual clips. Discussion and Conclusion: Several issues required resolution to allow high-fidelity online simulation to be delivered. Switching platforms, adjusting pre-briefs for actors to include technical aspects of stage management, transitions and IT support greatly improved this and supported the achievement and maintenance of high fidelity scenarios for participants and observers. Actors' spaces were tested to ensure the lighting, sound quality and camera angles were good. Actors were guided to dress their environment at home with input from technicians. We overcame initial difficulties for a scenario set on a psychiatric ward, by inviting the actor into our simulation centre. This allowed the technician to dress the environment and have more control over the audio-visual set up. The male actor used a hand-held cam to create a much more immersive experience, which was deemed to be an improvement by our team. A closer view of facial expressions resulted in a more empathetic approach to the patient, as his fears and worries were much more apparent and this was reflected on in the debriefs. Online simulation provides quality outcomes for participants, which will enable greater access for clinicians in remote or overseas locations to attend high quality simulation training. We plan to deliver full-day formats in future.