SC40 Improving paediatric trainees' confidence in skills essential to neonatal emergency management through regular brief in situ simulation training. (November 2018)

• Record Type: Journal Article
• Authors: Jamieson, Katharine; Chisholm, Philippa
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 4(2018)Supplement 2
• Page Start: A34
• Page End: A35
• Publication Date: 2018-11
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2018-aspihconf.63
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: Growing evidence supports simulation-based training (SBT) as an effective educational intervention with translation of learning to the workplace. 1 Limitations of traditional simulation centre based teaching include accessibility, cost and limited knowledge regarding duration of learning retention and need for repetition of attendance. Simulation integrated into the clinical environment with on-duty clinicians during their actual workday ( in situ ) offers the potential for frequent repetition, and experiential learning within the team with whom participants normally work. 2 We looked at the impact of a regular in situ multi-disciplinary neonatal simulation programme on technical and non-technical skills. Methods: A weekly 30 min in situ neonatal simulation programme was implemented in a tertiary neonatal unit in 6 month cycles to coincide with junior doctor intake between 2017–2018. Sessions occurred after handover when clinical duties allowed, and were attended by junior doctors and neonatal nursing staff (student to Band 7). Low fidelity simulation scenarios were designed based on commonly faced scenarios (e.g., premature infant, meconium exposure) or more rarely encountered but potentially challenging situations (eg. breaking bad news). Debriefs were facilitated by a consultant, senior trainee or senior ANNP trained in simulation and debriefing. Feedback was collected immediately after each session with regard to perceived value, relevance, acceptability, multidisciplinary approach and impact of the simulation (measured with a Likert scale where negative opinions were scored 1–2, positive 4–5 and neutral 3). Additionally a questionnaire was sent out at the beginning and end of one 6 month programme to assess participants' confidence in simulation, as well as specific clinical neonatal conditions addressed by the simulation scenarios. Results: Feedback regarding sessions was overwhelmingly positive, with mean scores and confidence intervals as follows: Relevance to practice: 4.87 (4.77–4.98) Value of in situ: 4.79 (4.68–4.91) Lack of disruption to clinical duties: 4.49 (4.34–4.64) Benefit of refection: 4.73 (4.58–4.88) Safe learning environment/debrief: 4.82 (4.74–4.90) Usefulness of training with other MDT members: 4.83 (4.76–4.90) Perceived benefit on clinical practice: 4.82 (4.75–4.89) Provisional results suggest that self reported confidence in both technical and non-technical skills increased after participation in the 6 month programme. Conclusions and recommendations: Regular brief in situ simulation proved a valued, and acceptable method of enhancing participants' confidence in teamwork and technical skills essential to effective neonatal resuscitation. We propose this as a cost-effective training tool for use in neonatal units, with benefits in team morale, clinical safety and patient outcome. References: Boet S, Bould MD, Fung L, et al . Transfer of learning and patient outcome in simulated crisis resource management: A systematic review. CJA 2014;61:571–82. O'Leary F, Pegiazoglou I, McGarvey K, Novakov R, Wolfsberger I, Peat J. Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre-based, high fidelity scenarios. Emerg Med Australas2018;30(1):81–8.