SC11 PaED SIM – a paediatric emergency department simulation programme to deliver multi-disciplinary clinical teaching in the management of paediatric emergencies. (November 2018) - Holt, Ashley
Abstract : Background: Reduced training hours and the appropriate need for senior specialist input in emergencies can result in reduced exposure to paediatric clinical scenarios for Emergency Department (ED) staff. Simulation training can improve standards by reinforcing skills by repetition and also introduce clinicians to scenarios that they may have not yet faced in everyday practice. ¹ In-situ simulation in paediatric emergency medicine has been shown to provide significant realism and participant engagement. ² We delivered simulation sessions to ED staff to determine if multidisciplinary in-situ simulation was an effective educational technique for improving clinical knowledge and confidence in paediatric emergencies. Summary of education programme: A fortnightly in-situ simulation programme was implemented in the Emergency Department at our hospital. The simulation was facilitated jointly by a Paediatric Simulation Fellow and Paediatric Emergency Medicine Consultant. Scenarios were mapped to the RCPCH Paediatric Emergency Medicine Syllabus. Sessions were evaluated by feedback questionnaire, and participants rated their confidence from one (very low) to five (very high). Summary of results: 99 participants have taken part in 14 in-situ training sessions to date. Participants included students and experienced staff from a range of disciplines, including nursing, medicine, PAs and ACPs, with between 0–8 years specific Paediatric experience. Feedback was overwhelming positive. All participants reported that the teaching was relevant to their training and of high quality. Recurring themes included both improved clinical knowledge of the scenario and non-technical elements such as teamwork and communication, as well as department-specific learning e.g. awareness of utilising tertiary support and retrieval networks. 93% reported improved confidence following the teaching session, and the average confidence level assessed by Likert scale increased from 2.11 pre-teaching to 3.43 post-teaching. A similar increase in confidence was seen across all grades of participant. In 63% of cases the participant had not managed the particular clinical scenario themselves before attending the session. Discussion, conclusions and recommendations: Participants from a range of professions and experience levels reported significant benefit from attending the regular in-situ simulation programme. Simulation-based education gives staff exposure to clinical conditions that they may rarely encounter independently and can help develop skills in leadership, team working and decision making. Feedback has been used to expand the bank of scenarios to include those prioritised by ED staff. Ongoing work may include follow up assessments of skills and knowledge, more sessions run with joint Paediatric and Emergency teams, developing a multi-disciplinary faculty, and/or developing methods of evaluating patient-level outcomes. References: Clerihew L, Rowney D, Ker J. Simulation in paediatric training. Arch Dis Child Educ Pract Ed2016;101:8–14. O'Leary F, Pegiazoglou I, McGarvey K, Novakov R, Wolfsberger I. Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre-based, high fidelity scenarios. Emergency Medicine Australasia2017;30(1):81–88.