P52 Experience of critical incidents and the clinical usefulness of simulation in first year anaesthetic trainees – interim results -Dr nick wilson, Dr daniel bell (consultant anaesthetists). (31st December 2017)

• Record Type: Journal Article
• Authors: Bell, D; Wilson, N
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 3(2017)Supplement 2
• Page Start: A65
• Page End: A65
• Publication Date: 2017-12-31
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2017-aspihconf.134
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Background: Anaesthesia has for some time been a speciality in which simulation is particularly well suited. Anaesthetic trainees from the East of England Deanery attend three mandatory simulation days during their core training. A range of clinical situations and critical incidents are simulated at each, with structured debriefing to link to clinical practice. The same trainees attend all three programmes, providing an ideal opportunity for follow up of this cohort. Aims: To evaluate whether trainees felt their simulation experience was useful in their subsequent management of these emergencies in clinical practice. Methods: Second year anaesthetic trainees attending their obstetric simulation day anonymously completed questionnaires listing the critical incidents they had witnessed at their first two simulation days, asking whether they had experienced each in their clinical practice. If they had encountered a listed scenario, they were asked to rate how useful they found the simulation practice in their clinical management on a scale of 1 (Not at all useful) to 5 (Very useful). We considered a rank of 4 or 5 to indicate that the simulation practice was useful. Results 52 trainees responded over a 2½ year period (100% response rate). One delegate did not provide any specific information on the use of simulation for many scenarios and was not included. 10 delegates did not provide a response regarding overall benefit of simulation in clinical practice. Of those that responded, 100% agreed that simulation resulted in delivering better clinical care to patients. Discussion: Overwhelmingly, trainees felt that skills learnt from simulation allowed them to deliver better care to patients in clinical practice (100% of those responding). However, there were some differences in how useful simulation was between different critical incidents (see Graph 1). 'Drill based' or algorithm-led management reported higher scores in benefiting subsequent clinical practice. In comparison, scenarios with less regimented management, relying on supportive care reported less benefit. There appeared to be a trend between incidence of emergencies and use of simulation. Frequently encountered scenarios tended to report simulation as being useful, whereas rarer emergencies were of less use. This may reflect smaller sample sizes and therefore larger variation. However, this could be explained by frequent exposure in clinical practice consolidating principles learnt from simulation. This could be an argument for more frequent simulation practice to consolidate learning for rarer emergencies.