1259 Improving trainee confidence in Non-Technical Skills through in-situ simulation & shared learning in a children's emergency department. (17th August 2022)

• Record Type: Journal Article
• Authors: Wasala, Desha; Wright, Katie
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A30
• Page End: A31
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.49
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: 'To Err is Human: Building Safer Healthcare System', published in 1999, highlighted that errors in medicine are directly related to human factors. Non-technical skills (NTS) constitute a significant proportion of human factors and implementing this into medical education can lead to better patient safety outcomes. Simulation is well evidenced as an effective way of improving NTS. The aim of this unique project is to improve confidence in trainee NTS in a children's emergency department (CED) through in-situ simulation and shared learning. Methods: Three PDSA cycles were run with focus on improving NTS in CED through in-situ simulation over a period of 4 months from March to July 2021. The first PDSA cycle involved reinstating weekly in-situ simulation conducted by designated consultants and registrars. The second and third cycles built on this through feedback from trainees. These cycles focused on sharing learnt NTS from the weekly simulation sessions with all trainees in the department via a dedicated education WhatsApp group, and by displaying key learning points on a departmental education board on a weekly basis. Feedback was collected from departmental surveys (using SurveyMonkey®) after each PDSA cycle, which required trainees to rate their confidence in NTS from 0 (no confidence) to 4 (high confidence). The following 5 areas of NTS comprised the focus of this work: leadership, teamwork & communication, situation awareness, task management and decision making. Results: 17 out of 21 trainees in CED responded to the surveys. Figure 1 presents trainees' NTS confidence ratings following each PDSA cycle. Most trainees responded as being confident (rating 3) in all 5 NTS in the all three surveys. Notably, there was a 24% and 23% improvement in the confidence ratings between the 1st and 2 nd PDSA cycles for task management and decision making respectively. Whilst task management and decision making continued to improve following the third PDSA cycle, there was no further improvement in trainee confidence in other NTS. There was an overall sustained improvement in most NTS areas in comparison to the start of the project, apart from in leadership and situation awareness which showed 5% and 3% a decline in confidence ratings. Conclusion: The non-technical skills of task management and decision-making showed a sustained improvement with in-situ simulation and sharing learning. This project highlighted areas of focus (leadership and situation awareness) for future in-situ simulation based NTS learning. Further PDSA cycles targeted to these specific NTS are recommended.