Traditional Poster Round
Context: : Trainees can have a limited exposure to paediatric emergencies during their training due to reduced training hours and such situations requiring early senior involvement.
Simulation training can improve patient care by introducing healthcare professionals to situations that they may have not faced in real life practice. In-situ simulation has the benefit of using the usual team in their usual environment with real life equipment. By using in-situ simulation within the Emergency Department it can lead to earlier recognition of sick children, prompter management and subsequent reduced mortality and adverse events.
Our goal was to deliver simulations within the Emergency Department to staff to determine if in-situ simulation was effective at enhancing clinical knowledge and confidence in paediatric emergencies.
Description: : Within our Emergency Department, we deliver a fortnightly in-situ simulation programme, which was delivered by the paediatric simulation fellow and paediatric Emergency Medicine consultant over the period of 2017-2018.
The scenarios were targeted to the Royal College of Paediatrics and Child Health Emergency Medicine curriculum. Participants included a wide range of healthcare professionals including medical and nursing students, doctors, nurses, physician associates and advanced clinical practitioner with levels of paediatric experience from 0 to 15 years.
Observation/Evaluation: : The programme was evaluated using a feedback questionnaire, which contained a mixture of free text comments and Likert scales. The confidence of participants was rated before and after the scenario from one (very low) to five (very high).
To date, 160 participants have taken part in 21 in-situ simulations. The feedback has been very positive.
• 100% of candidates have rated the teaching was of high quality
• 100% of participants evaluated the simulation to be relevant to their training.
• 72% of candidates reported an improvement in their confidence in managing the scenario post the teaching session (average increase in confidence level from 2.05 to 3.4/5).
Free text feedback from candidates was centred on an improvement in their clinical knowledge as well as non-technical factors such as communication, teamwork and human factors and increased situational awareness.
Discussion: : Overall our in-situ programme has had a significant benefit for professionals within the Emergency Department. The team have gained confidence and have experienced a wide variety of clinical presentations, which they may have rarely managed alone. They have enhanced their skills in leadership, teamwork and decision-making. The feedback obtained has been used to develop further relevant scenarios such as major trauma and burns. It has led to improvement in our protocols and easier access to equipment.
The programme continues to run fortnightly with aims to advance the programme further involving multispecialty teams such as paediatrics and anaesthetics who would likely be involved in many scenarios and thus promote further interprofessional learning.