Theme
Simulation
INSTITUTION
Maidstone and Tunbridge Wells NHS trust, Maidstone, Kent
The EWTD and ever-changing shift patterns have meant that foundation doctors (FD) are increasingly spending less time in the hospital with reduced opportunity to safely learn key practical skills. The busy working environment presents a challenge to seniors in finding time for teaching and supervision in performing procedures.
Core trainees (CT) and the use of simulation techniques may provide a solution to these issues by reliably reproducing a clinical environment in which trainees can practice.
AIM
To set up a simulated practical skills weekend based on the Foundation Programme Curriculum objectives.
OBJECTIVE
Provide theoretical and hands-on teaching on a total of 8 key skill procedures
METHODS and MATERIALS
Content and Delivery
Delivery was through simulation using models and equipment provided by our simulation centre. A total of 8 procedures were taught (Table 1). Candidates had to describe the indication for the procedure, relevant anatomy, complications during and after the procedure and post-procedure care.
Central lines and CVP theory |
Femoral, arterial lines and ABG |
Ascitic taps and drains |
Lumbar Puncture |
Chest drains and pleural taps |
Fracture interpretation, management and cast application |
Joint aspiration |
Suturing and Laparoscopic boxes |
Tutors
Appropriately trained anaesthetic, surgical and medical doctors provided didactic and practical teaching.
Participants
The weekend was offerend to all Foundation level doctors.
Assessment
A Pre and Post-course questionaire was provided to assess learning.
- 20 participants (FY1 and FY2 doctors)
- Comparison of pre and post-course questionnaires demonstrated: increased levels of confidence in performing all procedures with a reduction in the learners' perception of procedural complexity. Confidence in managing post-procedure complications was also improved.
Figure 1: Delegate assessment of Procedure Compexity pre and post-course
Figure 2: Delegate assesment of confidence in performing the procedures pre and post-course
Figure 3: Delegate assesment in confidence in dealing with post-procedure complications pre and post-course
Core trainees are well positioned within the training system to provide peer-assisted learning to Foundation trainees due to their accessibility and approachability. The use of simulation provides a safe and effective environment to learn and become confident with procedural skills and ancillary skills such as communication without compromising patient safety.
Simulation training delivered through peer-assisted learning by core trainees is a valuable teaching modality for foundation doctors and has far reaching effects for both the tutor and tutee.
Tunbridge wells Postgraduate centre