Regular in situ simulation improves participants' confidence in technical and non-technical skills required for managing a medical emergency
Aims
To assess whether an embedded hospital-wide in situ simulation programme improves the confidence of learners in managing medical emergencies across different disciplines, specialties and grades.
Methods
Wide multidisciplinary in situ simulation (ISS) programme has been implemented at the Homerton Hospital since 2014 across medicine, intensive care, emergency department, paediatrics, obstetrics and endoscopy. As a simulation faculty we agreed by consensus on 10 technical and five non-technical skills considered beneficial during a medical emergency. We asked participants to rate on a five-point Likert scale how confident they felt in carrying out these skills and to disclose how many ISS sessions they had attended. Surveys were completed prior to taking part in a planned ISS. We collected surveys over a 4-month period from October 2017 to January 2018. Participants included doctors, nurses and health care assistants (HCAs). We used Microsoft Excel to calculate the Pearson's correlation coefficient for the number of times participants had attended ISS vs degree of confidence expressed in carrying out a skill. Student's t-test was used to calculate statistical significance.
Results
Forty-five participants were recruited; 20 doctors (foundation year 1 to specialty trainee year 2), 18 nurses (Bands 5 to 7) and six HCAs (Bands 2 to 4) from acute medicine, elderly medicine and endoscopy. The median number of in situ sessions attended was one (range 0–8). A positive correlation was found between the number of sessions attended and the participants’ confidence in all of the 15 skills assessed (Table 1 and Table 2). Of these, 12 achieved statistical significance (p<0.05).
Conclusion
Serial attendance at ISS correlated with improvement in confidence across a range of skills or knowledge, which are important in a medical emergency. This improvement is seen regardless of specialty, discipline and seniority. ISS improves learners’ confidence scores from pre- to post-simulation but this is the first study we are aware of that demonstrates a continued improvement in confidence with repeated ISS. This would appear to validate the resources expended on embedding an ISS programme within a department or hospital.
Conflict of interest statement
None declared.
- © Royal College of Physicians 2019. All rights reserved.
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