PG85 Up-skilling the workforce. Preparing to return to frontline medicine in the support of COVID-19

Abstract

Background The novel coronavirus pandemic has the potential to cause significant morbidity in the United Kingdom with the risk of demand for hospital bed capacity significantly outstripping supply.1World Health Organisation guidance suggests that up-skill of non-acute medical and dental practitioners for rapid re-deployment into the acute medical environment is a vital task in ensuring appropriate surge capacity resilience.2 We report an ‘upskilling’ course at our institution. Summary of work A two-day course containing four key components was provided to pre-redeployment candidates. Day 1: Classroom–based teaching introducing COVID–19, infection prevention control and personal protective equipment use. Intermediate life support tutorials and low–fidelity simulation of a deteriorating patient. Day 2: Practical clinical skills session refreshers including venepuncture, cannulation, catheterisation, and arterial blood gas sampling. Followed by an opportunity to practice in a series of fully immersive high fidelity acute clinical scenarios proceeded by hot video–assisted debrief. Candidates completed pre and post course questionnaires. A follow up post course questionnaire will be sent out one-month post course. Unpaired (two tail) t-test analysis was used to analyse participant confidence scores pre and post course. Thematic analysis of qualitative feedback was also performed. Summary of Results Eighty-five candidates undertook the course with 76 (89%) completing pre & post questionnaires. Significant increases in candidate reported confidence were reported in; assessment of acutely unwell patients, leading a clinical team in the context of an acutely deteriorating patient and in handing over acutely unwell patients to senior acute clinicians. Candidates also reported significant confidence score increases regarding non-technical skills such as clinical decision making, demonstration of situational awareness, task management and team working. Participant qualitative feedback suggested three main advantages of the course: Simulation useful to tie up key skills learnt and to put skills into context, practical skills sessions useful refresher of common ward based activities, overall the faculty were enthusiastic and engaging and helped candidates to get the most out of the course. Discussion and Conclusions Our two-day multifaceted course provided non-acute medical and dental practitioners with significantly improved self-reported confidence in a number of key technical and non-technical domains. Clinical decision making and assessment of the deteriorating patient are critical for the maintenance of patient safety in the acute medical environment, in the context of medical human resource planning for a global pandemic. We hope that this course complemented ward based experiential learning at the start of the pandemic. References Imperial College London. Strengthening hospital capacity for the COVID-19pandemic. Available at: https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-15-hospital-capacity/(accessed 16 May 2020) Strengthening the Health Systems Response to COVID-19 Technical working guidance. Maintaining the delivery of essential health care services freeing up resources for the COVID-19 response while mobilizing the health workforce for the COVID-19 response. Available at: http://www.euro.who.int/__data/assets/pdf_file/0007/436354/strengthening-health-systems-response-COVID-19-technical-guidance-1.pdf, (accessed 14 May 2020)