PG124 Creation of a regional simulation course and scenario bank for internal medicine trainees

Abstract

Background The new Internal Medicine Training (IMT) Stage 1 curriculum mandated skills lab and simulation training for the first time1. Whilst simulation-based education is used widely in many other specialties, it is not a widely used teaching modality for medical trainees2. There is a lack of understanding among some physicians about simulation therefore most Trusts in region were not in a position to offer high quality simulation training to their IMTs. Summary of Work A one day course was created, covering technical and non-technical skills, directly mapped to the IMT curriculum. Themes included anaphylaxis, asthma and handover, hypoglycaemia and mistakes/duty of candour, recognition of deterioration and ceiling of care decisions, as well as breaking bad news. In addition to participating in their current role, trainees also assumed roles of more junior doctors, nurses and healthcare assistants after a pre-brief to ensure they were comfortable stepping outside their usual position. Following this, a scenario bank was created to share with Trusts within the region to ensure local delivery and consistency. Summary of Results Almost all IMTs in region booked places, however the covid-19 pandemic forced the final two courses to be cancelled. The scenarios were based on real patients and in particular, the medication error scenario was co-created with a senior pharmacist to ensure accuracy and realism. The delivery of this scenario was changed after initial feedback indicated it had been a little complex; feedback after the change was very positive. All participants reported that their confidence had improved in the topics covered and would recommend the course to colleagues. The feedback was overwhelmingly positive, even from IMTs who had negative perceptions of simulation prior to attending. Assuming different roles was highlighted as a positive aspect as they were able to gain greater appreciation for their colleagues. Discussion, Conclusions, Recommendations This regional course has allowed IMTs to develop confidence in both technical and non-technical skills, as well as provide standardised, high quality training. Trusts are being supported to deliver the created scenarios locally, which will hopefully ensure sustainable simulation for IMTs going forwards. References Joint Royal Colleges of Physicians Training Board, (2019a) Curriculum for Internal Medicine Stage 1 Training, Available at: https://www.jrcptb.org.uk/sites/default/files/IM_Curriculum_Sept2519.pdf (Accessed 23/08/2020). Joint Royal Colleges of Physicians Training Board and Health Education England, ( 2016) Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach, Available at: https://www.jrcptb.org.uk/sites/default/files/HEE_Report_FINAL.pdf (Accessed 22/08/2020).