PG35 Maximising opportunities for in situ operating theatre simulation with short, accessible sessions – lessons learnt during a pandemic

Introduction In situ simulation in the operating theatre has potential in highlighting latent environmental threats, trialling new procedures and human factors training1. During the peak of the COVID-19 pandemic, elective operating was cancelled, and teams formed to manage emergencies. Following the initial peak, emergency intubations reduced before elective operating could resume. Staff were therefore on-site in case of emergencies, but regularly available for training. We piloted a series of short in situ theatre simulation sessions for the multidisciplinary team. Methods The one hour sessions each comprised an introduction, case briefing, 15-minute simulation scenario and 25-minute debrief. Scenarios were medium fidelity, with some higher-fidelity practical elements maintained e.g. IV access, intubation, manual handling. Scenarios included common anaesthetic and surgical emergencies e.g. major haemorrhage, anaphylaxis. The Plus/Delta debrief model2 was used. Pre- and post-course questionnaires were undertaken, using the validated Human Factors Skills for Healthcare Instrument (HuFSHI)3 evaluation system and a question on the perceived usefulness of the session. Data was paired and compared for service evaluation. Results 9 sessions were undertaken in 3 weeks. 93 attendances were captured, of which paired data was obtained for approximately two thirds. All participants who responded to the question ‘did you think that today’s activity was a good use of time?’ answered affirmatively. In ‘monitoring the big picture during a complex situation’, scores increased by 1.42 (t(64)=7.78, p Discussion and Conclusion These sessions aimed to reduce ‘downtime’ at a time when formal training had ceased out of necessity. Uptake of these sessions was high, and recruiting learners subjectively easier than pre-pandemic in situ training, in part due to team presence without planned activities. The abbreviated, one-hour format provided a time-efficient delivery method. The informal approach and storage of simulation equipment within a designated training theatre meant that the session was easily adapted/rearranged in case of emergencies. Elements of these sessions (short duration, informal approach) might be utilised in improving uptake and efficiency of future theatre training. Attention should be paid to addressing, rather than just identifying, gaps in knowledge or latent threats in this short time. Failing this, steps should include follow-up sessions or distribution of further learning materials. References Owei L, Neylan CJ, Rao R, et al. In Situ Operating Room-Based Simulation: A Review. Journal of Surgical Education 2017;74(4):579–588. Fanning R and Gaba D. The Role of Debriefing in Simulation-Based Learning. Simulation in Healthcare. 2007;2(2):115–125. Reedy G, Lavelle M, Simpson T, et al. Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings BMJ Simulation and Technology Enhanced Learning 2017;3:135–141.