The impact of simulation training in doctors

Abstract

Background: Patient simulators are increasingly used in the training of healthcare professionals. The main advantage is the ability to provide training in managing complex scenarios in a controlled risk-free environment (1). However, this involves heavy investment of resources hence, it is important to demonstrate the effectiveness of learning from patient simulators (1). Studies investigating the long-term benefits of simulation training on performance are very limited (2). Aim: To investigate the ability of foundation trainees in applying the knowledge and skills learnt in the simulation centre to clinical practice. Method: An acute care high-fidelity simulation course was introduced for trainees to enhance their management of acutely ill patients which is part of the curriculum tailored to foundation training. The course incorporated the features recommended by the BEME review for effective learning (3). 64 trainees have completed the course which was held in groups of 8. Volunteers were invited to keep a reflective diary over a period of 8 to12 weeks in managing acutely ill patients clinically. 5 trainees have returned their diaries to date (This study is still in progress). Interviews were carried out individually in these trainees to improve validity. Results : All 5 trainees reported an increased confidence in managing acutely ill patients since they were able to integrate the skills learnt at the simulation centre to their clinical practice more readily as it was practical and interactive.. They were able to remain calm and apply what they learnt as they were subjected to similar situations during their simulator training. All were able to appreciate the dynamic nature of the course where events happened in real time. One commented that he was able to manage an elderly cardiac patient who required cautious fluid management effectively as a direct result of the simulation training. Here are some quotations from some trainees: ’I was able to communicate effectively and was an efficient team member during a cardiac arrest’ ‘Having done two acute emergency simulation scenarios and observed six others, I learnt that the principles of assessing critically ill patients were the same and I didn’t panic when I saw patients in crisis situations anymore’ ‘ The course taught us what could go wrong and how to get prepared early to avoid patients deteriorating and I was so pleased that I managed a brittle asthmatic patient efficiently’. 3 felt that learning through realistic scenarios, they were able to readily visualize and remember complex clinical problems they might not have come across in clinical practice yet. Further results will be presented. Discussion: Only data from 5 trainees at 8 to12 weeks were analysed however, our findings demonstrated the importance of integrating simulator training into the junior doctor’s curriculum. The dynamic nature of the simulator scenarios seemed to give a bigger impact which enabled the skills learnt to be retrieved readily in clinical practice. Conclusion: The preliminary results of transferability of skills learnt from the simulation centre to clinical practice in terms of managing critically ill patients is encouraging. Simulator training could be an effective adjunct to our current traditional teaching.