What do Foundation Year 1 and 2 medical trainees think about taking part in scenario-based simulation training together?

Abstract

Introduction: The University of Hertfordshire’s Intensive Care and Emergency Simulation Centre (HICESC) has been delivering simulation training in partnership with the East & North Herts NHS Trust since 2004 for medical trainees (1). In 2005, the Modernising Medical Careers agenda has restructured the training years following medical school education with a brand new curriculum (2). By the end of their first two years of training they have to become competent at recognising and managing acutely ill patients. Methods: Groups of 8 participants, formed of 4 FY1 and 4 FY2 trainees, are invited by the Trust’s Post-Graduate Medical Education centre to attend a day long simulation session in HICESC. During the session trainees are briefed about the expected Learning Outcomes, introduced to the concept of simulation, the environment, and the patient simulator (Laerdal SimMan). The rest of the day involves 8 successive scenarios and debriefings were each FY1 is paired with an FY2, but initially only the FY1 trainee goes in the simulation room to meet the patient with a nurse (Faculty acting), while the other waits in the corridor. This forces the first trainee on the scene to manage the patient until help is summoned and arrives, and a hand-over is provided to the FY2. At the end of the day participants are questioned about their view of the session, and more particularly the way it is organised, sometimes in comparison to other simulation experiences they may have had. Results: Over the last 2 years, 24 sessions involving a total of about 160 FY1-2 trainees have been delivered with the East & North Herts NHS Trust. For all of them it was their first simulation learning experience where FY1 and 2s received training together. They found it very appropriate, enjoyed working together, and none suggested it should be changed. They generally reported that it was very realistic for an FY1 to call for an FY2. They also felt that working in pairs improved their team working skills and communication skills. They also felt that the session was less intimidating as they ended up being 2 trainees dealing with the patient, rather than coping on their own or feeling that they were individually assessed. Conclusions/Discussion: To our knowledge all other centres providing such training run separate sessions for trainees of different levels however the feedback received has encouraged us to carry on organising joint simulation training sessions for FY1 and 2. It allows for the delivery of a higher level of material in some areas for FY1, while sometimes providing information which are important reminders for FY2 trainees.