Background Acute and inpatient paediatric services no longer exist at Maidstone Hospital. Periodically, severely unwell children still present to the accident and emergency (A&E) department. Due to the paucity of such cases, health professionals may become deskilled in their management. In-situ paediatric emergency simulation scenarios have therefore been developed and conducted in A&E since November 2013.
Methodology The simulation faculty ran unexpected multidisciplinary in-situ scenarios, with staff called to simulated peri-arrests. The scenarios were adaptable, dependent upon the experience of the individuals and teams involved. The simulation was followed by a debriefing session focusing on cognitive and behavioural skills as well as human factors. Feedback from participants was used to improve in-situ simulation and ensure its validity as an effective learning tool.
Results Maidstone and Tunbridge Wells NHS Trust already has an established simulation service. Since August 2012, 13 emergency medicine healthcare professionals, 46 anaesthetists and 38 paediatric staff have received high-fidelity training within its simulation suites. To date, there have been three paediatric in-situ sessions in A&E, with 16 health professionals providing feedback.
Although 11 (69%) respondents had previous experience of simulation, only 3 (19%) had participated in in-situ simulation. 16 (100%) of those who provided feedback felt the debriefing session addressed important non-technical skills. 16 (100%) participants either agreed or strongly agreed they felt more confident in managing acutely unwell patients after the in-situ simulation.
Potential impact The simulation faculty wishes to increase the number of health professionals participating in paediatric in-situ simulation. We aim to consider different means of assessing the long-term efficacy of in-situ simulation compared to standard simulation training. Presently, only a small number of healthcare professionals have been involved with this project. However, early results suggest in-situ simulation is a useful learning tool, enabling teams to train together within the working environment.
Thomseth E and De Munter C. Laerdal Case study 2010. In situ simulation in pediatric wards, St Mary’s Hospital, Imperial College Healthcare. Available from: < http://www.laerdal.com/au/casestudies > [7 June 2014]
Laerdal. Improving patient care with in-situ simulation. Available from: < http://www.laerdal.com/us/UserStories/46578903/ >. [6 June2014]
- Category: Course or curriculum evaluation/innovation/integration
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