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81 Trust grade doctor and registered nurse simulation
  1. AJ Hughes,
  2. M Smith
  1. University Hospitals of Leicester NHS Trust, UK


Background NHS trusts recruit doctors from abroad into ‘trust grade’ posts to ensure adequate medical cover. These ‘non-training’ posts have a high turnover owing to a number of issues around feeling valued and career progression. To address these challenges, our trust developed a range of measures to improve retention of these doctors of which this simulation course is one.

Aim To improve the confidence of foreign doctors managing specific challenges when working in the NHS.

Method A literature review was undertaken to better understand issues foreign doctors encounter when working in the NHS. Themes were put to a focus group and a survey was generated. Identified needs were then cross referenced with national and local induction resources. From this, scenarios were written to tackle some of the difficulties experienced and complement other induction processes. In addition to discussing human factors and clarifying clinical points, these scenarios allowed a discussion of subjects such as: hierarchy and assertiveness, patient and relative communication, paternalism, ‘being open’ and dealing with complaints, inter-professional communication and team-working, nursing roles in the UK, ethics and law regarding DNAR orders and information governance.

Doctors from all specialties in adult medicine were invited and nurses were included to accurately reflect ‘real life’ multidisciplinary working relationships. This enabled both professional groups to gain insights into workplace conflicts. Scenarios were adapted for each course to suit the mix and clinical background of those attending.

Results Feedback was sought via free text and visual analogue scale responses to set questions. Early indications show increased confidence in the subjects mentioned above was shown (the pilot will complete by September 2016).

Conclusion This novel simulation programme improves the confidence of foreign doctors working in the NHS in managing a range of situations which, although challenging to most clinicians, are particularly difficult for this group.

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