LOVE - Simulation - HATE Really consolidates learning LOVE IT !!! Improves confidence Reinforcing LOVE - Simulation - HATE I’ll do something wrong Actual hands on practice HATE IT !!! Worrying Everyone watching Can’t act

Clinical Education Deteriorating Patient Simulation ABCDE Assessment (Janis Langdale, Clinical Educator) Escalation & SBAR Handover (Dr Ailsa Howie, Consultant General Medicine) Emergency Respiratory management (Dr Elizabeth Steele, Consultant Anaesthetist, Neuroscience) Simulation Stephen Hartley & Dina Robertson Resuscitation Officer Clinical Education Team 3 x simulation stations Seizure Acute Head Injury Sepsis Reflect on: What went well What would they do differently What was the main take home point

Feedback NEGATIVE POSITIVE “Not enjoyable doing the actual sim” “Don’t like acting” “Did not enjoy this activity (at first), however found this method of learning very effective” POSITIVE “Reflecting on how I react and communicate in deteriorating situations” “Makes you think methodically” “Reinforces learning” “I realise I know more than I think” “Debriefing as a team was really useful” “Improves confidence” “hands on time to practice, make mistakes, then get it right”

Simulation as a quality improvement tool Location – Ward 32, Neurosurgery Aim – Test the effectiveness of the emergency escalation policy Scenario – 56 year old man arriving on the ward post surgery following C6/7 Anterior Cervical Decompression and Fusion and subsequently developing life threatening airway compromise from an expanding neck haematoma Preparation – Story Board, Learning outcomes, intro to SimMan3G, staff engagement, Target Group - DCN ward staff – Staff nurses, CSW’s, FY2’s, On call SpR, Resource nurse, Anaesthetist, Ward managers Simulation – Real time, location, staffing numbers Feedback – Discuss anxieties, barriers, difficulties, reflect on what went well and improvements can be made

Difficulties faced – Action – It was taking up to 6 mins for switchboard to answer, to get help. Staff had to search lists to find which SpR was on call Difficulty getting hold of an Anaesthetist Action – Adapt the current NHS Lothian poster’s headings to specifically fit with Neuroscience requirements with specific bleep numbers and names Ensure all staff know how to “fast bleep” in a medical emergency Adopt a single emergency bleep number for an SpR who is on site to carry

Before After

Consolidates learning Improvement tool It can empower and give confidence It is a safe and reflective learning tool