Four day shadowing programme A Blended Approach Andi Fox-Hiley Department of Medical Education Leeds Teaching Hospitals

What did we blend? Didactic E-learning Ward simulation Skill assessment

Why did we blend? TRAINEE PATIENT Safety Support

Content Technical Skills Communication Team Working Error Awareness Systems and Technology

Programme Evaluation Ward Simulation Evaluation Poster Conclusion

e-Induction

Nasogastric e-Learning

Trainees were asked what best described their thoughts about the activity Q1. The content was relevant to your roles and responsibilities Q2. The content was important for your job role Q3. The content fulfilled your expectations Q4. You would recommend the content to others Q5. The activity will enable you to carry out your role more effectively Q6. You will do things differently as a result of completing this learning activity Trainees were asked what best described the usefulness of the following activities 1 2 3

Trainees were asked how much of what you have learnt during the activity was: Q1. New information, knowledge and/or skills Q2. Information, knowledge and/or skills I have previously learnt Q3. Information I knew well and had applied, but the course helped me practice it Q4. Repeating and covering information, knowledge and/or skills I already know and have well developed Trainees were asked to share any further information they felt would improve the programme 1 2 3

1 2 3

Evaluation 83% Response Rate Scenarios Environment Timings Organisation General 83% Response Rate

Evaluation Scenarios Scenarios Environment Timings Organisation General Good mix, realistic, discussion time and good drug prescribing. (x25) Good level, manageable but challenging. (x5) Good variety, and clinical relevance to FY1. (x9) Good level, and accurate. Pitch right. (x3) I would have preferred that the actors acted all day. Instead of moving around/slightly rushed. (x1) Quite challenging, and excellent. (x1) Realistic scenarios, and actors were very good, but got interrupted at times. (x5) Realistic and relevant. Distractions were accurate and provided a valuable learning tool. (x3) Fine no issues at all. (x3) Good varied, and nice to refresh. (x6) Created what would be a challenging first day. Very useful. (x2) Good variety, and acting was good. Prioritisation excellent. (x2) Useful and realistic. Would like smaller groups? (x3) Useful to have common problems and associated forms explained. (x1) Very believable, and likely to occur on the wards. (x1) Covered a good range of topics, and communication issues. (x1) Well prepared. Scary though. (x2) Covered a wide range of topics. (x1) Excellent/Very good. (x1) Good use of common situations. (x1) Scenarios were good, because you were constantly interrupted. (x2) Very useful, especially when linked to the forms that we will have to use. (x1) More interpretation of results would improve scenarios. (x1) Very common and interesting. (x1) Good variation of scenarios. I was very anxious. (x2) Good scenarios good actors and helpful. (x1) Stressful situations that could happen on the wards. (x1) Really useful session. Interactive patients. (x1) Opening shift AMU really useful/evening shift. (x4)

Evaluation Environment Scenarios Environment Timings Organisation General Lovely. I liked the set up. Would like smaller groups? (x6) A bit off putting at first with 20 people watching, but o.k in the end. (x2) Quite good, felt able to ask questions (realistic). (x8) Informal, felt able to ask questions/educational. (x2) Set up well. Especially the ward. (x5) Very effective and realistic, right level, and the stress factor. (x4) Highly appropriate leaning environment. (x2) Obstructive for doctors with the technician moving cameras. (x2) What a fantastic centre. (x1) High pressure with people watching. (x1) Informal. Well prepared. (x2) Great actors and staff etc. Good ward scenarios and environment. (x6) Groups were quite big. (x2) Good mixture of humour and practice information. (x6) Similar to ward. (x1) Comfortable. (x3) Needs less noise. A lot of staff was moving around. (x4) Everybody was lovely. (x1) Friendly and informal. Very appropriate. (x6). Difficult to work on your when in front of so many people. (x1) Well set up centre. Good to have an FY1 for input and generally having a variety of stages/nursing staff represented. (x2) I did not feel pressured or humiliated at any point. Very encouraging. (x2) Good professional environment. (x1) Suitable, light and adequate. (x2) Excellent/Very good. (x16)

Evaluation Timings Scenarios Environment Timings Organisation General Perhaps smaller groups, and more time interacting, and to debrief. (x5) Good, got to do enough (only needed short section on own). Good to have all paperwork to do too. (x1) Good/Very good and great. (x18) Some posts were very small compared to others. (x2) Very well organised, ran very smoothly. (x3) Was good to go up in short bursts? (x3) Good, plenty of time for discussion. (x3) Enough time discussing each point. (x3) about right. Good interruptions. (x3) Would have been better to have the LGI start in the morning, but not a huge issue. (x1) Good use of timings. (x12) Good duration. (x8) Gave a sense of urgency. No pressure. (x3) Well organised. (x1) May need a little longer in the ward situation. (x6) Slow start with NG tubes. (x2) Too much time between Ng tube and scenario’s. (x2) Good amount of time for stimulations. (x4) Sometimes a lot of waiting around, especially in the morning. Felt a little rushed. (x3) Give time for people to participate? (x3)

Evaluation Organisation Scenarios Environment Timings Organisation General Flawless/Excellent. (x5) Very good. (x4) Really good. (24) Very well organised. The food was outstanding. (x15) Good actors, and well run. (x2) Appropriate timings. (x1) Excellent!! (x1) Good all of the facilitators knew what they were doing. (x1) Well organised. Especially for all grades. (x6) Very good. Best organisation. (x1) Very well organised, as always. (x5) Seemed about right. (x1) The freezing for scenarios was great. (x2) No concerns. (x2) A little disorganised at the start, but no problems after that. (x1) Maybe a little bit more of an explanation as to what the process of the scenarios will be? (x1) was really good, but did not start second session until 1pm. (x2) I liked the clipboards. (x1) Able to help, and seek help when necessary. (x2) Run well. (x2) Fine apart from the slow start. (x1) Satisfactory. (x3) Waiting around at times, which was a little annoying. (x2) Paperwork organised. (x1)

Evaluation General Scenarios Environment Timings Organisation General A very useful simulation setting. (x2) enjoyed it, feel reassured. (x1) Has helped me feel more prepared. (x1) Really useful, but quite scary. (x4) Useful. (x3) This was a great day, and very interesting. Thank you for asking me. (x1) Thank you, it was helpful. (x3) Thank you!!! (x4) Enjoyed it. Non-judgemental attitudes. (x1) Useful scenarios, good to use the forms. (x1) Useful exercise.(x2) Would be good to have these spaced out throughout the year.(x3) Allowing people to volunteer would be better. (x1) Really useful session. Especially the prescribing. (x2) Superb. (x1) I really enjoyed today. The principles are great. (x1) Enjoyed the session overall. (x3) Very useful exercise. Would be good to have more sessions.(x2) Useful to observe and have a good learning experience. (x3) Great way to go over the LTHT specific forms. (x2) Would be better in smaller groups. (x3) Useful before starting work. (x5) Smaller groups would be more useful. (x4) Helpful staff, and willing to discuss. (x1) I found this very useful, for clinical practice. Especially my first call on shifts. (x1) Thank you for the opportunities to practice. (x2) Would have liked a bit more on prescribing and the drug chart? (x1) Useful especially to be warned of forms. (x3) Brilliant teachers. (x3) Very helpful. Staffs were friendly and helpful. (x3) Really useful experience of prioritising patients. (x3) Excellent idea. Never done anything like this before. (x3) Good (x4)

Conclusion Improve and repeat Explain the rationale for designing the programme Explain to the trainees how we have built on the 2012 evaluation Include regional leadership fellows to help us achieve the above Systems Prescribing Resus team

Thank you Any questions?