10th Edition Pilot Faculty perspective 2017 National Update day Dr Harry Walmsley

Introduction Preparation – participants / faculty / course director Practicalities Skill station changes Faculty / student interactions

Preparation - Participants m-learning completed – mostly yes - correlation with MCQ mark Cannot attend if not done it – allowed 2 weeks post course Cost of course – 2 days - cost of materials

Preparation - Faculty Print off chapters & skills – no manual No lectures to prepare (exc Initial Assessment) BUT huge amount of work in preparation – faculty notes Faculty meeting night before course Skills – big changes – 9th edition stations merged - very scenario orientated – evolving - skills - some demo, some 4 stages - new skill stations – Adjuncts, Trauma team Moulage – as before Triage, pre and post course MCQ – as before

Practicalities Course director Deputy course director 8 other faculty – minimum Co-ordinator 16 participants Day 1 exhausting – BUT doing each station 1 or 2 x and not 4 x better Day 2 easier

Skill Stations – practical issues Four airway stations – more equipment & space needed Skills follow each other very closely Coordinator turnaround swift ? More rooms? Difficult for faculty to check skill stations Time management essential – some skills harder than others eg disability Some stations faculty notes of 30+ pages

Skill Station – running them Faculty notes – some very repetitive Content introduction Learning objectives Relevance Several different scenarios with case progressions in all Stimulus questions Key discussion points – could become a mini lecture Skills acquisition points – some demo/discussion - some all students (4 stage) Lots of opportunities for 4 stage & felt more natural Summary of each scenario

Airway Skill Station Manageable within time Airway assessment – demo/discuss Jaw thrust – demo/discuss Nasal, oral airway, suction – 4 stage BVM (1 & 2 person) – 4 stage Discussion of paediatric airway v adult (5-10mins) LMA insertion – 4 stage LEMON assessment – demo/discussion COETT – demo/discuss only Surgical cricothyrotomy – adult – 4 stage Needle cricothyrotomy – child – 4 stage

Circulation Skill Station Scenario 1:- Assessment of shock – discuss Wound packing – demo & discussion enough Tourniquet – 4 stage Scenario 2:- Pelvic binder – demo but each getting to tighten it IO – 4 stages Femoral line – demo. ? Do we need to show it.

Disability Skill Station Very rushed – only first 2 scenarios covered 9th edition head injury & cervical spine skill stations combined Fewer skills – became discussion 4 scenarios – extradural, neurogenic shock, subarachnoid haemorrhage, central cord syndrome One 4 stage skill – log roll Primary and secondary survey neuro assessments New and old GCS Head and C-spine assessment Radiological investigations Referral process – SBAR communication template

Other Skill Stations Breathing:- Ran to time. CXR moved to Adjuncts Assessment of chest injuries Chest drain insertion – 4 stage Needle decompression (child) – 4 stage Elderly chest injury, sucking chest wound, severe chest injury – all demo / discussion Secondary Survey:- 4 scenarios – can`t cover all. ?Reduce number Mostly demo / discussion Application of collar - 4 stage Need to know what covered in other skills

Day 2 Trauma Team video – discussion afterwards in 2 groups - closed discussion on handover, leadership, good and bad behaviour, feedback. Adjuncts – CXR, Pelvic Xray, Spinal Xray - ABCDE - scenario based - FAST - very much a discussion station Moulage demo – better on Day 1 Practice moulage (1 hr) - went down well Moulage – as previous courses.

Faculty / Student Interaction No course dinner Don`t meet all the candidates at skills – same group 3 times and one group not at all. Miss interactions with candidates during lectures SO – Initial assessment interactive discussion important on Day 1 Used discussion in skills to determine candidates insight, support others, ATLS ethos. Difficult to pick out IPs Don`t see or hear other faculty teaching on stations

Closure Two day course Careful writing of programme for maximum exposure to all candidates Pre course m-learning – how to make sure it is done Preparation +++ More rooms / space Skills – lot of discussion but flowed well - time pressures - some skills demo and some 4 stages - flowed well with 4 stage SG currently making changes to faculty notes ? Optimum number of faculty / participants More pilot courses needed