1. Immersive Simulation in the Foundation Programme
Dr Ben Shippey Dr Neil Harrison Dr Lesley Creighton Dr Lana Fischer

2. Introduction
Background to the project
What we did
Key messages

3. ‘Competent in 370 competencies!’
Foundation clinical placements
Clinical placements great for CVS exam etc but for some more specific and rare competencies this is a challenge

4. ‘The Foundation Programme is a two-year generic training programme which forms the bridge between medical school and specialist/general practice training.’

5. Simulation Based Education

6. ‘Competent in 370 competencies!’
Foundation clinical placements
Immersive SBE
A constructively aligned intervention allows a programme directors to know that more specific outcomes are being met as well as the essential skills

7. Research Questions
Plan
Reflect
Cycle
Which of the Foundation curriculum competencies do Foundation doctors feel they require more training in to support their learning during clinical experience?
Would a simulation based educational intervention be appropriate to address these needs?
Does the proposed intervention meet the identified training needs?
Act
Observe
NEEDS

8. Plan Reflect Re-Plan Reflect Re-Plan Reflect Cycle 1 Cycle 2 Cycle 3
Identify possible foundation competencies for programme
Reflect
Establish competencies to be addressed by intervention
Re-Plan
Conduct a literature review in light of cycle 1
Reflect
Consideration of suggestions
Re-Plan
Re-development of intervention
Reflect
Thematic analysis of data and re-develop intervention
Cycle 1
Cycle 2
Cycle 3
Act
Construct and deliver a questionnaire
Observe
Analyse data from questionnaire responses
Act
Develop an intervention
Observe
Study of the intervention by experts
Act
Deliver intervention and issue questionnaire
Observe
Run focus groups, tutor field notes

9. Analytic Hierarchy Process
Establish competencies for intervention
Goal
Trainee perceived usefulness 0.5
Clinical significance 0.5
Criteria
Alternatives

10. Cycle 1 Results CURRICULUM COMPETENCY TOTAL TRAINEE USEFULNESS SCORE
Emergency detention
Indicators for ICU
Assessment of capacity
Unsuccessful treatment
End of life care
Learning/communication difficulties
Angry patents
Safeguarding patients
Unconscious patient
Advanced care planning
Consult via interpreter
Palliative care
Medical Evidence
Physiological change
Monitoring therapeutics
Adverse drug events
Three way consultation
Challenging others infection control
TOTAL
TRAINEE USEFULNESS SCORE
0.082
0.074
0.073
0.071
0.064
0.063
0.061
0.057
0.056
0.055
0.054
0.048
0.043
0.042
0.041
0.019 1
CLINICAL SIGNIFICANCE SCORE
0.035
0.07
0.079
0.076
0.051
0.018
0.049 1
COMBINED RANKING SCORE
0.0585
0.0715
0.07
0.0665
0.0525
0.033
0.046 1
ACTION
ward round
clinic
impractical
sim not needed
already covered in ALS
too low

12. The interventions
FY Sim Ward Round
FY Sim Clinic
PACE

13. PACE and feedback/debriefing

14. Cycle 3 Results - Clinic

15. Cycle 3 Results – Ward Round

16. ‘Its been very good. Congratulations!’
Quotes
‘Very good session. Excellent feedback.’ ‘Discussions with tutors were very useful, gained tips about communication skills in each specific scenario.’ ‘Good range of topics covered.’ ‘Very useful real life advice on how to practice.’ ‘Patients all very realistic – didn’t feel too much like simulation.’ ‘It was excellent.’ ‘Good opportunity to cover things not covered in other teaching’ ‘Simulated scenarios of rarer clinical events’
‘Its been very good. Congratulations!’

17. Conclusions Important FY doctor training needs were established.
A constructively aligned pilot SBE programme was designed and delivered to all FYs in Tayside.
The programme met FY expectations and training needs.
Next steps…
Follow them into practice
National integrated programme of SBE to support FY clinical placements

18. Pilot programme of targeted SBE
Foundation clinical placements NHS Tayside
FY1 and FY2
Pilot programme of Immersive SBE

19. Foundation clinical placements
FY1 and FY2
Programme of Immersive SBE
Allows programmes directors to delivery a quality programme of training to an entire cohort of FYs

20. Thank you – questions?