bluuebunny/crossref_metadata_2025_split huggingface dataset:
167 Evaluating the Effectiveness of a Redesigned Simulation Programme for Final-Year Medical Students During their Assistantship Placement
Authors: Alam Azeem , Parker Hollie , Mathews Catherine , Simpson Thomas 
Published: January 2022

The transition to a foundation doctor is often a daunting process for medical students and, to prepare for this, students attend an assistantship placement in the final months of medical school. The transition to foundation year 1 (TTF1) programme is an 8-week placement where students shadow a junior doctor, taking on a vocational role, and attend various teaching activities including high-fidelity simulation. Evidence suggests that medical students transitioning to clinical practice feel unprepared for working on-call, managing acutely unwell patients and task prioritization, and are often unprepared for scenarios requiring expert communication techniques We aimed to evaluate the effectiveness of a redesigned simulation programme for TTF1 students, focussing on student satisfaction, confidence and attitudes across key domains.Fifty-three TTF1 students attended a 1-day high-fidelity simulation training day, separated into cohorts of 10 students. Students completed a pre-course (In terms of confidence, there was an improvement across all core domains, namely diagnosing and managing acute medical emergencies (2.8 vs. 3.8), performing cardiopulmonary resuscitation (3.0 vs. 3.6) and working effectively with colleagues in the interests of the patient (3.3 vs. 4.2). 96% of students found that simulation was a valuable learning experience, allowing them to integrate theory with practice. 94% of students felt that the simulation allowed them to analyse their behaviours and actions and 88% found that scenarios resembled real-world situations. Attitudes towards simulation were positive, with 92% of students agreeing that simulation is a good way of learning technical and non-technical skills. Qualitative themes focussed on the real-world applicability of the scenarios, increased confidence in task prioritization, closed-loop communication and early escalation.We have demonstrated the benefit of integrating simulation training within the assistantship period and the value of creating novel scenarios directly related to future practice as a junior doctor.
117 Murder on the Laboratory Floor
Authors: Charlton Jan , Cordes Jill , Hayes Thomas , Walton Carrie 
Published: January 2022

As leaders are now being encouraged to work across different organizations and in more complex ways, a Systems Leadership programme was developed. The programme required a final module to consolidate the learning which was simulation based. The candidates attending the ‘murder on the lab floor’ module were a mixture of clinical and non-clinical senior leaders from public and third sector organizations.The aim of the study was to design a half-day course utilizing the simulation structure of pre-brief, scenarios and debrief which enable the candidates to reflect on their own learning in the areas of leadership, communication decision-making and collaborative skills.We formed a working group to design the scenarios, which were a series of games, build prototypes, run pilots to assess suitability, identify modifications and ensure consistency. Games were linked to leadership traits to aid reflection through debriefing. Games were designed to be played face to face, or remotely, thus promoting inclusivity for shielding staff. A short pre-brief or introduction was filmed.In our first cohort, all candidates attended the 3-hour session in person. The pre-brief film was played to the candidates setting the scene of an industrial scientist collapsed on a laboratory floor. It outlined the aim to collect as many golden syringes as possible by completing seven 5-minute activities. The candidates were given 5 minutes to nominate which candidate would complete which of the seven games set out in the laboratory. The games were categorized as mental, physical, mystery and skill. The nominated candidate entered the laboratory fitted with a radio headset. Audio and video were fed to the debrief room and to remote candidates via Teams. Once the candidate entered the laboratory the timer was activated. Candidates in both rooms were expected to work together to solve the puzzle and demonstrate team dynamics, communication and strategic thinking. On completion of all games, the candidates participated in a structured debrief led by two of the faculty. This reflective process highlighted the intended learning points and also brought about a discussion examining the effects of COVID-19 on the individuals and their teams.Qualitative feedback was collected. Candidates stated that
It was the best session of the programmeThe method suited my style of learningI would like my team to go through the process as I found it so valuable.As this fitted social distancing guidelines it is a great alternative to an online programmeThe activities joined the dots between leadership theory and how we work in practice
198 A Novel ‘Virtual Simulation’ for The Advanced Life Support Group, Making a Dream a Reality: A Beginner’s Guide
Authors: Van Heyningen Carl Leith , Denning Kate , Joseph Sibi 
Published: January 2022

In the UK, it is a requirement for staff involved in paediatric critical care to remain up to date with advanced paediatric life support (APLS). To do so there is an expectation to participate in face-to-face courses on a four-yearly basis. The Advanced Life Support Group (ALSG), an organization dedicated to supporting professional education, sought to add to their resources in line with advances in online capabilities. With stakeholder input, the goal emerged to develop an engaging, interactive and entirely novel educational product. Here we present the pilot stages of our project.The aim of this project was to produce an educationally effective and novel product that learners of APLS would engage with and enjoy.Stage 1 involved determining clearly defined learning objectives mapped to the APLS curriculum. At a round table with stakeholders, educationalists, and a technologist an outline of the project was formed and the scenario of a sick baby with bronchiolitis chosen for a pilot. Informed by literature on serious game design, a branching narrative was created. Stage 2 involved collating resources. A photoshoot at Leicester Royal Infirmary A&E (Accident and Emergency) created a set of images. A video shoot at the Royal London Hospital A&E generated a series of videos. These were then edited and used to create a Microsoft PowerPoint slide set. Voiceovers to text, sound effects to add a hospital atmosphere and questions were then added. Stage 3 involved taking this draft and translating it into an interactive final product utilizing Articulate Software. This enabled its usage across smartphone, desktop, and laptop devices. Testing followed with anonymous online feedback informed by the 7Is framework We launched the pilot version at the RCPCH (Royal College of Paediatrics and Child Health) Conference 2021. Feedback was collected from delegates and continues to be collected via online participants. It is hoped that ongoing quality improvement cycles will assist in assuring a finished fully functional online virtual advanced paediatric life support simulation for release in 2022. Further stakeholder review is pending. Thus far it has been met with universal approval, i.e. all learners questioned expressed that they would like to utilize this novel style of education again. The average duration to complete the virtual simulation was 15 minutes. All learners rated their knowledge and skills in APLS to be either unchanged/revised or improved. Finally, interactivity online was felt to need improvement by most participants. Interactivity is key if high levels of engagement are to be achieved. Future testing will determine whether any educational impact is maintained across time. The current pilot version can be accessed at the following webpage
99 A Fresh Model in the Vehicles for Learning: Redesigning an Established, Traditional Airway Course to be Delivered in a Multi-Site Hybrid Format in the COVID-19 Era
Authors: Singhal Manvi , Kee Mitchell , Eady Jonathan , Martin Claire , McBrien Michael 
Published: January 2022

The Royal College of Anaesthetists (RCOA) stipulates that anaesthetists should be able to use advanced/novel airway management techniques. The RCOA-accredited annual Challenging Airway Course in Northern Ireland is a staple of the calendar, providing an opportunity for all those involved in airway management to gain, refresh and replenish skills. Having already been cancelled in 2020 due to the pandemic, there was a strong appetite, particularly within the trainee body, that it should be staged in some form this year.The aim of the study was to deliver a high-quality course that outlined the theory behind airway management, without loss of the hands-on aspects of equipment/techniques, to a large candidate group in a COVID-19 safe environment.Alteration of the face-to-face course to run in a hybrid multi-site format with both online components and practical workstations.The course was delivered simultaneously in real time across the multiple deanery teaching hospitals. There was a central hub from which the course lead could synchronize timings/broadcast recorded material. As part of contingency plans for any unanticipated technical difficulties, lectures were pre-recorded and played for candidates on the day. These were punctuated with four practical workstations that mandated two delegates per station. Additionally, some content was recorded for viewing online as pre-course material and new simulation videos of a failed intubation drill and the subsequent debrief were also created. For some unable to attend site locations, a fully virtual experience was also an option. These modifications allowed us to: maximize attendance without breaching social distancing guidelines; retain the hands-on aspect of using equipment/techniques and also maintain an excellent faculty to candidate ratio to allow ample time for practising/asking questions. The pre-course material also empowered the candidates to feel better prepared for the day. Post-course anonymous feedback was completed by the vast majority of delegates and was overwhelmingly positive. Pre-course material, facilities, content, lectures, simulations and workshops were rated highly. The use of airway exchange catheters was mentioned as the introduction of a new skill for many delegates. Apart from one candidate, no one had attended any RCOA-accredited airway events in the preceding year but 100% of the candidates would recommend this course to their peers. Amidst challenging times, we successfully restyled an established and respected course. The novel hybrid multi-site format allowed a larger number of candidates to network face-to-face and gain knowledge/practical skills within a COVID-safe environment. Until such times as ‘normality’ and perhaps beyond, this may be a new formula for learning.
13 Medical Emergency <i>in situ</i> Simulation Training for Dental Hygiene Therapists
Authors: Mahoney Jodie 
Published: January 2022

simulation, in the clinical environment, can help detect any issues with the systems, policies and practices within an organization that may not work. Many system errors go unnoticed until there is a real incident. Conducting simulation This simulation exercise is designed to develop the skillset of foundation dental therapists in respect of Medical Emergency recognition and management in their own working environment. The parameters for assessment included teamwork, knowledge, communication, effectiveness of actions and situational awareness.Research methods for this project included a learning needs analysis, surveying and interviewing previous cohorts of hygiene therapists. The conclusions of which highlighted the need for further training in managing medical emergencies. The learning needs identified from stakeholders relating to this course have been used to develop the learning outcomes using Blooms’ taxonomy Using GIBBs model of reflection, the 2021 delegates recognized personal learning needs including improvement in leadership and management skills, delivery of chest compressions and teamwork. Changes to practice were also recognized, for example, placing their emergency drugs in a more appropriate location. Using video, a ‘Hot Debrief’ method of evaluation was carried out whilst the experience was fresh. This proved to be powerful and enhanced personal reflection to support future learning and development. Later, an evaluation method in the form of a survey took place. Results of which showed that 50% of delegates had never partaken in simulation-based education before and 100% gave an excellent rating on the benefits to team and individual. One participant stated ‘this was such a good, real-life experience! I hope this can either be introduced into undergraduate training or as part of the practice annual BLS CPD!!’.A successful session needed prior communications with the practice staff to free up a surgery for use, inform present patients of the activity and understand where the emergency equipment was during the session for patient safety. The benefits of conducting
190 Virtual Work Experience in Medicine: Widening Participation
Authors: Keshtkar Fatemeh , Ellerton Laura , Kelly Ryan , Parr Tim , Mercer Simon 
Published: January 2022

The national lockdowns due to COVID-19 have caused significant disruption to schools and colleges. As well as interruption to their studies, pupils work-experience placements have been cancelled, particularly those based in healthcare. Despite this, the BMA continues to recommend all aspiring doctors undertake placements within healthcare to aid their application to medical school and give them an insight into being a doctor Creating a ‘virtual work experience’ using simulated video demonstrations in order for students to gain an understanding of what working as a doctor encompasses. This course was offered free of charge to help encourage students, particularly from low-income households.Invitation letters were sent to all public and private schools in Merseyside. Contact details and school information were obtained through the Office for Standards in Education, Children’s Services and Skills (OFSTED) Government website. Students were asked to fill out a pre- and post-course questionnaire.Seventy-five schools and colleges were invited. A total of 326 students registered for the course and 220 participated in the virtual conference. All participants were from 18 schools and colleges. Students, where at least one parent had attended university, felt more confident in applying to medical school and securing a place, this was significantly higher when a parent was in the medical profession. Students from private or schools rated as above average by OFSTED felt that they were more likely to apply to medicine than those in schools who were rated average or below-average. Overall, students felt that they had an improved understanding of the different roles of doctors following the course and the simulated scenarios were most useful in encouraging them to apply to medicine.Up to 20% of secondary schools provide 80% of all applicants to medicine, with half of the schools in the UK not providing any applicants to medicine at all. The selection alliance 2019 report on widening participation in UK medical schools suggested that there continues to be a discrepancy in underprivileged students applying to study medicine with barriers including limitations to securing work-experience placements
51 Preparing Ward Staff for Covid-19: Can Remote Simulation Replace Face-to-Face Learning?
Authors: Dunnell Liam , Sowole Luciana , Maule Sophie P. , Laws-Chapman Colette , El-Alami Wathik 
Published: January 2022

Human factors are essential to patient and staff safety, particularly during the COVID-19 pandemic with redeployment of staff to different roles in unfamiliar environments The aim of the study was to ascertain the efficacy of converting face-to-face simulation and debriefing into online asynchronous video-based scenarios and debriefing, to enhance understanding of human factors skills.In October 2020, a half-day simulation course commenced. Due to suspension of face-to-face teaching in December 2020 with COVID-19 cases rising, this was converted into a half-day online format through filming faculty participating in the existing scenarios. These films were shown to participants, followed by asynchronous online debriefing via Microsoft Teams. Both formats had e-learning as a pre-requisite. Data were collected using pre- and post-session questionnaires containing the Human Factors Skills for Healthcare Instrument (HuFSHI) Post-training, staff demonstrated improvement in self-efficacy of human factors skills for healthcare. There was no statistical significance between mean improvements for both formats; the greatest improvement was split equally (Table 1). 100% found the face-to-face (N = 24) useful, versus 98% online (N = 54). Communication was the skill most learnt (face-to-face 58%, online 65%), with teamwork (face-to-face 50%, online 48%), escalation (face-to-face 42%, online 57%) and self-care (face-to-face 38%, online 19%) also frequently mentioned. Aspect’s learners’ thought were good included the discussion-based element (face-to-face 50%, online 37%), interactivity (face-to-face 13%, online 31%), multi-disciplinary team involvement (face-to-face 13%, online 20%) and videos for the online format (19%). 21% wanted the face-to-face longer, 15% wanted the online shorter. 9% would rather the online was face-to-face.Online asynchronous debriefing produced similar outcomes to face-to-face for teaching human factors. We posit that this was because the videos were not ‘best practice’ – thus stimulating learning conversations, which accessed learners’ frames and past experiences. Challenges for faculty included: pace and volume of sessions, managing psychological safety, emotive discussions, screen fatigue, and technical aspects. A 6-month follow-up survey is planned and will be included in the presentation. Further work is required to understand why the results were similar.
59 Rapid Training During A Pandemic: An Evaluation of a Covid-19 Video E-Learning Package
Authors: Maule Sophie P. , Sowole Luciana , Dunnell Liam , Szulc Nick , Alami Wathik El 
Published: January 2022

As COVID-19 hospital admissions rose in 2020, there was a requirement to prepare wards and staff to care for COVID-19 patients, especially given the rapidly emerging and frequently evolving guidance, and high levels of re-deployment (GMC, 2020). In one London Trust, this need for educational material geared towards ward staff resulted in a multi-disciplinary simulation education team being commissioned to produce an e-learning resource. We measured the effectiveness of the resource for ward staff as well as any improvement in learners’ COVID-19 knowledge.The aim of the study was to quantify the effectiveness of an e-learning package in improving learners’ COVID-19 knowledge.In November 2020, an e-learning package was created, comprising a video series documenting the journey of a patient with COVID-19 covering admission to discharge (filmed from the patient perspective). This was integrated with content highlighting key aspects of COVID-19 care, ending with a mandatory assessment with an 80% pass mark. The e-learning was disseminated to hospital staff (doctors, nurses and allied healthcare professionals) with data collection via SurveyMonkey® from November 2020 for 3 months. Pre- and post-surveys were included to investigate the average improvement of learners and the impact of the resource on learner self-efficacy through self-rating on six learning outcomes. Free-text options in the post-survey allowed qualitative feedback, aiding continual resource development.In total, 108 learners, about half of whom were doctors, completed both surveys, with a significant difference (p < 0.01) between the pre- and post-learning results and an overall improvement in learners’ knowledge after completion of the e-learning (Average pre- and post-learning scores of learners’ self-reported knowledge and percentage improvement*Treatment escalation plans.E-learning can rapidly disseminate learning, at a time when most feel the pandemic has had a mixed or negative impact on learning opportunities (Dean E, 2020; GMC, 2020). The e-learning is continually updated with new evidence, with plans to expand access across London. An iterative process was undertaken with updates in response to learner feedback due to the speed at which the resource needed to be developed, for example, turning resources into PDFs for home access. The e-learning remains live given rising COVID-19 cases. Further work is required to investigate the effectiveness of this resource across London and how beneficial it has been for clinical work.
10 Introducing a Virtual Ward Round in Times of COVID-19
Authors: Westerman Tanith , Ahmed Liban , Mills Helen 
Published: January 2022

Many medical students feel unprepared for starting as FY1 doctors, and often report low confidence in taking responsibility for patients and working independently, and lack self-assurance in common FY1 skills, including assessing unwell patients and initiating management, task prioritization, referrals, documentation, ordering imaging and on-call shifts. These skills are developed during clinical placements; however, access to these opportunities during placements has diminished due to COVID-19 and concerns around patient safety. Simulation‐based teaching allows students to take responsibility and work within complex clinical environments without posing a risk to patients The aim of the study was to evaluate whether simulated mock ward rounds increase final-year medical students’ overall confidence and feeling of preparedness for starting as FY1 doctors.In total, 20 final-year medical students took part in the programme in two whole-day sessions. This was comprised of a simulated ward round of 10 patients. Students acted as FY1 doctors on the ward and carried out jobs, reviewed patients who deteriorated and had a number of tasks such as updating families, ordering radiology, initiating management and discharge summaries. Students’ confidence and preparedness was measured using pre- and post-course questionnaires. The questionnaires consisted of a 10‐point Likert scale for students to rate their confidence in key skills and overall preparedness for FY1 (1 = not at all confident, 10 = completely confident). These scores were matched and analysed using the Wilcoxon signed‐rank test. Additionally, there was blank spaces for feedback on the course which were analysed thematically.Pre- and post-course questionnaires demonstrated that students felt significantly more prepared for FY1 after the course (p < 0.001). There was also a significant improvement in nine other domains deemed important for FY1 that students had reported low confidence in (see Figure 1). Qualitative data revealed that students appreciated the programme. They stated its superiority to other educational methods such as shadowing or didactic teaching sessions.Students mean confidence score in overall preparedness and key skills before and after the programme. P < 0.001 for all domains.Simulated mock ward rounds can be used as an adjunct to clinical placements to increase medical students’ confidence about starting work, and to teach them valuable skills regularly utilized by FY1 doctors.