International Journal of Healthcare Simulation

Background and aim:

An NHS provider had no established simulation education opportunities for community based allied health professionals (AHP). Urgent Community Response (UCR) teams are interdisciplinary teams, comprised of nurses, paramedics, physiotherapists and occupational therapists, who provide care to adults in their home to avoid hospital admission [1]. Older people experience effective high-quality care when a multi-skilled clinician, working across the usual professional boundaries, can effectively address their needs rather than requiring numerous other professionals to visit them at home.

In this NHS Trust, intermediate care teams were required to include UCR referrals as part of their usual work. The physiotherapists and occupational therapists from these teams required upskilling to be able to safely support patients requiring this more acute and urgent level of care.

Clinicians working in the community have limited opportunity to observe and learn from each other. Simulation is an evidenced based educational activity to support the development of new knowledge and skills required in interdisciplinary teams working in clinical settings [2]. It was hypothesized that interprofessional simulation would be an effective educational intervention to support this upskilling.

Activity:

A faculty was established which included a simulation educator; simulation technician; a practice development AHP; and a physiotherapist with clinical experience of working within this setting.

Simulation scenarios were developed to reflect common referral presentations; the Skills for Health UCR Capability Framework [3]; and learning outcomes identified as priorities by the clinicians and service managers. The learning outcomes included applying an A to E assessment; the use of NEWS2 and the SBAR escalation tool when assessing an adult patient in their own home.

A modified Kirkpatrick evaluation form was used to evaluate the training.

Findings:

Three simulation training events were offered. There were 26 participants overall with representation from physiotherapy, occupational therapy, nursing and healthcare support workers. There were fourteen evaluation responses to a modified Kirkpatrick evaluation form. The evaluation identified that simulation provided an opportunity to learn from other professions; supported the practical application of learning; debriefing provided a safe learning environment; and that the learning would lead to changes in their current practice (see Table 1-A74).

Table 1-A74:

Evaluation themes with supporting examples

Theme	Verbatim comments
Pre-scenario teaching	The training at the start was great, really informative…was really important
Practical application of the learning	remaining calm in a crisis situation and providing accurate handoversenjoyed the practical nature of learninginteractive training is more effectiveExcellent way to learn
Relatable to clinical work	Case studies useful and relatable to day-to-day workWill incorporate SBAR and NEWS2 into our assessment documentation
Opportunity to observe and learn from others	Interesting to see our other teams approach situations
Debriefing provided a safe learning environment	…great discussion facilitation…very reassuring environment which I think a lot of staff found helped cement how much they did knowfacilitators created a supportive learning environment to make you feel comfortable

Conclusion:

Simulation training events were evaluated by participants from an interprofessional community team as a safe, practical and effective way to support their upskilling to provide an UCR service. Simulation should be considered as part of an education package to support interprofessional teams upskilling to provide new services in a community setting.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Acknowledgements:

This work forms part of a fellowship project funded by NHS England (South East) Workforce, Training and Education; with the Florence Nightingale Foundation and Canterbury Christ Church University.