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51 Preparing Ward Staff for Covid-19: Can Remote Simulation Replace Face-to-Face Learning?
51 Preparing Ward Staff for Covid-19: Can Remote Simulation Replace Face-to-Face Learning?

Article Type: In Practice Article History

Table of Contents

Abstract

Background:

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 [1]. With concerns that the second pandemic wave would engender greater pressures on general medical wards, the simulation team at a London teaching hospital set out to create a multi-disciplinary educational programme for ward staff caring for COVID-19 patients. The course, planned for face-to-face delivery, was rapidly converted to online simulation at the height of the pandemic.

Aim:

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.

Method:

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) [2]. Learners who attended both formats were excluded from quantitative analysis.

Results:

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.

Implications for practice:

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.

References

1. 

Alagha MA, Jaulin F, Yeung W, Celi LA, Cosgriff CV, Myers LC . Patient harm during COVID-19 pandemic: using a human factors lens to promote patient and workforce safety. J Patent Safety. 2021;17(2):8789.

2. 

Reedy GB, Lavelle M, Simpson T, Anderson JE. Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing inter-professional learning across healthcare practice settings. BMJ Simul Technol Enhanc Learning. 2017;3:135141.