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A75 Embedding Inter-professional Simulation-Based Education in the Emergency Department
A75 Embedding Inter-professional Simulation-Based Education in the Emergency Department

Article Type: Education Article History

Table of Contents

    Abstract

    Introduction:

    Interprofessional education (IPE) has been advocated on a global scale as an approach to improve collaborative practice and health care delivery [1]. A central tenet of IPE is if professions learn interactively together, they will develop the skills and knowledge to work more effectively with each other in clinical practice. Simulation-based education (SBE) is a rapidly evolving pedagogy within IPE. SBE offers participants the opportunity to learn in a controlled, psychologically safe environment. An indispensable component of all SBE is a structured debrief; to consolidate reflective interprofessional learning [1]. An emergent branch of SBE is In Situ Simulation (ISS). Literature included in a systematic review by Fent et al. (2015) [2] suggests the technique; which involves interprofessional teams managing simulated patient care scenarios in the actual clinical settings in which they work, improves clinical skills and interprofessional teamwork.

    Methods:

    An interprofessional faculty was established across two Emergency Departments in our Trust by a small, multidisciplinary team with a special interest in the benefits of SBE. All faculty members were trained in a debriefing tool; ensuring our simulation delivery, including pre-briefs and debriefs were standardized. A bi-monthly simulation program (Table 1-A75) was devised and advertised across both departments. Participation was welcomed from all ED specialties. Simulations were delivered in either a protected simulation environment or, when department acuity permitted, in-situ. Additionally, relevant disciplines were invited to participate in specific simulations, augmenting learning and collaborative practices. Staff were incentivized with certificates’ detailing CPD hours for portfolios. Nursing staff were given time in lieu for attendance.

    Table 1-A75.
    Schedule
    24/03/2022 Status Epilepticus
    07/04/2022 Traumatic Cardiac Arrest
    21/04/2022 Complete Heart Block
    05/05/2022 Unstable Tachyarrhythmia
    19/05/2022 Emergency Delivery/Neonatal Resuscitation
    06/06/2022 Obstetric Emergency (Eclampsia)
    16/06/2022 Rapid Tranquilisation Of Psychotic Patient
    30/06/2022 Massive Transfusion Protocol (GI Bleeding)
    14/07/2022 Congestive Cardiac Failure – Unstable
    28/07/2022 Life-threatening Asthma
    11/08/2022 Silver Trauma
    25/08/2022 Eye Emergency
    08/09/2022 Difficult Interactions With Colleagues, Patients Or Relatives
    22/09/2022 Hypertensive Emergency
    06/10/2022 Vertebral Artery Dissection
    20/10/2022 Procedural Sedation And Adverse Outcomes
    03/11/2022 Pneumothorax
    17/11/2022 Paediatric Sepsis
    01/12/2022 Elderly Abdominal Pain/ AKI/ Hyperkalaemia
    15/12/2022 Perimortem C-Section (Resuscitative Hysterotomy)
    05/01/2023 Massive P.E.
    19/01/2023 Hypothermic Emergencies
    02/02/2023 Ectopic Pregnancy
    16/02/2023 Seizures Due To Electrolyte Disturbances
    02/03/2023 Red-Flag Headache
    16/03/2023 Toxicology And Refusing Treatment
    30/03/2023 Aortic Dissection/ Aneurysm
    13/04/2023 Head Injury

    Results:

    Pre-and-post simulation feedback evidenced improved confidence with management of the clinical conditions being demonstrated. Over the course of the program, feedback was received from 239 participants. Of those, 238 would recommend attendance of a simulated scenario to a colleague.

    Learning from the delivered simulations was amalgamated by one of the ED consultants and disseminated through safety briefings and short learning videos via our ‘My Emergency App’ platform.

    Discussion:

    A patient safety culture shift was observed as multi-disciplinary staff increasingly engaged with the simulation events across both sites. A myriad of safety improvements was introduced from key themes and latent safety threats identified by learners through debrief processes. Circulation of salient learning points enabled staff who were unable to attend the simulation events to tangibly share learning [3], with the primary aim of delivering high quality, safe and effective clinical care to our patients.

    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.

    References

    1. Reeves S, Fletcher S, Barr H, Birch I, Boet S, Davies N, McFadyen A, Rivera J, Kitto S. A BMBE systematic review of the effects of interprofessional education: BMBE Guide No. 39. Medical Teacher. 2016;38(7):656–668.

    2. Fent J, Blythe J, Farooq O, Purva M. In situ simulation as a tool for patient safety: a systematic review identifying how it is used and its effectiveness. British Medical Journal STEL. 2016;1:103–110.

    3. Purdy E, Borchert L, El-Bitar A, Isaacson W, Bills L, Brazil V. Taking simulation out of its “safe container” – exploring the bidirectional impacts of psychological safety and simulation in an emergency department. Advances in Simulation. 2022;7(5):1–9.

    Weatherup, Magowan, McFadden, and Gallagher: A75 Embedding Inter-professional Simulation-Based Education in the Emergency Department