International Journal of Healthcare Simulation

Background:

Human factors training is the ‘focus on optimising human performance through better understanding the behaviour of individuals and their interactions’ [1]. This is essential within healthcare to improve clinical efficiency and safety. Aviation have long been industry leaders in delivering human factors training with mandated training [2]. Since 2010, emphasis on human factors within the NHS has increased [1] and is often incorporated into clinical simulation training [3], however there remains wide variation in the accessibility, quality, and understanding around human factors. We therefore sought to evaluate the delivery of our human factors teaching within undergraduate medical simulation in our district general hospital.

Methods:

A pre- and post-educational intervention questionnaire was collected from 50 undergraduate medical students following a simulation teaching day. Students were asked to rate on a scale of 1–5 (1 least- 5 most confident) various domains including their understanding of human factors. A questionnaire was collected from the simulation facilitators (10 junior doctors). Facilitators were asked whether they had received any formal training in human factors, as well as how confident they felt in delivering teaching within various domains, including human factors, on a scale of 1–5. A further white spaced questionnaire was completed detailing their understanding of human factors.

Results:

None of the 10 facilitators had formal human factors training and 50% rated their confidence level ≤ 3 when talking about human factors during the debriefing. However 80% rated 4/5 when discussing clinical skills or knowledge. This is reflected in only 50% of students rating a 5 in applying human factors following the simulation course whilst 78% rated a 5 in application of clinical skills/knowledge. Our white spaced questionnaire found a wide discrepancy in facilitators understanding of what human factors were and how to incorporate this into simulation, with the majority placing a heavy bias on non-technical skills.

Conclusion:

There was a lack of awareness of what human factors encompass within our facilitators, likely stemming from a lack of formal training. This in turn resulted in medical students being predominantly taught non-technical skills. As our facilitators come from staff from all areas of the hospital, therefore we propose a human factors module be made available to all hospital staff, as an innovative addition to our hospitals e-Learning platform. This will be mandatory for all future simulation faculty and we hope the ease of access will increase the number of faculty trained in human factors.

References

1. The National Quality Board. Human Factors in Healthcare, A Concordat from the National Quality Board. London: The National Quality Board; 2013. https://www.england.nhs.uk/wp-content/uploads/2013/11/nqb-hum-fact-concord.pdf [Accessed on 26/06/2022]

2. Reynolds R, Blickensderfer E, Martin A, Rossignon K, Maleski V. Human Factors Training in Aviation Maintenance: Impact on Incident Rates. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. 2010;54(19):1518–1520.

3. Reedy G, Lavelle M, Simpson T, Anderson J. Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings. BMJ Simulation and Technology Enhanced Learning. 2017;3(4):135–141.