International Journal of Healthcare Simulation

Background and aim:

High-consequence infectious diseases (HCID) are pathogens which spread easily between people, have high mortality rates, and lack effective treatment [1]. Examples include Ebola and Lassa fever. Most emerging pandemics, including COVID-19, are initially classified as HCID.

Assessment of patients with suspected HCID infection is an advanced procedural skill requiring application of enhanced infection control measures including patient isolation, personal protective equipment, and decontamination. There is a risk of healthcare worker infection if procedures are not followed [2]. HCID often present in non-specialist centres; there is a need for an accessible, educationally effective HCID course for NHS staff.

Activity:

We developed a course for clinicians in infectious disease and emergency medicine, in collaboration with the Health & Safety Executive and clinicians in the UK-HCID network. The course uses a blended approach; theoretical components are taught with online learning. Practical components are taught with high-fidelity, multidisciplinary simulation using VIOLET, a mannequin which coughs, vomits and sweats ultraviolet markers (Figure 1-A51) [3]. This simulates airborne, contact and fomite transmission, allowing visualization and debrief of contamination before and after PPE removal. Training culminates in summative assessment. Educational effectiveness was evaluated through curriculum-linked pre- and post-course tests, and self-rated confidence using Likert scales.

Figure 1-A51:

Ultraviolet tracers are used to replicate contact and airborne transmission of infectious pathogens in simulation scenarios

Findings:

Between 01/12/22 and 01/04/23, 57 specialized clinicians participated. All participants passed post-course competency-based practical assessments. Participants demonstrated significant gains in knowledge between pre- and post-course tests (mean score 61% vs. 83%, p = <0.0001). Pre-course, 36% (19/53) of learners reported feeling confident or very confident at PPE donning and doffing, rising to 97% (32/33) post-course. All participants rated their learning experience as high or very high quality.

Conclusion:

This is the first HCID simulation course internationally using ultraviolet markers to allow visualization of contamination. The course appears to be an effective educational intervention and improves learner confidence in PPE use.

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.