International Journal of Healthcare Simulation

Background:

Learning Together is a training model providing general practice (GP) and higher psychiatric trainees with peer learning opportunities across London in partnership with Health Education England. The initiative encompasses inter-speciality training days and joint clinics delivered by trainee pairs aiming to bridge the gap between mental healthcare in primary and secondary care. On the basis of this model, a full-day online simulation-based education (SBE) course for these groups was designed and delivered with a specific focus on inter-professional education and issues related to co-consulting ^[1].

Aims:

The aim of this study was to use SBE to enable sharing of knowledge, skills and approaches to clinical practice to improve inter-professional collaboration in the context of co-consulting in primary care.

Method:

A full-day online SBE course for GP (ST2/3) and higher psychiatric trainees (ST4 and above) was delivered to 64 participants over six deliveries. It included five live scenarios using professional actors depicting mental health presentations to reflect the overall learning objectives. Scenarios were followed by a structured psychologically informed debrief chaired by trained facilitators with support from an external senior GP. A mixed-methods evaluation was used. Participants completed the Human Factors Skills for Healthcare Instrument (HuFSHI) pre- and post-course, rating their level of self-efficacy in managing issues, such as ‘constructively managing others’ negative emotions at work’ and ‘working effectively with a new team in clinical situations’ (Cronbach’s alpha = 0.96) ^[2]. Participants rated aspects of course quality on a 5-item scale and provided additional course feedback via open-ended questions.

Results:

Responses from 51 participants were analysed (response rate = 79%). Median HuFSHI scores increased from 70 to 86 for the overall group (Z = 5.881, p < 0.001). Sub-group analysis between both trainee groups (i.e. GP and higher psychiatric trainees) showed no significant HuFSHI score differences. High scores were reported for scenario quality (90% of participants) and provision of a safe and constructive learning environment (91.7% of participants). Ninety per cent of respondents would recommend the course to colleagues. Emerging themes from the qualitative data were positive reflections on the importance of patient-centred care and appreciation of the value of inter-professional collaboration and joint clinics.

Implications for practice:

Findings demonstrated improvements in participants’ self-efficacy as measured by HuFSHI. Qualitative data suggest a deeper understanding and appreciation of patient-centred care and inter-professional collaboration. Considering the need for early intervention, prevention and delivery of mental healthcare in primary care, this early evidence supports the potential role of SBE in developing integrated care.