IntroductionLearning from simulation takes place to a large extent in debriefing; however, there is still sparse knowledge about the advantages and disadvantages of debriefing methods. 2 common forms are video-assisted and oral only debriefing. We set out to determine if there is increased knowledge acquisition for candidates undergoing video, rather than oral debriefing.MethodsSecond year doctors were randomised to a training day with oral or video feedback. Candidates underwent an emergency clinical scenario followed by feedback. The candidates completed 30 multiple choice questions related to managing common clinical emergencies presimulation and postsimulation training.ResultsThere was no significant difference in the postscore mean for the oral debriefing (128.3, SD 5.16) and video-assisted debriefing group (127.1, SD=5.96). There was significant interaction between precourse and postcourse scores with superior knowledge acquisition for candidates with lower precourse scores (p=0.008). The candidates with lowest precourse score showed significant improvement in the orally debriefed group in comparison to video debriefed group.DiscussionOur results showed that video debriefing has equivocal effect to oral debriefing. Oral debriefing provides superior knowledge acquisition to learners with lower precourse test scores.
Background Simulation is used in summative assessment for major Genito-Urinary Medicine Examinations such as Dip GUM1 and Dip HIV2. However, the use of simulation to enhance induction training of junior doctors is not widely practiced. A recent trainees’ survey in GUM showed around 85% of trainees would find simulation helpful if it is included in their induction program. We are therefore proposing to run a simulation based induction course for the new trainees in GUM. Methodology The course will consist of 2 sessions Session one: Skills workshop Stations will include: Female Pelvis: practice speculum insertion, cervical cytology sampling, obtaining microbiology samples and bimanual examination Male Pelvis: practice examination and sampling techniques. Pelvis for rectal examination: practice examination of the prostate, proctoscopy and sampling techniques Skin infections and Anatomy of Male and female genital tract: illustrations of normal anatomy and common dermatological conditions. Practice the use of liquid nitrogen and curettage Session two: Scenario-based simulation 5 to 6 clinical scenarios, based in a simulated GUM outpatient clinic based on commonly presenting cases. The aim is to enhance the relevant communication skills needed in a GUM setting. Expected outcome Improvement in examination skills and efficiency Increase in awareness and knowledge of commonly presenting conditions in GUM Increase in confidence during clinical consultations Potential impact Adequate preparation will increase trainees’ efficiency and level of confidence in tackling difficult cases Better understanding of the nature of work in GUM and team dynamics will improve working relationships which will ultimately result in better patient care References The Society of Apothecaries of London: Guide to Genitourinary Medicine. Version 2014/21 (last accessed June 2014) The Society of Apothecaries of London: Guide to the Diploma in HIV Medicine Version 2014/17 (last accessed June 2014)
A needs analysis is the cornerstone of an educational programme development.1 Most needs analysis of felt needs is performed through surveys as they are easy to conduct. More innovative strategies are needed2 to generate needs analysis for new courses development. Focus groups are ideal for generating discussions around ideas expressed,3 in order to explore perceptions in depth. Being commissioned by the Yorkshire Deanery to create a new simulation-based course for FY2 doctors, we conducted a focus group interview with an aim to identify trainees’ needs, and build a new course based on both the existent curriculum, and their felt needs. Methodology Clinical governance approval was obtained. FY2 doctors from Hull and East Yorkshire NHS Trust were invited to attend. Eight trainees attended from a variety of placement following formal consent for participation. The facilitators framed the discussion using four questions. The discussion was transcripted and analysed using Krueger’s framework. We designed a simulation course addressing clinical and communication challenges. Results We present how the focus group results are linked to this new course and how the post course feedback validates and confirms the focus group results. 98% of the course participants reported the course as ‘’ very relevant to their needs’’. Conclusions We have demonstrated that stakeholder input prior to conception of a course are vital for the success of the course. One could argue that a single focus group interview is not enough for obtaining reliable results, but this problem was reduced by inviting trainees from different specialities, and different hospital placements. We believe that focus group interviews should be adopted more widely for ascertaining views of participants to support new course development. References Lockyer J. ‘’Needs Assessment: Lessons Learned’’, The Journal of Continuing Education in the Health Professions 1998;18:190–192 Norman GR, Shannon SI, Marrin ML. ‘’The need for needs assessment in continuing medical education’’, BMJ 2004; [doi: .]- online Krueger RA, Casey MA. Focus groups: A practical guide for applied researchers, 2000; (3rd ed.). Thousand Oaks, CA: Sage
Background To effectively run immersive simulation, we utilise actors taking on various roles.1 Although some centres have a bank of medical actors, many are unfamiliar with high fidelity simulation. As simulation-based learning becomes increasingly embedded in training, we anticipate increasing demand in the number of actors.2 Currently there are very few train the trainer courses to train actors for medical simulation, and we have identified a need to provide this. We present our proposed day programme for novice actors. Methodolgy After an initial period working with simulation naive actors, and taking into account their feedback we identified 4 domains: background and purpose of simulation, role of the actor in debrief, technology used with simulation including filming, and practical theory. The training day will be run within our simulation centre combining small group lectures and discussion, practical demonstration and opportunity to practice within a real simulation with peer feedback. Results We will assess the effectiveness of our course through self reported confidence levels in understanding of basics of simulation and application to medical teaching, ability to understand scenario objectives and their role in the scenario, ability to provide debrief. We will use pre and post test design to gauge improvement of confidence levels and gather qualitative data from reflections to enable us to get a wider perspective of their views. Potential impact We believe that this first train the trainer course for actors in our region will enable us create a bank of actors who will not only help deliver simulation in our centre but also maximise our ability to deliver high quality immersive simulation courses. By liaising with the actors, we will be able to reflect on the scenarios and their realism We believe that our model of training can be replicated elsewhere to build a strong supply of actors. References Cleland JA, Abe K, Rethans JJ. The use of simulated patients in medical education: AMEE Guide No 42. Med Teach 2009;31(6):477–86 Nestel, et al. Key challenges in simulated patient programs: An international comparative case study. BMC Medical Education 2011;11:69
Background Learning from simulation takes place to a large extent in debriefing,1 however there is still sparse knowledge about the advantages and disadvantages of debriefing methods.2 Two common forms are video-assisted and oral only debriefing. We have set out to determine if there is increased knowledge acquisition for candidates undergoing video, rather than oral debriefing. Methodolgy Qualified second year doctors were randomised to a training day with either oral or video feedback. Candidates underwent a 15 min emergency clinical scenario followed by 30 min feedback. The candidates completed 30 MCQs to establish baseline knowledge of treating common clinical emergency scenarios, and repeated these after simulation training. From projected statistical analysis we will have a sample size of 135 candidates. Results Interim results for 97 candidate’s pre and post course MCQs are available at this time. Both groups have demonstrated a statistically significant increase in their pre and post test percentage score (oral 79.9% vs 85.9%, p =< 0.0001, video 80.0% vs 84.9%, p =< 0.0001). There is no statistically significant difference in the post test percentage scores between oral and video groups (85.9% vs 84.9%, p = 0.2576). Potential impact There is an improvement of knowledge from the simulation training day, but we have not demonstrated a difference between video to oral debriefing. Simulation training aims to teach human factors abilities which MCQs are unable to measure. We will also be undertaking 3 month interviews to analyse candidate’s understanding of human factors and how they relate to their work. This will allow us to investigate further the role that video feedback can play in simulation-based learning. References Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005;27(1):10–28 Raemer et al. Reseach regarding debriefing as part of the learning process. Simul Healthc 2011;6(Suppl):S52–7
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