Simulation-based training of junior doctors in handling critically ill patients facilitates the transition to clinical practice: an interview study

Abstract

BackgroundJunior doctors lack confidence and competence in handling the critically ill patient including diagnostic skills, decision-making and team working with other health care professionals. Simulation-based training on managing emergency situations can have substantial effects on satisfaction and learning. However, there are indications of problems when applying learned skills to practice. Our aim was to identify first-year doctors’ perceptions, reflections and experiences on transfer of skills to a clinical setting after simulation-based training in handling critically ill patients.MethodsWe used a qualitative approach and conducted semi-structured telephone interviews with a sample of twenty first-year doctors six months after a 4-day simulation-based training course in handling critically ill patients. Interviews were transcribed verbatim. A content-analysis approach was used to analyse the data.ResultsThe following main themes were identified from the interviews: preparedness for clinical practice, organisational readiness, use of algorithms, communication, teamwork, situational awareness and decision making. The doctors gave several examples of simulation-based training increasing their preparedness for clinical practice and handling the critically ill patient. The usefulness of algorithms and the appreciation of non-technical skills were highlighted and found to be helpful in managing clinical difficulties. Concern was expressed related to staff willingness and preparedness in using these tools.ConclusionsOverall, the simulation-based training seemed to facilitate the transition from being a medical student to become a junior doctor. The doctors experienced an ability to transfer the use of algorithms and non-technical skills trained in the simulated environment to the clinical environment. However, the application of these skills was more difficult if these skills were unfamiliar to the surrounding clinical staff.Trial registrationNot applicable.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1447-0) contains supplementary material, which is available to authorized users.

Non-technical skills of medical students in the course of pediatric emergency simulations are associated with their mindfulness: an observational cohort study

“…However, in other acute care simulations, non-technical skills significantly predicted students' clinical performance as assessed by nurses [15]. In one of the studies, like in our group, repeating the simulation improved non-technical skills, such as communication, teamwork, situational awareness and decision making [16]. However, Clarke et al showed that the only variable affecting the overall assessment of nontechnical competencies during simulations (also evaluated by the Ottawa GRS) was the residents' progress in the specialization program (so-called PGY status) or clinical experience rather than stress or its subjective feeling [17].…”

Simulation-based team training in time-critical clinical presentations in emergency medicine and critical care: a review of the literature

“…Improvement in Ottawa GRS, but not statistically significant from pre- to post-course. Marker et al [ 28 ] To identify first-year doctors’ perceptions, reactions, and reflection on transfer of skills after simulation-based training 4-days simulation-based training. No Ex situ High-fidelity No Interviews Increased preparedness.…”

Non-technical skills progression during anesthesiology residency in Portugal: the impact of a National Pedagogical Plan

“…Simulation activities, beyond their known impact on the learning of technical skills in a safe environment, are a powerful form of concrete and active experiences with a high retention level that potentially changes behaviors (leadership, communication, and resource management), ultimately increasing patient safety [6,15,16]. Therefore, they can be considered a bridge between theoretical lessons and clinical practice, helping junior doctors to deal with emergencies [17].…”