Paediatric simulation training - a hospital wide initiative.

Within a district general hospital in Scotland, paediatric simulation took place on a dedicated day every 4 months out with the ward area. This proved difficult to sustain because of ward constraints and only a small number of staff benefited because these sessions ran so in-frequently. These issues prompted a review to investigate how effective simulation could be achieved for all staff involved in caring for children. In situ Simulation according to Lok et al (2015) can detect deficiencies in clinical systems and the environment which in turn can improve clinical practice and patient safety. These findings reflected the goals of the unit’s educational philosophy. Two wireless mannequins were purchased which could be used throughout the hospital to enable staff to access training within their own clinical area.
Description: Following the above review it was decided that simulation would take place on a weekly basis on a day when the on-call consultant paediatrician was available for a period of time to facilitate simulation. The simulated sessions take place within the paediatric ward area with all members of the multidisciplinary team being involved. The Sessions are timetabled into the medical students teaching rota. In addition sessions have taken place in theatre recovery, clinics and accident and emergency. These scenarios have been developed to suit the specific learning needs of that particular area. Varied medical and surgical clinical scenarios are used to ensure there are a wide range of conditions covered.
Observation: Between January – September 2015, 21 documented simulations have taken place. The occasions where simulation did not take place were due to ward constraints and mannequin malfunction. Within the debrief, learning points are discussed and each participant is asked what they have learned from the session. These learning points are all documented as well as action points. The learning points are broken down to generic and condition specific and are highlighted every morning at the medical/ nurse handover to ensure dissemination of the information to all staff. The learning points are displayed within the ward area as well as e-mailed. The action points are specific issues that have been raised within the simulation that require an action.
Discussion: Within the district general hospital, paediatrics are seen as the driver in simulation as it is now embedded into our teaching and learning practice. A study by Seethamraju and Mackinnon (2014) looked at behaviours within simulation and they found that there is an increase in confidence and skills through simulation as long as it is an ongoing process. The learning points have been greatly received by all members of the multidisciplinary team, however an evaluation needs to be undertaken to determine how beneficial
the staff feel weekly simulation is to their practice.