Education and training

Shropshire's military, NHS, and volunteer community collaborate to provide an innovative training course for medical registrars (2024)

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Type of publication:
Conference abstract

Author(s):
*Eardley K.; *Mackintosh A.; *Wood G.;

Citation:
Future Healthcare Journal. Conference: The future of medicine. RCP annual conference. Regent's Park, London United Kingdom. 11(Supplement) (no pagination), 2024. Article Number: 100046. Date of Publication: April 2024.

Abstract:
Introduction: The position of Medical Registrar is one of the most important for the delivery of safe and effective emergency care in the acute hospital. It is also one of the most challenging physically and mentally. Health Education England West Midland's School of Medicine commissioned Shrewsbury & Telford Hospital NHS Trust (SATH) to deliver a 3-day residential course specifically designed to cover a wide range of competencies and clinical skills, but specifically to help equip the medical registrar with strategies to better manage the complexity, the cognitive load, and psychological stress of the role in a fun and interactive way. Material(s) and Method(s): The course was codesigned by SATH Volunteers, 202 Multi-role Medical Regiment (202MMR), NHS England OP COURAGE, SATH Clinical Simulation team, and RCP Chief Registrar. Feedback during the course meant that delegate's individual learning needs were identified and addressed in Course. Faculty provided feedback in person and a survey monkey was sent to the delegates on completion of the course. Results and discussion: The following course was delivered to 16 Internal Medicine Year 3 doctors. Deteriorating Patient Clinical Simulation Course: Delegates managed simulated clinical scenarios of deteriorating patients. Complexity called upon prioritisation, delegation, escalation, and communication skills. Simulated relatives were used calling on skills of breaking bad news, duty of candour, best interests' decision making, and providing compassionate end of life care. Human Factors Course: 202MMR Army Reservists and permanent staff delivered a course utilising the Centre of Army Leadership training packages. Using several engaging activities, the delegates gained a greater understanding of self and how their emotions, behaviours, and perceptions play an important role in their ability to be a safe and effective clinician, leader, and follower. Hospital Cardiac Arrest Clinical Simulation Course: All scenarios led onto cardiac arrest and included additional complexity requiring discussion with relatives including breaking bad news and making end of life decisions. Mental health session: This session provided a safe space for the delegates to talk about their experiences working in the NHS. Sustaining mental health and coping strategies and concepts were explored. Written feedback from the delegates was very positive and included: 'It was the best simulation course I have ever attended'. 'Role play by volunteers from the community was a unique experience which I have not observed in previous such training. This provided excellent opportunity to receive feedback on various aspects of our performance'. 'Focus on teamwork, leadership and followership is rarely spoken about in other training. Very dynamic and engaging'. 'Training in army barracks with command tasks correlating with leadership, teamwork and human factors. Interactive sessions, everyone was involved, valued, and listened'. 'The arrest scenarios were much truer to life than ALS courses eg relatives, debrief, bleed, thrombolysis'. 'Very useful feedback. Great to have the opportunity to try this before starting on the reg rota. Hugely appreciated thank you'. Conclusion(s): Utilising the skills and experiences of the NHS, military, and wider community significantly enhances the quality of clinical simulation and human factors training for the medical registrar.

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COVID Recovery Laparoscopic Simulation Program for Gynaecological Registrars-Trainee Perceptions of Regional Model (2024)

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Type of publication:
Journal article

Author(s):
Azeem, Zahra; Odendaal, Joshua; Ghosh, Donna; *Tapp, Andrew; Hassan, Ismail

Citation:
Journal of Minimally Invasive Gynecology. 2024 May 11.

Abstract:
STUDY OBJECTIVE: The acquisition of gynaecological operating skills can be challenging for trainees given the conflicting demands of clinical work. Alternative models of surgical skill training such as laparoscopic simulation is, therefore, required. This study demonstrates the development of a regional gynaecological surgery laparoscopic simulation program and trainee perceptions of such an approach. DESIGN: An intervention-based cohort study. SETTING: A regional model based in West Midlands training region. PATIENTS/PARTICIPANTS: Responses from sixty-four trainees in the training region who participated in his regional program were included. INTERVENTION: A three-stream curriculum was developed to deliver key training outcomes as required by the Royal College of Obstetricians and Gynaecologists (RCOG) core curriculum as a component of a Covid Recovery Program. Courses were held in seven teaching hospitals. Courses consisted of both theory and practical teaching. MEASUREMENTS: A structured feedback tool was used to collect trainee perceptions of the programme. Trainee satisfaction was measured on the Likert scale of 1-3. A qualitative thematic analysis was conducted with rank-order analysis of coded free-text responses. MAIN RESULTS: Overall, the majority of trainees 92% (n=58/64) were very satisfied with the course. Rank-order analysis demonstrated hands-on-practice to be the key perceived benefit of laparoscopic simulation amongst basic and intermediate trainees whilst feedback on procedural skills was felt most useful amongst advanced trainees. CONCLUSION: A regional approach to laparoscopic simulation training is both achievable and acceptable. Trainee perceptions of usefulness are altered by seniority and experience. This should be accounted for in the development of laparoscopic simulation programmes.

Professional Education Facilitators introduction into the AHP Workforce (2023)

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Type of publication:Service improvement case study

Author(s):*Tony Davies

Citation:SaTH Improvement Hub, July 2023

Abstract:To introduce effective Professional Education Facilitators into the AHP workforce by August 2023 as evidenced by the increase in student numbers, staff questionnaires and an increase in tariff funding (which ultimately increases spending on education within the trust).

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Formative Objective Structured Clinical Examinations (OSCEs) as an Assessment Tool in UK Undergraduate Medical Education: A Review of Its Utility (2023)

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Type of publication:
Journal article

Author(s):
*Al-Hashimi, Khalid; Said, Umar N; Khan, Taherah N.

Citation:
Cureus. 15(5):e38519, 2023 May.

Abstract:
The Objective Structured Clinical Examination (OSCE) is a globally established clinical examination; it is often considered the gold standard in evaluating clinical competence within medicine and other healthcare professionals' educations alike. The OSCE consists of a circuit of multiple stations testing a multitude of clinical competencies expected of undergraduate students at certain levels throughout training. Despite its widespread use, the evidence regarding formative renditions of the examination in medical training is highly variable; thus, its suitability as an assessment has been challenged for various reasons. Classically, Van Der Vleuten's formula of utility has been adopted in the appraisal of assessment methods as means of testing, including the OSCE. This review aims to provide a comprehensive overview of the literature surrounding the formative use of OSCEs in undergraduate medical training, whilst specifically focusing on the constituents of the equation and means of mitigating factors that compromise its objectivity.

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Improving Training Compliance Cleanliness Teams (2023)

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Type of publication:
Service improvement case study

Author(s):
*Hayley Farmer, *Stacey Jones, *Julie O’Donoghue, *Natalie Matthews, *Sharon Smallwood, *Tracey Fanning

Citation:
SaTH Improvement Hub, 2023

Abstract:
Back in March 2022 the Domestic Teams statutory and mandatory training had been 83% for PRH & 75% for RSH. The domestic teams have found it a challenge in the last few months to complete their mandatory training. In June their compliance dropped to 76% for PRH and 67% for RSH and it has been difficult to raise this compliance %. This coincided with the introduction of the Learning Made Simple platform. We have taken the opportunity to investigate this variation in compliance %, looking at whether the introduction of the Learning Made Simple platform has been the main reason for a decrease in compliance or whether other factors are involved and test various solutions to increase compliance. On the 8th January 2023 report the team at PRH are now at 94.76% and 93.96% for RSH.

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Evaluating the perceptions of workplace-based assessments in surgical training: a systematic review (2022)

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Type of publication:
Systematic Review

Author(s):
Mughal Z.; *Patel S.; Gupta K.K.; Metcalfe C.; Beech T.; Jennings C.

Citation:
Annals of the Royal College of Surgeons of England. (no pagination), 2022. Date of Publication: 14 Nov 2022. [epub ahead of print]

Abstract:
INTRODUCTION: Workplace-based assessments (WBAs) are intended to maximise learning opportunities in surgical training. There is speculation as to whether mandatory assessments in this form contribute to a tick-box culture. The objective of this review was to investigate surgical trainees' attitudes towards WBAs. METHOD(S): This systematic review of qualitative studies was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. The literature was searched on the Medline, Embase, PubMed and Web of Science databases on 22 March 2022. RESULT(S): Sixteen studies were included in the review, mostly carried out on users of the Intercollegiate Surgical Curriculum Programme portfolio in the UK. Trainees felt that WBAs were educationally useful, providing opportunity for feedback, but this was overshadowed by a pressure to reach a set annual quota for WBAs and achieve high scores. Other themes included inaccurate recording of WBAs, the role of WBAs as formative or summative assessments, engagement and accessibility of trainers, and lack of time to complete WBAs. CONCLUSION(S): Negative perceptions about WBAs were widespread among surgical trainees despite a recognition of their capacity to facilitate learning. This review supports the recent removal of the annual quota for WBAs in UK surgical training programmes.

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A quantitative cross-sectional study assessing the surgical trainee perception of the operating room educational environment (2022)

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Type of publication:Journal article

Author(s):Rupani N; Evans A; *Iqbal M

Citation:BMC Medical Education, 2022 Nov 08; Vol. 22 (1), pp. 764

Abstract:Background: Limited hours and service provision are diminishing training opportunities, whilst increasing standards of surgical proficiency is being sought. It is imperative to maximise the value of each educational event. An objective measure of higher surgical trainee perception of the operating room environment in England has not been performed before and this can steer future change in optimising educational events in theatre. The Operating Room Educational Environment Measure (OREEM) evaluates each component of the learning environment to enable optimisation of these educational events. However, the OREEM has not yet been assessed for reliability in higher surgical trainees in England. The aim of the current study was to explore areas of strength and weakness in the educational environment in the operating room as perceived by surgical trainees' in one English region. The secondary aim was to assess the reliability of the OREEM.Methods: Using a quantitative approach, data was collected over one month from surgical trainees in England using the OREEM.Results: Fifty-four surgical trainees completed the questionnaire. The OREEM had good internal consistency (α = 0.906, variables = 40). The mean OREEM score was 79.16%. Areas for improvement included better learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). Trainees were most satisfied with the level of supervision and workload (average subscale score = 82.87%). The learning environment favoured senior trainees (p = 0.017). There was a strong correlation between OREEM and the global satisfaction score (p < 0.001).Conclusions: The OREEM was shown to be a reliable measure of the educational environment. It can be used to identify areas of improvement and as an audit tool. The current perception of the education environment is satisfactory, however, areas of improvement include reducing service provision, empowering trainees to plan lists, improving teamwork and using tools to optimise the educational value of each operation. There is a favourable attitude regarding the use of improvement tools, especially for dissatisfied trainees.

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