Amrita D’Souza, Catherine Hornby, Tony Little, Poonam Patel, Helen Ward, Ravi MenonThis month we are focusing on the work of the London and South East region from the perspective of IMT2s and incoming associate college tutors (ACTs) at North Middlesex Hospital in London. The doctors reflect on developing a simulation programme designed to help address the common fear held by IMTs of stepping up as future IMT3 medical registrars.
As IMT2s and incoming associate college tutors (ACTs), we felt the need to develop a simulation training programme tailored to IMTs at our hospital, which would also help to address the common fear held by IMTs of stepping up and leading arrest or peri-arrest calls as future IMT3 medical registrars. In August 2022, we founded and organised the monthly IMT Peri-Arrest Sim Training programme, which is facilitated by Mr Tony Little, lead resuscitation practitioner at North Middlesex University Hospital, London (NMUH).
We conducted pre-sim and post-sim questionnaires in order to assess confidence and familiarity of IMT1–3s in participating in and leading peri-arrest and arrest calls in PDSA Cycle 1. We have now conducted three peri-arrest sim sessions over 4 months and are collecting longitudinal feedback following our IMT cohort through the year, tracking their confidence after repeated sim sessions.
'We felt the need to develop a simulation training programme tailored to IMTs at our hospital, which would also help to address the common fear held by IMTs of stepping up and leading arrest or peri-arrest calls as future IMT3 medical registrars.'
Following on from this, we pioneered the IMT Mixed Faculty Sim programme. Our first pilot ran in November 2022 with participation from nursing colleagues recruited via practice development nurses (PDNs) to increase fidelity and formal teaching on human factors, facilitated by Dr P Patel, our trust simulation lead and paediatric ED consultant. We conducted pre- and post-mixed faculty sim pilot questionnaires, which showed increased confidence of IMTs participating in peri-arrest and arrest calls, as well as increased familiarity in the concept of human factors, in PDSA Cycle 2. IMT3s also felt they had more familiarity in debriefing peri-arrest and arrest calls post pilot. Free text answers also included feedback that it was: ‘a really useful concept for multi faculty [Sim]’ and that it was ‘good to have nurses and other IMTs in the scenarios to learn from them’.
Our IMT Mixed Faculty Sim programme is planned from January 2023, based on IMT scenarios from HEE that meet the IMT curriculum and have been written by previous IMT3s. These scenarios can be adjusted by our Sim Faculty for different IMT grades who attend and involving trainees at each level as separate plants. Our Sim Faculty also includes medical consultants, Dr Helen Ward and our IMT training programme director Dr Ravi Menon.
We will conduct pre- and post-Mixed Faculty Sim session questionnaires for each session in 2023 and reflect on feedback from each session to implement change into the next PDSA cycle and shape our sim programme. We aim to establish its continuity beyond our year as ACTs at NMUH.
Acknowledgments: We would like to thank Dr Falguni Tailor and Dr Clara Salice for their help with designing pre- and post-sim questionnaires for our monthly Peri-Arrest Sim Training programme.We would also like to thank Idi Arewa (practice development nurse) and Pajany Vythelingum (former trust sim lead) who helped to recruit nursing colleagues for our Mixed Faculty Sim programme. Finally, thank you to the IMTs and the nursing colleagues who attended and participated in our sim sessions and for their valuable feedback.