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Thackray D.1, Berry M.2, Burrell F.3, Chapman R.4, Ewings S.5, Gough S.6
1University Southampton, Faculty of Health Sciences, Southampton, United Kingdom, 2HHFT, Physiotherapy, Basingstoke, United Kingdom, 3HHFT, Physiotherapy, Basingtoke, United Kingdom, 4HHFT, Physiotherapy, Winchester, United Kingdom, 5University Southampton, Statistical Sciences Research Institute, Southampton, United Kingdom, 6Manchester Metropolitan University, Manchester, United Kingdom
Background: This project focused on newly qualified staff and non-respiratory qualified staff attending a bespoke simulation-based training programme to prepare them for on-call duties.
Purpose: All qualified physiotherapists are expected to participate in respiratory on-call provision even if respiratory is not their chosen speciality. Senior respiratory staff identified that there was a lack of uptake in the mandatory on-call training and they were keen to develop a simulation-based education (SBE) programme. Collaboration between educators and clinicians led to the development of a bespoke SBE programme using the Integrated Simulation and Technology Enhanced Learning ISTEL1 framework and conceptual model of cardiorespiratory clinical reasoning2. Real on-call case studies were modified and learning outcomes were mapped to the Association of Chartered Physiotherapists in Respiratory Care ACPRC competency matrix3.
Methods: Staff attended a one-day SBE programme where they assessed and treated 3 adult patients in the first phase of the training programme and 3 adult case studies and one paediatric case study in the second phase. The ACPRC on-call competency questionnaire3 and the Critical Thinking in Respiratory Care questionnaire4 (CTRC) were used pre and post training. The perceived effect of the simulation training was measured post training using the Satisfaction with Simulation Experience Scale5 (SSES).
Results: Data from the first phase has shown forty-three qualified staff volunteered to participate, 81% were female. Sixty seven per cent worked within respiratory, with 72% of those working in inpatients. Of those working outside of respiratory, 54% had treated respiratory patient within the last 3 years. A Wilcoxon Signed Rank test was used for pre-post intervention data for clinical reasoning and competency. This is presented as a median difference and p value (MD, P value). Significant improvements were observed in all areas of the ACPRC on-call competency questionnaire following SBE: assessment (-1.5: 0.020), treatment (-2:0.0005), competence (-2.5:0.020) managing (-1;0:002), confidence (-1: 0.043) and skills matrix total 0.0005. Significant improvements were observed in five of the seven sections of the CTRC questionnaire post simulation: anticipating (1:0.015), trouble shooting (2:0.001), negotiating ((1:0.031), decision making (1:0.032), reflecting (1:0.004). No significant changes were seen for prioritising (0:0.110) and communicating (0:0.918). Satisfaction with simulation as training medium was good: the minimum score was 3.7, maximum 5.0, with median of 4.3, (likert scale 1-5). Data is being collected for the second phase of the project.
Conclusion(s): Overall, data suggests that simulation based on-call training improved self-reported competency and clinical reasoning.
Implications: This is the first study of its kind to evaluate the impact of the training on self-reported clinical reasoning and competency. The design principles have been repeated at a second Trust using new case studies suited to the training needs of their staff. It is anticipated that data from both projects will contribute to understanding if SBE is of value for newly qualified staff and non-respiratory staff. It may also lead to developing a national framework for SBE on-call training programme using this pedagogy. Further evaluation is being undertaken of the second phase of this project and a cost analysis of providing this method of training.
Funding acknowledgements: This project was supported by a grant from Higher Education Innovation Fund, University Southampton.
Topic: Education: methods of teaching & learning
Ethics approval: University Southampton Ethics and Research Governance committee approved this study. Ethics number 16920.
All authors, affiliations and abstracts have been published as submitted.
