High fidelity simulation suite for respiratory physiotherapists

ABSTRACT

Keywords Simulation;Respiratory;Education Purpose: On-call physiotherapy can be a daunting and stressful experience. The aim of the high fidelity simulation suite in clinical education is to practice true to life on-call scenarios in a safe, supported and non-judgemental environment. The objectives included increasing confidence in assessing and treating acutely unwell deteriorating patients;improving communication between physiotherapy colleagues and the MDT and escalating care appropriately. Methods: Six case studies were designed to replicate a true to life situation to challenge clinical reasoning and help improve confidence in an on-call situation. A simulation co-ordinator was present during the simulation to act as the nurse on duty. The participants were encouraged to communicate with each other and work together. They could ask the nurse questions and the control room could feedback the information. The facilitators in the control room observed the simulation, changed clinical observations in response to treatments and responded as the patient through a microphone. The simulation was fluid and whilst it was designed to target specific clinical skills, if clinically reasoned the participants could use any treatments that they felt were appropriate. Colleagues watched the simulation from a viewing room and made notes to feedback to their peers. After the simulation, a de-brief was carried out to enable participants to reflect on the scenario in the form of facilitated discussion to share learning from each other. Results: We have successfully completed 6 scenarios with 20 physiotherapists. Reflections were completed via a group de-brief and participants were given the opportunity to complete a structured reflection for continuing professional development. Participants’ feedback in response to the simulation was very positive, reporting to be “just right” in terms of skill level and beneficial to their clinical and professional development. It has increased participants confidence in assessing and treating acutely unwell patients as well as highlighting the importance of escalating care to the appropriate members of the multi-disciplinary team, identifying strategies for effective communication. Conclusion(s) The experiences created an open learning environment in which mistakes were not judged but lead to a greater potential for continuing professional development via self-reflection and peer reviews. Whilst some found the experience daunting and uncomfortable it has the potential to increase skills, knowledge and confidence, similar to the findings by Mansell, Harvey and Thomas, 2019. High fidelity simulation could increase skills of non-on-call physiotherapy staff quickly to help meet workforce requirements demanded by surges to service demand such as the COVID-19 pandemic. This has highlighted the need to transform clinical education to improve service provision and delivery of on-call physiotherapy service and enhance patient experience. Further investigation is warranted to identify how high fidelity simulation could also enhance collaborative working within the multi-disciplinary team in acutely unwell patients. Impact The project can be used as evidence for the use of high fidelity simulation I on-call physiotherapy training for increasing respiratory competence of newly qualified physiotherapists and students;upskilling non-on-call physiotherapists according to workforce requirements and improving multi-disciplinary team working. Funding acknowledgements Not funded.