Just-in-time interprofessional training: lessons from the NHS Nightingale London.

The Coronavirus 2019 (COVID-19) pandemic placed significant pressure on healthcare systems across the globe, with many clinicians redeployed in unfamiliar specialties or disciplines. In England, a just-in-time interprofessional training and education programme was rapidly established to upskill nearly 2,500 people who volunteered to work at the NHS Nightingale London Hospital. Of the 488 respondents in our evaluation, representing a 20% response rate, most felt confident and safe to start work in NHS Nightingale London. Key findings were: streaming of learners should be driven by predicted shared roles in the workplace and previous experience; in situ training to experience how teams work together in the real clinical setting was well received; and online learning should be focused on essential learning. A just-in-time interprofessional training programme can be effective in upskilling and redeploying healthcare staff in emergency situations, and can be useful for supporting staff redeployment or upskilling across the NHS more widely.

Inside The O2: the NHS Nightingale Hospital London education center.

As part of the response to COVID-19 in the United Kingdom (UK) the NHS Nightingale Hospital London was rapidly established in March 2020. Set up in the ExCel, an international conference center, it aimed to address the anticipated shortfall of intensive care beds in London. Whilst this hospital garnered huge amounts of publicity in the UK, less widely discussed is the Nightingale Education Center. The education center was instrumental in ensuring that there were staff across all professions ready to work there and had interprofessional education at its core. In a period of under two months it inducted and upskilled over 2,500 people from multiple healthcare and non-healthcare professions. That is more than most hospitals would induct in a whole year. To complete interprofessional training on this scale the education center decamped from the ExCel to The O2, a 20,000 capacity arena, and remained there for six weeks beating the iconic artist Prince for the title of longest running residency. This report offers a reflection on the authors' time spent working in the Education Center as members of the 'Core Operations' team. The content of the article is based upon the authors' reflections, first-hand experiences and field observations. It offers a reflection upon the massive undertaking of setting up an education center in an entertainment venue, as well as the successes and challenges of working interprofessionally in this unique space and under pandemic conditions.

Experiences of using simulation in dementia education.

This article describes the development of a simulation training day for multidisciplinary teams (MDTs) working on acute adult wards with the aim of improving their confidence in supporting people with dementia who are distressed. Recommendations are made for those who may be interested in delivering simulation training in their area of practice. Registered nurses, non-registered support workers and occupational therapists experienced in dementia care took part in a one-day simulation training pilot session that included three 'skill stations' with three patient simulation scenarios. A session at the end of the day was used to generate qualitative feedback and develop a strategy to advance this style of teaching. Feedback highlighted the need for further development of the skill stations and scenarios. The pilot showed that simulation training works well from an MDT perspective, but the content requires careful consideration in terms of stretching participants' abilities without causing high levels of anxiety.

Reliability of team-based self-monitoring in critical events: a pilot study.

BACKGROUND: Teamwork is a critical component during critical events. Assessment is mandatory for remediation and to target training programmes for observed performance gaps. METHODS: The primary purpose was to test the feasibility of team-based self-monitoring of crisis resource management with a validated teamwork assessment tool. A secondary purpose was to assess item-specific reliability and content validity in order to develop a modified context-optimised assessment tool.We conducted a prospective, single-centre study to assess team-based self-monitoring of teamwork after in-situ inter-professional simulated critical events by comparison with an assessment by observers. The Mayo High Performance Teamwork Scale (MHPTS) was used as the assessment tool with evaluation of internal consistency, item-specific consensus estimates for agreement between participating teams and observers, and content validity. RESULTS: 105 participants and 58 observers completed the MHPTS after a total of 16 simulated critical events over 8 months. Summative internal consistency of the MHPTS calculated as Cronbach's alpha was acceptable with 0.712 for observers and 0.710 for participants. Overall consensus estimates for dichotomous data (agreement/non-agreement) was 0.62 (Cohen's kappa; IQ-range 0.31-0.87). 6/16 items had excellent (kappa > 0.8) and 3/16 good reliability (kappa > 0.6). Short questions concerning easy to observe behaviours were more likely to be reliable. The MHPTS was modified using a threshold for good reliability of kappa > 0.6. The result is a 9 item self-assessment tool (TeamMonitor) with a calculated median kappa of 0.86 (IQ-range: 0.67-1.0) and good content validity. CONCLUSIONS: Team-based self-monitoring with the MHPTS to assess team performance during simulated critical events is feasible. A context-based modification of the tool is achievable with good internal consistency and content validity. Further studies are needed to investigate if team-based self-monitoring may be used as part of a programme of assessment to target training programmes for observed performance gaps.

Impact of an embedded simulation team training programme in a paediatric intensive care unit: a prospective, single-centre, longitudinal study.

PURPOSE: To evaluate the impact of an embedded simulation-based team training programme on perceived performance and to compare the effect over different phases of the programme. METHODS: This was a prospective, single-centre, longitudinal study over the first 2 years of the programme. A total of 219 multidisciplinary health-care professionals participated in simulation sessions, followed by anonymous evaluation questionnaires. The programme was divided into three different phases: introductory (first 6 months), intermediate (second 6 months) and established phase (second year). RESULTS: A total of 88.7% of participants evaluated the impact on overall practice as effective, 56.5% reported a highly effective impact. A total of 90.9% (391/430) of questions on non-technical skills (communication and teamwork) showed an effective impact, 55.6% a highly effective impact, whereas only 70.2% (262/373) of questions on technical skills showed an effective impact. There was a significant (p < 0.001) increased score for effective impact in all categories between the introductory and intermediate phase, which was maintained throughout the established phase. Overall, 72.7% of the participants felt more confident to attend a future critical event, 32.5% were highly confident. In the longitudinal analysis there was a stepwise significant (p < 0.05) increase of confidence of participants. In a subgroup analysis (n = 143) there was a significant (p < 0.001) higher confidence in participants who had attended at least 3 sessions (90.7 vs. 61%). CONCLUSION: There is a 6- to 12-month learning curve in the implementation of an embedded multidisciplinary team training programme. Repeated exposure to simulation is most beneficial to crisis resource management training and single, isolated exposure may not be sufficient.