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Simulation

A national strategy is being developed to ensure that we can continue to ensure equity of access to simulation education and training across England that provides value for money and delivers patient-centred and high-quality educational outcomes.

We want to work in close collaboration with simulation networks and education experts to implement this strategy and ensure that blended learning using simulation, e-learning and other technology and techniques become commonplace in curricula and training pathways and in continuing professional development.

The simulation strategy is aimed at:

  • Ensuring there is equity of access to simulation facilities, equipment, faculty and learning opportunities nationally, so that all learners and staff can benefit
  • Developing a distributed network, so that common systems are in place
  • Shaping standards for the delivery of simulation education and training so that high standards of delivery are provided
  • Growing the evidence base for the effectiveness of simulation, so that there is continuing improvement

The next steps are to work with simulation groups, partners and other key stakeholders across our organisation to develop the national simulation strategy. This will be aligned with the objectives in the our Mandate and other national programmes, together with the our TEL strategy, other key national reports and guidance.

Whilst work needs to be carried out to shape the national simulation strategy, existing work is being delivered that supports the overarching aims.

The TEL Programme team has been working with the Association for Simulated Practice in Healthcare (ASPiH) to develop the simulation standards aimed at all healthcare professionals to design and deliver effective simulation education, grouped around broad themes: faculty, activity, resources. These are currently in draft format and further work is underway to engage and consult on their deliverability.

Working with the Joint Royal Colleges of Physicians Training Board (JRCPTB) and with an expert group, work has been undertaken to look at how to effectively embed simulation into core medical training (CMT) curricula. The output of this work is detailed in the joint report Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach.

The recommendations are based on a detailed review of the literature and expert opinion on best practice. It examines those aspects of the CMT curriculum that can be appropriately and effectively taught using SBE and provides recommendations for their mandatory implementation.

The key findings are as follows:

There is good evidence (T3)1 that certain CMT practical procedures (central venous catheterisation, thoracentesis, abdominal paracentesis) and emergency presentations (cardiorespiratory arrest) can improve patient outcomes if taught using SBE. There is no obvious reason why additional CMT procedures should not also be taught using SBE, indeed the evidence points to it being desirable to do so

There is reasonable evidence (T2) that non-technical and human factors skills required by CMT can be effectively taught using SBE

The teaching of CMT essential and desirable procedures (see Appendix 2 for more details) and also non-technical skills using SBE is already widespread within the UK and CMT TPDs support this training.

The findings are intended to assist Training Programme Directors, Heads of Schools of Medicine, Foundation Schools, Local Offices of HEE, consultants and everyone else involved with the delivery of CMT, in understanding exactly how and where simulation can be used most effectively to improve educational outcomes and trainee experience.

The report and its findings were discussed at the Conference of Postgraduate Medical Deans (COPMeD) in February 2017 and received well. Following this, the JRCPTB will put the proposal for simulation to be included as a mandatory element of the new internal medicine curriculum, to be submitted to the General Medical Council later in 2017.

The supporting evidence for this action, plus additional recommendations, is discussed in the main report. It should be noted that all different types of SBE can be used to achieve the required learning outcomes. Examples include (but are not limited to) task training, manikin-based simulation, standardised patient approaches or virtual reality. This is subject to the availability of equipment and faculty.

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