A simulation programme for foundation doctors focusing on the management of acutely unwell patients

This page is aimed at people who work in medical education and training. It gives information about the successful organisation of a simulation programme for foundation doctors at the North Bristol NHS Trust.

What is the simulation programme?

The initial assessment and management of acutely unwell patients is an area that many foundation doctors find challenging and stressful.

The influence of human factors on a doctor’s ability to work under pressure is increasingly recognised by the medical profession. But many junior doctors have limited awareness of this.

Immersive simulation can be used to develop an understanding of the importance of human factors and focus on changing doctor’s behaviour to improve the management of acutely unwell patients.

What has been introduced?

At North Bristol NHS Trust the postgraduate centre runs a regular simulation programme for foundation doctors, which focuses on the management of acutely unwell patients in the crucial first 15 minutes. Each foundation doctor must attend two simulation sessions throughout the year. These sessions incorporate a range of acute scenarios which the junior doctors may encounter on the acute hospital wards.

During these sessions, the doctors have to rapidly assess a deteriorating patient and initiate appropriate management. The faculty has a range of medical conditions it can incorporate into the scenario to challenge the learners.

Following each scenario, there is 30 minutes of debrief. This follows a standardised framework (adapted from the frame-based feedback tool) and focuses on the clinical and non-clinical human factor aspects of the scenario.

Detailed information

Improving clinical skills

Foundation doctors have been very receptive to this shift in focus of the simulation training towards addressing human factors and how they influence their clinical practice.

Scenarios and debrief have increased their confidence in both clinical and non-clinical areas. The majority of foundation doctors have noticed that simulation training has improved the following skills: prioritisation, situational awareness, teamwork and delegation.

I want to learn more

For further information, contact Dr Charles Durdin at charles.durdin@nbt.nhs.uk or Dr Kay Spooner at kay.spooner@nbt.nhs.uk.