Life as a simulation fellow… so far! (Dr Pam Milligan)

Pam

My journey into the world of simulation began 6 months ago, at the beginning of August 2013, when I bravely stepped ‘out-of-programme’ from my day job as an Anaesthetic trainee in the West of Scotland. With a developing interest in education, and an awareness of the increasing use of simulation as a training modality, I thought this would be an exciting, useful, and most importantly fun fellowship to undertake for a year…And so far I have been right!

The first six months

In the beginning there were a lot of ‘first day at school’ moments for me. This included a crash course in technology… The limited amount of simulation I had done before during my ALS instructing had not really prepared me for mannequins who can talk, bleed, be anaesthetised and even have caesarean sections!

But being immersed with the technology, and surrounded by expert technicians and supportive educational co-ordinators at the centre, made the steep learning curve possible to climb.  I eventually felt competent to turn on the plugs, connect up the wires, and keep my fingers crossed that all the bits of equipment talked to each other. And if not, to turn them off and turn them on again…So far so good!

However, then I was introduced to the world of mobile simulation…. The centre director announced that we were packing up SimMan and Smots (our audio-visual recording systems), and going on a SimFamily day out to the SECC in Glasgow, to provide some mobile simulation for the Society of Acute Medicine Conference.   One large van and one very tiny elevator later we were, to my amazement, on the second floor of the SECC running immersive simulated scenarios, 30 miles from our home in Larbert.

SimLady showing signs of sepsis at the Sepsis Study Day, FVRH, Oct 2013

This proved to be very valuable training, as I was previously unaware that our SimMan (or SimLady,  depending on occasion) actually has a very active social life out-with the confines of the Scottish Centre for Simulation and Clinical Human Factors (SCSC^HF) (S)he regularly visits the staff in theatre recovery, the staff in ICU, and most recently made a cameo appearance at our Education Centre, helping provide training at the very successful national Sepsis Study Day for more than 100 delegates.

Non-technical skills and human factors

However, in addition to learning the technical side of simulation training, one of the most beneficial aspects of my fellowship so far, has been learning how simulation can be used to provide ‘non-technical’ skills training, in all branches of clinical practice. As the SCSC^HF is a centre of expertise not only for high-fidelity simulation, but also for Human Factors training, I have been privileged to work alongside faculty who are national experts in Patient Safety, Human Factors and non-technical skills.

I have gained huge insight into how this type of simulation training can be used to help groups of individuals work together better as teams, within their own specialist area and inter-professionally.  From the knowledge I have gained regarding the influence of human factors in healthcare, I now also understand why this type of training is so important in developing the patient-centred, safety culture which we are striving for.

The final six months

My final thoughts are on what the next 6 months of my fellowship hold in store. As an anaesthetic trainee with an interest in non-technical skills, my main project for the year has been to set up a new Anaesthetists’ Non-Technical Skills (ANTS) course, which will be run at the SCSC^HF and also at the Royal College of Anaesthetists in London as part of the Anaesthetists as Educators programme. With much help and guidance from the faculty at the SCSC^HF, which includes some of the experts who developed the ANTS framework in 2003, I am very excited that the first pilot of this course will run at the SCSC in March 2014.

And last, but most certainly not least, I am looking forward to visiting Rwanda in July 2014. Over the last few years, the SCSC^HF has formed close links with the University of Rwanda, Kigali, who have developed a programme of simulation training in partnership with visiting colleagues from Canada (CASIEF).  During my 2 week visit, I hope to run some anaesthetists’ non-technical skills training, and provide a faculty development course for the Rwandan clinicians.

In conclusion, the first 6 months of my simulation fellowship have been challenging, interesting and fun in equal measure, and I am grateful to all the fantastic staff at the SCSC^HF who have made it so.  I have no doubt the next 6 will be the same…