Tell me what you want, what you really, really want: Emergency Medicine trainees survey (by Laura McGregor, Ed Co for EM)

One of our aims at SCSC^HF is to maximise the utilisation and effectiveness of simulation for learning amongst frontline healthcare staff.  In keeping with this, one of the first things I wanted to do when I started my role as Educational Coordinator for Emergency Medicine (EM) at SCSC^HF was to determine the true training needs of EM trainees across Scotland.  Using this information I hoped we would be able to start adapting  and further developing  existing simulation courses as well as design new courses to meet the current educational needs of today’s EM trainees in Scotland.  The survey responses were presented at the Scottish ASPiH conference in April of this year….. for those who missed it, here is some of the detail.

Through an online survey we collected responses from 68 trainees (62% response rate).  There were responses from each of the four deaneries and across the breadth of training grades from CT1 to ST6, as well as out of programme trainees and those undertaking Paeds EM.  Of the total, 68% had previously been on a simulation based course – leaving 32% who had never had any such teaching, this didn’t truly surprise me, but I was a little saddened to think of a third of our EM trainees never having had such important educational opportunities.

Previous experiences of simulation-based medical education (SBME)

Trainees gave feedback about the positive and negative aspects of their previous experiences of SBME:

What would EM trainees like to learn through SBME?

Further to this we collected data regarding both the technical and nontechnical skills that they felt they could – and would like to – learn through SBME.   These responses in particular will aid us in shaping the development of new courses and linking them to the College of Emergency Medicine Curriculum.
The 3 highest priority technical skills were:

1. Emergency airway skills
2. Major trauma
3. Paediatric emergencies

The 3 highest priority non-technical skills were:

1. Teamwork and coordination
2. Authority and assertiveness
3. Leadership

What stops EM trainees from attending SBME courses?

We also asked about the factors that inhibit trainees being able attend courses  - 93% cited limited study leave as the main factor, and 64% also felt cost was another important factor. 

General views of EM trainees regarding SBME 

We asked questions specific to the trainees' general views of the importance of SBME in EM in Scotland.

• 95% felt that there was a need for more SBME 
• 93% felt that SBME should be formalised as part of their local training programme
• 88% felt that they would like to become a member of simulation faculty in the future and teach on simulation courses themselves
• 88% felt that improving SBME for EM in Scotland would be helpful to trainees given the current EM crisis in recruitment and retention of doctors

I was particularly encouraged by the fact that trainees are not only enthusiastic about being taught through SBME but are also keen to teach others – I am hoping that given the opportunity many might complete the faculty development course that is already available at SCSC^HF. 

So what now?

In terms of course development  - we have recently run a pilot course for ACCS level trainees that was a great success and will return in the autumn.  Later this month we are also running a further pilot course specifically for advanced Paediatric EM skills.  The PEM course has been developed by an excellent faculty - Dr Roger Alcock (Consultant in EM and PEM at Forth Valley), Dr Marie Speirs (Consultant in PEM at Yorkhill RHSC), Dr David Rowney (Consultant Anaesthesia, Intensive Care and Retrieval at Edinburgh RHSC) and me.  This pilot course is already overbooked and I am sure is going to be a great success and prove to be popular.  Each of these courses are also aimed at developing the nontechnical skills that have been highlighted as important learning needs – particularly teamwork and team coordination.

Further to this we are currently examining the possibility of developing a Major Trauma Course (potentially led by SCSC^HF faculty as in situ training within individual Emergency Departments) as well as a course designed specifically for EM trainees in Obstetric and Gynaecological Emergencies.  Although the target audience for these courses will initially be the EM trainees themselves, it is intended and anticipated that nursing staff and paramedic staff will be involved in time as observer candidates.  

So to conclude…. the trainees have told us what they really, really want…. And we will continue to try to fulfil these specific trainees needs at SCSC^HF.

For more info:

Have a look at our EM page on the website:
http://scschf.org/courses/emergency-medicine/

Contact Laura:
Laura.McGregor@lanarkshire.scot.nhs.uk