High-fidelity in-situ simulation – A novel training modality for non-invasive ventilation

Introduction: Non-invasive ventilation (NIV) is an expanding treatment modality requiring staff experience and training to ensure clinical effectiveness. Non-specialist junior doctors and nurses often have infrequent exposure to NIV thereby limiting confidence. Patients requiring NIV are often critically unwell and effective crisis resource management (CRM) skills (e.g. communication, leadership, task delegation) are often critical in achieving patient compliance and formulating clear treatment plans. For these reasons, high-fidelity simulation provides an opportune training modality where trainees can practise in a safe “real” setting to increase self-confidence and develop key CRM skills. Method: We designed an “in-situ” high-fidelity simulation-training module where trainees partake in pre-designed undisclosed scenarios leading a multidisciplinary team involving a nurse blind to the scenario and faculty “plants”. Scenarios are constructed to provide challenging clinical and ethical situations pushing trainees abilities to promote key skills at a registrar level. Candidates used a 6-point Likert Scale questionnaire to self-analyse their performance and learning post-simulation. Results: Pilot results show trainees have found the module improves confidence in managing respiratory failure requiring NIV when added to a standard training programme. The module additionally develops trainee insight into their situational awareness as well as key communication, clinical decision-making, leadership and team-working skills enabling a structure for future focused improvement. Conclusions: High-fidelity simulation can be used as an effective training tool as part of a comprehensive NIV training programme.