SC4 Returning to work in anaesthesia: simulation for success

Returning to work after a significant break can be daunting. For anaesthetists any hiatus from clinical practice can impact on their performance of essential practical skills, clinical judgement, situational awareness and the ability to remain calm under pressure. In 2012 a Return to Work (RTW) survey in the West Midlands found that 71% of trainees had difficulties returning after a prolonged break and that their return could have been improved. Guidance from the Royal College of Anaesthetists (RCoA) recommends a structured, supported return after a break of more than 3 months and subsequently a RTW programme has been introduced in this region. A repeat survey in 2015 showed an improvement in the RTW process but suggested some training specifically for those returning to work would enhance the programme. Consequently, we devised a course specifically to target this need using high fidelity simulation training as the basis for a refresher course. Our first course took place in April 2016; this was a combination of simulation training using SimWard and small group discussions. Candidates ranged from CT1 to consultant, all of whom had been off for more than 6 months for a variety of reasons. A pre-course questionnaire was sent out to gauge expectations and areas of concern. 67% had done nothing else in preparation for their RTW and 50% felt that time away had impaired their performance. Unsurprisingly, practical procedures, decision making and dealing with emergencies needed attention, with 67% reporting low levels of confidence in their ability. The course was very well received; universally recommended and complemented on the “realistic scenarios” and “very friendly and approachable faculty”. Candidates agreed that it increased knowledge, confidence, would improve patient safety and reduced anxiety. We have two further courses in 2016, where we will build and improve on the progress already made.