P38 Our experience of diversifying simulation

Background Medical simulation is widely used in both undergraduate and post graduate medical education. A number of established formats exist, including linear, branching, rapid cycle simulation and Live Die Repeat. 1 2 There is literature supporting improved patient safety, technical and nontechnical skills following the use of educational simulation. However, simulation provision and its evaluation tends to be in terms of individual simulation formats, rather than including a number of formats within a multimodal session. A multimodal educational session has the benefit of reinforcing learning using different learning styles. We document our learner and faculty experience of multimodal simulation sessions, comparing them to standard single format simulation. Methods Learners attended either BST only simulation, or BST/LDR combined simulation sessions. Pre and post questionnaires were completed by the learners, recording their responses using seven-point Likert scores. Technical and non-technical task confidence was scored, as well as overall session feedback. The BST/LDR learners also completed a LDR white box survey. Results In total 16 FY1 and 14 FY2 doctors attended one of six simulation sessions (19 BST and 12 LDR/BST). Learners reported a positive experience for LDR/BST sessions, preferring them to BST only sessions. Combined sessions recorded improved scores for simulation enjoyment as well as confidence in non-technical skills compared to BST only sessions. Of the 12 LDR/BST learners, 11 preferred the LDR simulation format. One participant scored LDR and BST as equal. All 12 stated that LDR reinforced their learning and that they would attend another LDR simulation session. The delayed 3 month survey also recorded a change in clinical behaviour from one participant following the LDR/BST simulation session. Discussion and conclusion The combined LDR/BST sessions achieved higher scores for simulation enjoyment as well as improved confidence in non-technical tasks. This may represent the merits of diversifying simulation sessions to reinforce learning via different simulation formats with the same session. Alternatively, the improved scores may signify the specific benefits of LDR as a simulation format. Our institution plans to complete LDR only sessions, as well as combined simulation sessions to incorporate linear and rapid cycle simulation. Educational theory supports the potential benefits of reinforcing learning with a multimodal simulation approach. However, more research and practical work needs to be undertaken to explore the actual benefits for learners. References Cook DA, Hamstra SJ, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Med Teach2013;35(1):844–75. Sunga K, Sandefur B, Asirvatham U, et al . LIVE. DIE. REPEAT: A novel instructional method incorporating recursive objective-based gameplay in an emergency medicine simulation curriculum. BMJ Simulation and Technology Enhanced Learning 2016;2:124–126.