P10 Who watches the watchmen? An audit of simulation activity across a large acute hospital trust in the south west of england

Background The ASPiH Standards Framework for Simulation Based Education (SBE) in Healthcare was launched almost three years ago1 2, with the aim of defining the appropriate structures and processes required to deliver effective SBE. The new Post-Graduate Medical Education (PGME) ‘SimSpace’ at North Bristol NHS Trust was designed from the outset with reference to these standards, with programmes and activities mapped to the four key themes defined by ASPiH. Nevertheless, as a large regional trauma and tertiary referral centre, in a city with an established culture of SBE delivery, we were aware of multiple groups across our organisation also undertaking SBE on a regular basis. In order to better understand the extent and quality of SBE outside of PGME’s immediate control, we used the ASPiH Standards Framework to inform an audit of these activities. Summary of work We undertook an on-line survey of departmental educational leads to ascertain what (if any) and how frequently SBE activities are delivered, how topics and learning objectives are identified and selected, the composition and training of faculty, and who provides overall leadership for SBE within their department. We also explored their awareness of guidelines for the delivery of SBE and how these informed their departmental practices. Summary of results We found a large variation across the organisation, with some departments undertaking frequent and organised activities and others with little or no programmed SBE. There was also variation in the nature and training of the faculties used to deliver these activities, and in the design and development of SBE programmes. In departments where SBE was most established, named individuals were often identified as having overall responsibility for its delivery. Discussion and conclusions The ASPiH Standards Framework proved a useful tool for designing and implementing SBE programmes within our bespoke SimSpace environment, but variation in knowledge and implementation of this guidance across the established activities of our organisation impacted on our ability to effectively audit the quality of SBE delivered outside of our immediate circle of influence. Recommendations In an environment in which SBE is widely practiced by individuals with varying degrees of engagement with existing validated standards, structures must be developed to educate the educators and ensure the uniform high quality of SBE delivery. One solution might be the creation and adoption of ‘Simulation Registries’, mapped to the ASPiH Standards Framework, in which all SBE activities across an organisation could be catalogued for future audit purposes. References The ASPiH Standards Project Team. Simulation Based Education in Healthcare: Standards Framework and Guidance. Lichfield: Association for Simulated Practice in Healthcare 2016. Purva M, Nicklin J. ASPiH standards for simulation-based education: process of consultation, design and implementation. BMJ Simul Technol Enhanc Learn 2018;4:117–25.