SC14 ‘human factors day’: ward simulation for developing medical students’ non-technical skills

Background Non-technical skills, or ‘Human Factors’ are the skills required to interact with colleagues and the work environment. 1 They include team working, prioritisation, time management and situation awareness; poor performance in these domains can lead to error and clinical incidents and therefore impact patient safety. Recently there has been a focus towards improving Human Factors with team training exercises, often using simulation. The use of simulation has gained popularity as it provides a ‘safe space’ for trainees to practice before encountering a real patient, thus preserving and enhancing patient safety, which is especially relevant in the undergraduate domain. Simulation can facilitate practical team-based learning, and teamwork training has been shown to improve performance and enhance patient safety, for example in obstetrics, where team training has been shown to reduce adverse neonatal outcomes. 2 Summary of education programme The ‘Human Factors Day’ was designed to introduce and develop final year medical students’ non-technical skills within a simulated ward environment. As an immersive simulation experience, pairs of students worked their way around 7 scenarios to cover common situations students may experience when they become foundation doctors. The scenarios were designed to interact to introduce distraction and create the illusion of a busy medical ward; each scenario focused on a different non-technical skill. Results 47 out of a total of 87 students (54%) over two academic years filled out an evaluation questionnaire (in addition to standard feedback), designed to assess readiness for the GMC’s ‘outcomes for graduates’. The results show that 70% of students felt prepared for their foundation jobs following the simulation day (this is similar to figures from the GMC, 2014), and 85% felt that the skills learnt through simulation had set them up well for working as a foundation doctor. For specific non-technical skills competencies there were high levels of preparedness; ‘adapting to change and uncertainty’, ‘prioritization’ and ‘team-working’, preparedness increased to 79%, 85% and 100% respectively. Discussion, conclusion and recommendations Developing skills to deal with the non-technical aspects of medicine is key for undergraduate medical trainees. An effective way to develop these skills in a safe environment is with the use of a ward simulation. Using this intervention was associated with high levels of preparedness both overall and for specific non-technical skills competencies. This is an intervention that could easily be replicated in other institutions, with a range of health care students, either individually or in an interprofessional setting. References Wright MC, Taekman JM, Endsley MR. Objective measures of situation awareness in a simulated medical environment. Quality and Safety in Health Care 2004;13(suppl 1):i65–i71. Draycott T, Sibanda T, Owen L, et al. Does training in obstetric emergencies improve neonatal outcome?BJOG : An International Journal of Obstetrics & Gynaecology 2006;113(2):177–82.