PG12 Transfer of skills from simulation to the workplace in internal medicine

Introduction The transfer of training of simulation-based education to the clinical workplace is of crucial concern to medical educators. Burke and Hutchins’ literature review outlines a taxonomy of major factors influencing transfer: learner characteristics; intervention design and delivery; and work environment influences.1 The Internal Medicine Training (IMT) simulation strategy involves an IMT boot camp for trainees in Scotland in their first year of the three-year training programme. This constitutes a three-day course involving immersive simulation scenarios, communication workshops and mastery learning of procedural skills. Using the IMT boot camp to provide an appropriate educational context, this study aimed to explore the factors influencing the transfer of training from simulation to the workplace. Methods Following ethical approval, IMT trainees were invited to take part in interviews three to six months following their participation in the IMT boot camp. Interviews were semi-structured, addressing the main themes of the boot camp and experiences of utilising skills and lessons learnt in the workplace. Interviews were anonymised, transcribed verbatim and analysed using template analysis. Burke and Hutchins’ taxonomy of major factors influencing transfer was used as a conceptual framework to illuminate and analyse the data, focussing on intervention design and delivery, and workplace influences.1 Learner characteristics were not explored as part of this study. Results A total of 16 IMT trainees took part in interviews. Trainees appreciated that the IMT boot camp aligned with their curriculum and they deemed it to be pitched at their level. Instructional strategies including practice and feedback, active learning and behavioural modelling were valued. Self-management strategies such as procedural approach and reflective practice, as well as ongoing access to online materials, were helpful in promoting transfer of training to the workplace. In terms of work environment influences, trainees reported difficulty in transferring their asepsis training due to lack of appropriate equipment and the prevailing workplace culture towards asepsis experienced on medical wards. They also reported a lack of opportunities to perform procedures and a lack of supervised practice once they had been deemed competent. Discussion This study applied a framework used in other disciplines to analyse evidence of transfer of training from the national Scottish IMT simulation boot camp to the workplace. There were encouraging findings relating to the intervention design and delivery, but the framework highlighted barriers within the clinical workplace which need to be addressed to enhance the opportunities for transfer of training from the IMT boot camp. References Burke L, Hutchins H. Training transfer: an integrative literature review. Hum Resour Dev Rev 2007;6(3):263–96.