Abstract
Introduction: Simulation-based training (SBT) has been adopted by various specialties and is often used to complement other aspects of education. Geriatric medicine is a diverse speciality, requiring healthcare professionals (HCPs) to navigate complex social, medical, and ethical issues, necessitating a multifaceted and interdisciplinary approach making SBT the ideal vehicle to train geriatric medicine trainees. SBT is currently not a formal component of geriatric medicine training in Ireland. Trainees experience varying levels of exposure to SBT and the different uses, with many trainees reporting lack of knowledge of design and implementation of gerontological SBT. WICOPSIM is a dedicated gerontological simulation facility that promotes transdisciplinary SBT and encourages faculty to develop their own specialist interdisciplinary simulation scenarios. The WICOPSIM faculty were approached by the postgraduate medical training college to facilitate a study day for geriatric medicine trainees demonstrating the design and implementation of gerontological SBT.
Approach: A faculty consisting of the Royal College of Physicians Ireland (RCPI) Irish Clinician Educator Track (ICET) training fellow, WICOP simulation fellow and two Consultant Geriatricians co-ordinated the event. All geriatric medicine trainees were invited to a one-day SBT event hosted at the WICOP simulation facility. The event commenced with a suite of didactic lectures focusing on simulation theory and application. Lectures included ‘Simulation in the Context of Medical Education’, ‘Preparing for a Simulation Scenario’, ‘The importance of Prebrief and Psychological Safety’, ‘How to Run a Simulation Scenario’ and ‘The Debrief-Where the Learning Happens’. All lectures were delivered by clinical educators with experience in geriatric medicine and/or SBT. This was followed by the demonstration of a simulation-scenario focusing on the interdisciplinary management of a patient whose capacity is in question. A two-part scenario consisting of a multidisciplinary team meeting with a social worker and memory clinical nurse specialist and subsequent patient clinic visit was delivered followed by a SBT participant workshop.
Evaluation: Fifty-two trainees attended the event with all five training years represented. Forty-five trainees completed the post-event survey. Two trainee reported previous high experience with SBT as a learner and as teacher respectively. Thirty-nine reported a low level of SBT experience, while five trainees had no previous SBT experience. Of those who reported previous SBT experience, 52% (n=22) had experience in gerontological SBT. 98% (n=44) were satisfied with the variety of topics presented. The simulation demonstration, debrief, simulation design workshop and participant designed scenarios met 100% trainees’ expectations. All trainees indicated that they are highly likely to recommend to colleagues to attend this training event in the future. All trainees agreed SBT should be a routine element of training in geriatric medicine. 69% (n=31) intend to run SBT within their own department in the future. 98% (n=44) felt more prepared to design and run a scenario following the event.
Conclusion: This event successfully introduced geriatric medicine trainees to the design principles and practices of gerontological SBT. The positive feedback generated amongst geriatric medicine trainees suggests this may be a useful tool to enhance the geriatric medicine training experience and warrants further exploration.