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Board 108 - Program Innovations Abstract The Yorkshire Acute Internal Medicine Simulation Programme (Submission #1105)

Introduction/Background A recent survey of training conducted by the Royal College of Physicians of UK1 had identified that junior medical trainees were apprehensive and intimidated by the prospect of becoming medical registrars and dealing with less frequently encountered medical emergencies and procedural skills. The lack of experience has partly stemmed from the adherence of Hospitals, in the UK to the European Working Time Directive2 rules. To support their transition from junior trainees to registrars, the Yorkshire deanery already conducts the Acute Simulated Course in Medical Emergencies. On similar grounds, we have proposed to design and deliver a simulation based course addressing both technical and non-technical skills that will continue to augment training at various levels of the Specialist Acute Internal Medicine training programme in the Yorkshire deanery. Methods The design of the programme was based on three aspects: 1) Curriculum - The Joint Royal Colleges of Physicians Training Board of UK3 is responsible for setting and maintaining standards for specialist training in the UK. Our course is mapped to this curriculum. 2) Stakeholders - The three training programme directors (TPD) in the deanery were approached individually to discuss the proposal and gather their thoughts and comments based on their vast experience with regards to gaps in training. 3. Trainees - An email survey of training needs was conducted where all the Acute Medicine trainees were sent questions related to procedural skills, technical skills, non-technical skills and experience with simulation based medical education. Apart from the three above mentioned aspects, a simultaneous inventory of simulation equipment and facilities was conducted and where deficiency was identified and equipment was procured. Based on training needs assessments we have proposed a comprehensive programme which will run as four separate days for trainees at different levels of training. Trainees in their first year of training will benefit from a practical skills refresher course - (chest drain insertion, abdominal paracentesis, knee arthrocentesis, electrical cardioversion and central venous catheter placement). Second year trainees will attend a one day course dealing with difficult medical emergencies. Human factors course will be run for year three trainees and year four trainees will learn advanced specialist procedural skills like temporary cardiac pacing and Sengstaken tube insertion. Conclusion We believe our proposal will meet training needs as identified by our trainee survey and will fill gaps in the training where there is lack of experience due to limited exposure to these technical and non-technical skills. The human factors skills do not get much attention in routine training and thus, simulation will give us the opportunity to identify, address and improve awareness. Faculty recruitment and sustainability are two limiting factors that we have identified. With the heightened awareness of need for improving patient safety through simulation-based medical education, we envision that a lot of our colleagues will come forward and play an active role in training the healthcare workforce of the future. References 1. Royal College of Physicians. The medical registrar: empowering the unsung heroes of patient care. London: RCP, 2013. 2. A guide to the implications of the European Working Time Directive for doctors in training. EWTD Reference Group December 2009. 3. http://www.jrcptb.org.uk/trainingandcert/ST3-SpR/Pages/acute-medicine.aspx. Disclosures None.