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Simulated ward rounds- a unique approach to teach non-technical surgical skills for newly appointed residents in Urology

Abstract: PD46-07
Sources of Funding: The simulation bootcamp was funded by Health Education England- Yorkshire and Humber, Karl Storz, Coloplast and Allergen.

Introduction

Residents encounter a step change in responsibility during their entry into speciality training and are often expected to run a ward round but are seldom given a formal training for its effective conduct. Along with technical skills, it is increasingly recognised that non-technical skills such as communication, team working and leadership play a vital role in reducing adverse events in surgery. Simulation based learning can be used to complement training.

Methods

A ward round scenario was designed as one of the modules during a urology simulation boot camp for newly appointed trainees in urology. This module comprised simulated patients with typically encountered urological problems along with a nurse and intern. To test the non-technical skills, various interruptions and distractions were introduced. We assessed this module using structured feedback forms; self-reported confidence scores (5 point Likert scale) and also uniquely performed a cognitive load assessment using the NASA- Task load index (NASA TLX) multi-dimensional assessment tool.

Results

32 delegates attended the boot camp of which 19 were males. _x000D_ At the conclusion of this module, 83% delegates felt 'more confident' in running an acute urology ward round. 90% delegates felt challenged in decision making skills during the simulation and believed that they would change their behaviour in ward settings. A vast majority felt that the scenario helped them think critically, develop better insight into teamwork, improved communication skills and learn the importance of handover. 96% delegates enjoyed the exercise and would recommend to other trainees at their level. _x000D_ The cognitive load assessment using the NASA TLX (table 1) showed that among the six domains, performance and mental demand were the most challenging aspects in this module with mean scores of 12.1 and 11.9 respectively. Physical demand scored the least with mean score of 6.3._x000D_ _x000D_

Conclusions

We have demonstrated that simulation can improve the confidence of newly appointed residents in leading the ward rounds which in turn could result in improved patient care and better team working. The NASA TLX scale helps to identify the residents cognitive workload in different working environments and can facilitate learning technical and non-technical skills. _x000D_ _x000D_ _x000D_

Funding

The simulation bootcamp was funded by Health Education England- Yorkshire and Humber, Karl Storz, Coloplast and Allergen.

Authors
Sanjay Rajpal
Uwais Mufti
Andy Myatt
Craig Mcllhenny
Chandra Shekar Biyani
Sunjay Jain
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