‘Train-rehearse-think-repeat’, helping algorithms work: In-situ theatre team training on a budget

Background Although simulation is an effective learning tool that improves patient safety,1 the space, time and resources to achieve additional training for theatre staff are at a premium. Algorithms are routinely used to support patient safety in healthcare but the opportunity to learn them is rare.2 This presentation will provide insights into how the combination of in-situ team training (on a budget) was developed to improve patient safety in theatres.

Methodology To facilitate improvements in the use of common algorithms in both paediatric and adult theatres, a simulation innovation was developed to allow the multi-disciplinary team (MDT) to train and rehearse ‘high risk, low frequency’ (HRLF) events together.3 This innovation generated the possibility to allow MDT teams to practice rare (HRLF) events in-situ. This innovation was developed with minimal funding and utilised theatre space when not in use.
Intervention
‘Train’: Related to the standard MDT training (e.g. basic and advanced life support).
‘Rehearse’: The MDT were given the opportunity to rehearse rare HRLF events using in-situ simulation.
‘Think’: Following simulation, all MDT members participated in a detailed debrief.
‘Repeat’: Post-debrief, participants had the opportunity to repeat elements of the simulation to galvanise new learning. A further opportunity for participants to repeat the scenario is provided six months later, to demonstrate retention of skills and knowledge.

Results/outcomes Initial evaluations will be presented including, cost analysis, simulation facilitator observations, participant feedback and impact. Key findings include changes in participant’s technical and non-technical skills, improved understanding and use of algorithms.

Potential impact Initial findings indicate that this low cost in-situ simulation innovation improves the use of algorithms in theatre. By augmenting emergency algorithms and mandatory life support training, MDT members are able to ‘train, rehearse, think and repeat’: learning together in-situ to build resilience and confidence amidst the unpredictability of theatre practice.

References
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Chiniara G, Cole G, Brisbin K, Huffman D, Cragg B, Lamacchia M, Norman D. Simulation in healthcare: a taxonomy and conceptual framework for instructional design and media selection. Med Teach 2013;35(8):1380–1395