1. Using simulation to develop leadership – value of an educational fellow
Dr Anand Shah MRCP

2. Objectives
Define aspects of medical simulation critical to develop leadership
How to develop infrastructure to enable simulation training across all specialities and repetition of training for candidates.

3. Example of effective simulation training
Educational fellow placed at district general hospital for 6 months.
General medical SpR
Supervision and support from local teaching directorate
No significant time to help with teaching sessions however

4. In-house ‘in-situ’ multidisciplinary simulation training for local medical ST trainees

5. 2 candidates per simulation session
Setting in medical HDU
Approval of ward sister and Consultant
2 candidates per simulation session
One SHO (ST1/2) and one trainee nurse (other trainees watching)
Faculty
FY1s and FY2s playing themselves
3 additional faculty (SpRs and Consultant medical/anaesthetic staff) playing roles and operating Sim-man (behind curtains with webcams for visualisation)
All volunteering time outside of other commitments

6. ST trainees ‘acting up’ as Medical SpRs
Challenging scenarios where they would not be expected to know/have all the answers
Mix of technical and non-technical skills assessed and reviewed

7. Significant improvement seen with repetition.
Debrief
In separate room
2 faculty leading (one doctor, one senior nurse)
Cross-specialty feedback encouraged.
Part of debrief focussed on technical aspects of case as well as non-technical development points
Specific personal development points given to each trainee which would be discussed with their educational supervisor to develop a PDP
All trainees encouraged to repeat the training in 2-3 months, but in particular trainees with difficulty.
Significant improvement seen with repetition.

8. 40% trainees able to repeat training
All ST trainees and medical HDU nurses able to partake in training sessions
Improved working relationship within department
40% trainees able to repeat training
At end of fellowship no further training sessions organised
No Consultant/SpR able to commit to time required to organise and lead sessions
New educational fellow one month later, Anaesthetic trainee, developed new training sessions for anaesthetic trainees. No continuation of previous training sessions.

9. Discussion points
What aspects of simulation training are critical/useful to develop the leadership qualities required with seniority?
What are the advantages/disadvantages of educational fellows?
What is required to enable and what barriers prevent continued simulation training in all specialities for trainees with the capability for regular repetition?