1. Simulation and Optimising Returning to training
Giulia Miles, Centre Manager
Trent Simulation & Clinical Skills Centre
Dr Caroline Brown, Assistant Director
Postgraduate Education
Nottingham University Hospitals NHS Trust

2. Safe Systems, Adaptable Teams, Capable Staff
TSCSC 2004 ……Today
Clinical and procedural skills
Non- technical and professional capabilities
Patient stories
Faculty development
High reliability teams
Organisational Learning & Resilience
TSCSC has evolved in terms of its work and how this can support the development of safe capable healthcare staff of all professions. This has increasingly addressed the needs to demonstrate high quality ‘non-technical’ skills, known more generically as ‘interprofessional and interpersonal skills’ (especially in the higher education sector) and ‘professional capabilities’ including team work and leadership (more so amongst qualified staff).
The centre has also pursued patient-centred education and safety improvement themes using powerful narratives to promote candid and often illuminating facilitated discussions amongst students and staff.
On a broader healthcare system and organisational level the centre actively leads and promotes development of educational faculty and trainers, whilst offering similar development opportunities for staff wanting to improve their awareness and capabilities in patient safety improvement. In more recent years we have built and strengthened relationships with academic, commercial and professional networks within and beyond healthcare. This has all benefited NUH and the wider local or regional health care system by our desire to engage with organisational leaders to promote a learning culture (both from avoidable harm and excellence), develop greater awareness of safety systems and how their design supports effective and safe care as well as helping address productivity and efficiency workstreams.
However we feel that we are not in a position to support NUH and its place in the changing landscape of our healthcare systems anywhere near as much as we would wish. This has arisen by the centre being required by the Trust to pursue external commissioned activity, which we have undertaken successfully throughout our lifespan, whilst internal funding has been much less well developed. This will be considered in later slides.
Networks & partnerships
Patient Safety
Human Factors
Learning from Excellence
Safe Systems, Adaptable Teams, Capable Staff
Safe, formative, applied to practice

3. ‘Simulation is a technique—not a technology—to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner.’
1.Gaba DM. The future vision of simulation in health care. Qual Saf Health Care 2004;13(Suppl 1):i2–10.doi: /qshc
Embedded in real world practice and supports transfer of learning to practice. Individuals working in teams

4. Sim Modalities Part task trainers VR
Full immersion high fidelity simulation
In situ sim
Simulated patients

5. Effective teamwork and leadership
Clinical and procedural skills
Effective teamwork and leadership
Non technical skills and professional capabilities
System Issues

6. Simulation ‘journey’
Understanding learner needs Clear learning outcomes Pre-briefing and preparation
Safe Environment
Facilitated debrief
Experiential learning
Rehearsal for performance
Develop confidence
Learn and
re-learn
Demonstrate progress
Transfer to Practice

7. Demonstration
Simulated Patient

8. Regional Approach East Midlands Simulation Network
Leicester
Northampton
Kettering
Derby
Nottingham
IRiS – scenario sharing platform
Collaboration to Supporting RTT

9. NUH
Scoping and understanding what trainees and trainers require Design and deliver a pilot day (Sept ‘18) Developing local network Develop effective learning needs analysis tool

10. Situational Judgement Responses
An enhanced Learning Needs Analysis approach for individual and team skills, behaviours and patient safety capabilities
Situational Judgement Responses
What each employee: UNDERSTANDS DOES NOT UNDERSTAND MISUNDERSTANDS
What each employee’s: CONFIDENCE is in what they think they understand
The second novel tool being introduced as part of the programme in its current year is an enhanced Learning Needs Analysis (LNA). This makes use of an assessment approach called ‘Situational Judgement Responses’ (SJRs) that has been used extensively in other industries for leadership and management development programmes. In healthcare it has been used primarily within the education sector for selection into Medical Schools as well as at a postgraduate level in progressing through different stages of specialty training.
Validated tool (Cognisco)
Widely used across many industries- civil service, banking, NHS, US healthcare
Learning needs analysis
Looks at understanding and confidence
Individual/team /organisation
Which employees are likely to: Apply the RIGHT knowledge with high confidence
Which employees are likely to: Apply what is WRONG and potentially influence others
Which employees will benefit from: Receiving focused COACHING and feedback in practice

11. RISK TRAIN NOVICE COACH TALENT +100 UNDERSTANDING -100 50 +100
CONFIDENCE & CAPABILITY TO EMBED IN PRACTICE
ROLE MODELS & TALENT IDENTIFICATION
ONGOING DEVELOPMENT OF SPECIFIC KNOWLEDGE WITH TRAINING
DEDICATED ACCESSIBLE KNOWLEDGE & TRAINING
PRIORITY
DEVELOPMENT
UNDERSTANDING
-100 50
+100
CONFIDENCE
Measures Understanding and Confidence
Identifies areas for targeted development
Provides an effective platform for Coaching
Eliminates unnecessary, untargeted and ineffective training
Supports talent management
High understanding with high confidence = Above Standard
High understanding with low confidence = Coaching Confidence
Below benchmark understanding with varying confidence = Knowledge Focus
Low understanding with low confidence = Significant Knowledge Focus
Low understanding with high confidence = Priority Development Required
RISK
NOVICE
TRAIN
COACH
TALENT

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