Does size matter? : The experience of a small simulation centre

Background: Healthcare simulation centres (SC) are becoming widespread across the UK. However, simply providing access to simulators does not guarantee their effective use. Idea/Concept: Modest SC using trained faculty can be educationally beneficial and a cost-effective alternative in assessing junior foundation doctors’ clinical competence and communications skills. Method/Implementation: We set up an all-in-one room simulation centre incorporating a medium-fidelity simulator. We provided 3 hour sessions where doctors, in small groups, performed individually in scenarios based on common medical/surgical emergencies. Debriefing focussing on non-technical skills and medical management issues ensued. We assessed the candidates’ learning experience using post-course questionnaires with a 6-point Likert scale (0=strongly disagree, 5=strongly agree). Results: 56 participants were trained of which 80% had previous experience of high-fidelity simulation training. Most felt comfortable with the simulated environment (mean=4.26,SD=0.89), believed the scenarios were realistic (mean=4.3,SD=0.73) and the course would have a positive impact on their future clinical practice (mean=4.62,SD=0.72). All trainees felt they were given useful feedback regarding their performance (mean=4.52,SD=0.61) and the debriefing sessions enhanced their clinical knowledge (mean=4.52,SD=0.64). Discussion: Despite being time-consuming, educational feedback and debriefing has been shown to be the most important part of simulation training. Careful planning and judicious use of space and equipment within an institution is crucial. Providing a supportive and motivational environment for participants and faculty expertise during debrief sessions were essential in the success of this program. Conclusion: Simulation-based training using carefully crafted scenarios combined with feedback from skilled facilitators can be an effective educational tool irrespective of the size of the centre.