Wellcome Centre for Human Neuroimaging, University College London, London, UK.
UCL Medical School, University College London, London, UK.
Clin Teach. 2021 Jun;18(3):252-257. doi: 10.1111/tct.13308. Epub 2020 Dec 6.
Simulation training is an effective tool for improving confidence in healthcare workers. During the recent COVID-19 pandemic, large numbers of staff required re-training to manage unfamiliar situations. We present a set of medical student-led clinical simulation sessions and evaluate their effects on (i) confidence among redeployed healthcare workers managing COVID-19 patients and (ii) medical students' confidence as educators.
Half-day simulation training sessions consisting of three COVID-related clinical scenarios were devised by senior medical students and delivered to a group of approximately 150 healthcare workers over six repeated sessions prior to redeployment to COVID-19 wards. We distributed an anonymous pre- and post-simulation questionnaire to 36 participants in the final group exploring their experiences. The confidence scores were analysed using the Wilcoxon signed-rank test. Following the delivery of teaching, medical students completed a questionnaire assessing their personal experiences of designing and delivering the exercises.
Data are available for 35/36 participants approached. Respondents reported being significantly more confident after the training in all aspects of managing COVID-19 patients, including triage, complex discharge, recognising deterioration, initiating basic life support, managing symptoms and advising on visiting policies (p < 0.001); 97% of respondents rated the training as useful. Thematic analysis of medical students' responses demonstrated mutual benefit.
This study demonstrates the strengths of simulation training in helping to build staff confidence in a rapidly evolving situation and highlights the value of medical students in supporting a hospital's response to an outbreak. We recommend further studies of student-led simulation exercises, including longer-term follow-up.
模拟培训是提高医护人员信心的有效工具。在最近的 COVID-19 大流行期间，大量员工需要重新培训以应对不熟悉的情况。我们提出了一组由医学生主导的临床模拟课程，并评估了它们对（i）管理 COVID-19 患者的重新部署医护人员的信心和（ii）医学生作为教育者的信心的影响。
由高年级医学生设计的半天模拟培训课程，包括三个与 COVID 相关的临床场景，在重新部署到 COVID-19 病房之前，分六次重复向约 150 名医护人员小组提供。我们向最后一组的 36 名参与者分发了一份匿名的模拟前后问卷，以探索他们的经验。使用 Wilcoxon 符号秩检验分析置信度得分。在完成教学后，医学生完成了一份问卷，评估他们在设计和提供练习方面的个人经验。
共对 36 名受访者中的 35 名进行了数据分析。受访者报告说，在管理 COVID-19 患者的所有方面，包括分诊、复杂出院、识别恶化、启动基本生命支持、管理症状和建议探视政策方面，培训后他们的信心明显增强（p<0.001）；97%的受访者认为培训很有用。对医学生的回应进行主题分析表明，这是一个互利的过程。
这项研究证明了模拟培训在帮助员工在快速变化的情况下建立信心方面的优势，并强调了医学生在支持医院应对疫情方面的价值。我们建议进一步研究学生主导的模拟练习，包括长期随访。
