SP212DEVELOPING A SIMULATION-BASED TRAINING PROGRAMME IN RENAL EMERGENCY MEDICINE FOR MEDICAL TRAINEES

Abstract

Introduction and Aims: Foundation programme and core medical trainees frequently express concerns that they feel ill-equipped to safely and effectively manage emergencies that may arise in patients with kidney disease, especially those who have been transplanted or who are receiving dialysis. Simulation-based training provides a safe and supportive environment for healthcare professionals to enhance their clinical knowledge, communication and teamwork skills when dealing with emergency scenarios. Uniquely, it also allows participants to identify and address the potential for and consequences of human factors in these situations. We undertook to design a simulation-based education session for trainees joining our renal department, utilising the trust's specialist simulation facilities and multidisciplinary team. Our aims were to enhance participants' confidence in dealing with renal, dialysis and transplant emergencies, increase their ability to effectively access and work with other members of the team and to ensure patient safety in the department. Methods: Sessions are run at the time of trainee departmental induction, and take place in a dedicated simulation suite using a high-fidelity manikin (LaerdalTM SimMan 3G). The faculty is comprised of members of the simulation, medical and nursing teams, as well as a renal registrar trained in simulation facilitation and debriefing. Session structure is as follows: participants are introduced to the team, facilities and manikin, following which they take part in a scenario (individually or in pairs) alongside a nurse, with a renal registrar contactable by phone. The remainder of the group watch proceedings in another room via a real time camera feed. Clinical scenarios include severe sepsis in a haemodialysis patient, anuric acute kidney injury with pulmonary oedema and hyperkalaemia, immediate complications post-renal transplantation and peritoneal dialysis peritonitis. Debriefing follows the DAE (description, analysis, application) format. Participants are invited to ask questions of all members of the faculty, and complete evaluation forms which are used to inform future sessions. Results: Participants give overwhelmingly positive feedback, stating that the sessions improved their clinical knowledge and confidence, and their assessment and communication skills. Moreover, they often request additional scenarios and sessions, and have expressed a wish that every speciality utilise simulation training (to our knowledge we are the only speciality in the trust that does this for junior trainees, and has done for five years). Conclusions: Simulation training is of great utility in improving junior doctors' competency and confidence in dealing with acute renal emergencies, facilitates training in communication and teamwork skills, and allows human factors to be recognised and addressed. We are currently working to utilise our simulation facilities for multidisciplinary training for nephrology trainees, consultants and renal nurses.