G285 Paediatric preparation day: smoothing the transition for yorkshire and the humber foundation and gp trainees

Abstract

BackgroundDelivery of safe, high quality healthcare relies upon adequate training and education.1 Concern exists regarding the preparedness of junior doctors for their expected clinical roles despite Tomorrow's Doctors and the implementation of the Foundation Programme.2,3 Foundation and General Practice (GP) trainees rotate through secondary care paediatric rotations expected to perform clinical skills. Yet, the vast majority will have very limited practical paediatric experience. As traditional teaching methods including see one, do one, teach one' become increasingly unacceptable, simulation-based medical education (SBME) is being advocated to provide opportunities for deliberate practice and avoidance of patient harm.4 Internationally, paediatric bootcamps are starting to emerge. However, both regionally and nationally, bespoke opportunities for Foundation and GP trainees to develop practical paediatric skills prior to paediatric rotations are lacking. MethodsA one-day regional paediatric and neonatal skills course was developed and piloted for Foundation and GP trainees rotating into secondary care paediatrics. This provided trainees with the opportunity to observe and practice fundamental procedural and resuscitation skills on part-task trainers and low-fidelity manikins under the supervision of senior paediatric trainees. Course evaluation was achieved through a comparative pre and post-test design using confidence levels and a bespoke MCQ to assess knowledge acquisition for qualitative and quantitative data respectively. Observation/Evaluation 58 doctors attended four pilot courses. Complete pre and post-course comparison data was achieved from 57 trainees. The mean MCQ score rose from 60.7% (95% confidence interval, 58.5% to 62.9%) to 83.9% (82.4% to 85.3%), p < 0.0001. Although statistically significant increments in mean confidence levels were demonstrated for every skill, the largest increases were associated with performing lumbar punctures, paediatric and neonatal life support, cannulation and venesection. ConclusionThis simple intervention is a feasible way to support Foundation and GP trainees ahead of paediatric rotations. This should facilitate a smoother transition into their clinical roles, when complemented with departmental induction programmes. The opportunity to practice skills in a safe environment without the risk of patient harm is highly desirable in modern healthcare. We hope that our bespoke Paediatric Preparation Day course will be adopted to enhance future trainee and patient safety. ReferencesDepartment of Health. Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values. A mandate from the Government to Health Education England: April 2014 to March 2015 Brennan N, Corrigan O, Allard J, et al. The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors. Med Educ. 2010; 44:449-458 Matheson C, Matheson D. How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitals. Postgrad Med J. 2009; 85:582-589 Aggarwal R, Mytton OT, Derbrew M, et al. Training and simulation for patient safety. Qual Saf Health Care 2010; 19(Suppl 2):i34-i43