TY - JOUR
T1 - Simulation-based training of junior doctors in handling critically ill patients facilitates the transition to clinical practice
T2 - an interview study
AU - Marker, Søren
AU - Mohr, Marlene
AU - Østergaard, Doris
PY - 2019/1/8
Y1 - 2019/1/8
N2 - BACKGROUND: Junior doctors lack confidence and competence in handling the critically ill patient including diagnostic skills, decision-making and team working with other health care professionals. Simulation-based training on managing emergency situations can have substantial effects on satisfaction and learning. However, there are indications of problems when applying learned skills to practice. Our aim was to identify first-year doctors' perceptions, reflections and experiences on transfer of skills to a clinical setting after simulation-based training in handling critically ill patients.METHODS: We used a qualitative approach and conducted semi-structured telephone interviews with a sample of twenty first-year doctors six months after a 4-day simulation-based training course in handling critically ill patients. Interviews were transcribed verbatim. A content-analysis approach was used to analyse the data.RESULTS: The following main themes were identified from the interviews: preparedness for clinical practice, organisational readiness, use of algorithms, communication, teamwork, situational awareness and decision making. The doctors gave several examples of simulation-based training increasing their preparedness for clinical practice and handling the critically ill patient. The usefulness of algorithms and the appreciation of non-technical skills were highlighted and found to be helpful in managing clinical difficulties. Concern was expressed related to staff willingness and preparedness in using these tools.CONCLUSIONS: Overall, the simulation-based training seemed to facilitate the transition from being a medical student to become a junior doctor. The doctors experienced an ability to transfer the use of algorithms and non-technical skills trained in the simulated environment to the clinical environment. However, the application of these skills was more difficult if these skills were unfamiliar to the surrounding clinical staff.TRIAL REGISTRATION: Not applicable.
AB - BACKGROUND: Junior doctors lack confidence and competence in handling the critically ill patient including diagnostic skills, decision-making and team working with other health care professionals. Simulation-based training on managing emergency situations can have substantial effects on satisfaction and learning. However, there are indications of problems when applying learned skills to practice. Our aim was to identify first-year doctors' perceptions, reflections and experiences on transfer of skills to a clinical setting after simulation-based training in handling critically ill patients.METHODS: We used a qualitative approach and conducted semi-structured telephone interviews with a sample of twenty first-year doctors six months after a 4-day simulation-based training course in handling critically ill patients. Interviews were transcribed verbatim. A content-analysis approach was used to analyse the data.RESULTS: The following main themes were identified from the interviews: preparedness for clinical practice, organisational readiness, use of algorithms, communication, teamwork, situational awareness and decision making. The doctors gave several examples of simulation-based training increasing their preparedness for clinical practice and handling the critically ill patient. The usefulness of algorithms and the appreciation of non-technical skills were highlighted and found to be helpful in managing clinical difficulties. Concern was expressed related to staff willingness and preparedness in using these tools.CONCLUSIONS: Overall, the simulation-based training seemed to facilitate the transition from being a medical student to become a junior doctor. The doctors experienced an ability to transfer the use of algorithms and non-technical skills trained in the simulated environment to the clinical environment. However, the application of these skills was more difficult if these skills were unfamiliar to the surrounding clinical staff.TRIAL REGISTRATION: Not applicable.
KW - Algorithms
KW - Attitude of Health Personnel
KW - Clinical Competence/standards
KW - Clinical Decision-Making
KW - Critical Care/standards
KW - Critical Illness/therapy
KW - Humans
KW - Internship and Residency
KW - Interprofessional Relations
KW - Interviews as Topic
KW - Outcome Assessment (Health Care)
KW - Patient Care Team
KW - Physicians/standards
KW - Qualitative Research
KW - Simulation Training
U2 - 10.1186/s12909-018-1447-0
DO - 10.1186/s12909-018-1447-0
M3 - Journal article
C2 - 30621668
SN - 1472-6920
VL - 19
JO - BMC Medical Education
JF - BMC Medical Education
M1 - 11
ER -