Initial Anaesthetic Competencies Simulation Day
It is a requirement for all trainees starting their first Anaesthetic attachment (including ACCS trainees from all parent specialties) to complete an Initial Assessment of Competency at around 3 months. This includes the structured management of critical incidents and failed intubations demonstrated through simulation. Whilst some of this type of simulation is already present across Scotland, there is a challenge with rotations and timings to make sure that all trainees have equity of access and are given the opportunity to attend.
Our current recommendation to achieve this is to run regional training days for all trainees new to Anaesthesia. These IAC skills days would take place at the end of September/start of November (for those starting in August) and end of April/start of May (for those starting in February) and be run over a full day at regional simulation hubs in the North, East, South East and West of Scotland. A potential example of this training day is shown in appendix 1, which has been evaluated highly and details and outcomes published(1). It should be noted this course has been run with final year ODP student participants, and the benefit gained from this interprofessional approach was evident in the feedback. It is anticipated that this course could incorporate ODPs or Anaesthesia Associates in the future, and links with training programmes and the National Academy will be developed in the coming months.
Based on the current training numbers of ACCS and CT1 Anaesthetists, there will be around 80 trainees requiring an IAC Skills Day in September/November and around 30 in April/May. In trying to balance cost effectiveness with equitability we would suggest:
IAC Skills Days in late September/November for those new to Anaesthetics who commenced in August:
IAC Skills Days in late April/May, for those new to Anaesthetics who commenced in February:
As a backup for trainees that have a specific circumstance that means they cannot attend, we will either offer the opportunity to attend a date at a different region, or we will help support the local team to deliver these simulation workshops at a convenient time.
Eligibility: Anaesthetic Core Trainees and ACCS trainees in their first Anaesthetic post, who have done at least two months of an anaesthetic attachment. If you are not sure if you are eligible, please contact the email below.
Find out more and book online here.
Prioritising this simulation activity was based largely on the recommendations of trainers and trainees, but also aligns with the curriculum. There is a clear need for this training based on the high stakes and often unsupervised nature of both inter- and intra-hospital transfers of critically unwell patients. Increases in required investigations, the need for subspecialty management and lack of hospital beds has also increased the number of transfers required across Scotland.
Trainees often expressed anxiety and concern about managing particularly inter-hospital transfers for the first time on their own, without training and familiarity with equipment. Given this concern and some variation in equipment, it could be beneficial to deliver this training regionally. Timing of this course from Consultant supervisors and trainees based on their need to undertake transfers was thought to be at the beginning of their second year of training. There are a variety of transfer training courses in the UK that have been run or are under development, some of which use tutorials alongside scenarios and are more drills based. However, given the concerns of trainees and the potential/need of moving fairly swiftly to isolated unsupervised practice in the back of a moving vehicle, we would recommend the use of immersive simulation such as in the Scottish Inter-Facility Transfer (ShIFT) course. This has been developed with extensive multidisciplinary consultation and includes constructively aligned pre-learning packages, and has been evaluated highly. See appendix for details.
We will run around 8 courses a year for Anaesthesia and ICM trainees across Scotland at regional simulation hubs in all regions. The course is aimed at trainees at the end of Stage 1 or beginning of Stage 2, ideally just before they are expected to do their first inter hospital transfer. The focus of this course will be on inter-hospital transfers with the hope that the trainees will be introduced to some basics of intra hospital transfers during their first Intensive Care attachment.
Eligibility: ICM Trainees in ST3
The curriculum and trainee focus groups confirms a clear need for simulation to prepare trainees new to Obstetric Anaesthesia (second year of training indicative). The curriculum and lived experience of trainees and supervising obstetric anaesthetists suggests that a focus on NTS in the management of emergencies is required.
The requirement to address NTS has led to the development of more immersive simulation activities. These have been developed with Obstetric Anaesthetic content experts. Various scenarios from courses across the UK have been reviewed and adapted in line with training needs to develop a potential course that is detailed in appendix 4, and has been evaluated highly. Each scenario has been developed to focus on a different Obstetric Emergency and a specific NTS to ensure consistency of learning. This example has been delivered at several different regional simulation suites.
Due to the more resource-heavy nature of this course (with higher expert faculty to participant ratios) and the timings of rotations across the year, several courses will be required to run at regional simulation hubs throughout the year. Ideally trainees should attend courses within their region (gaining from the benefit of using local equipment, guidelines and practice) but if a trainee cannot attend a course in the timeframe required, it should be possible to attend one in a different region.
Eligibility: ICM Trainees in ST4
This course is currently under development. Find out more here.
This page was last updated on: 21.02.2024 at 16.26
