CLINICAL SKILLS Managed Educational Network Excellent skills for excellent care

Quality Education for a Healthier Scotland

CLINICAL SKILLSManaged Educational Network Excellent skills for excellent care

Multidisciplinary Simulation-based Adhoc Team Training

Quality Education for a Healthier Scotland

Aim

• To develop a novel training intervention to:

1. Improve leadership and teamworking within an adhoc multidisciplinary team

2. Improve the initial assessment/resuscitation of the acutely unwell patient

Quality Education for a Healthier Scotland

Methods 1

• 60 min session• 6 participants (mix of

nursing/foundation/medical/anaesthetic)• Integrated into working day• Short interactive presentation• Round table practice of communication skills• Simulated scenario & debrief

Quality Education for a Healthier Scotland

Methods 2

• Results – Pre & post course questionnaire including

modified ORMAQ questions pertaining to Confidence Assertion, Information Sharing, Teamwork, Leadership

– Clinical time points measured during standardised scenario

– Situation awareness tool at close of scenario

Quality Education for a Healthier Scotland

What Does our Team Need?

• All Members need to:– Know what the common goal is– Know what steps have been taken– Know what the next steps are

We want a proactive team

Shared Mental Models

Quality Education for a Healthier Scotland

XX

1

Leader

2 3 4 5 6

?nurse ?FY1

?nurse ?FY1

?ANP ?SHO

?ANP ?SHO

?Med Reg ?Anaes Reg

We all need some leadership skills

x

?you

Quality Education for a Healthier Scotland

SBAR in Team Assembly

• Situation– This lady was found collapsed in the bathroom, she was

surrounded by vomit• Background (if we know it)– I don’t know any further history at the moment

• Assessment so far– She is maintaining her airway and has crackles in her right

chest• Recommendation (delegation)– Can you get iv access

Quality Education for a Healthier Scotland

Individual Skills1. Think VOLUME!2. Use names when delegating tasks: – ‘can someone get iv access’

3. Don’t sugarcoat requests:– ‘I was wondering if you would mind…?’– ‘would it be possible for you to…?’

4. Develop a few phrases to get you out of sticking points– ‘Can I clarify…..?’ (goals, tasks required, plan)

John

Assertiveness Toolkit

Quality Education for a Healthier Scotland

Team skills

1. Introductions – name, grade, indication of competencies

2. Update arriving team members

– short & snappy SBAR!

3. Discuss progress with the whole team

– ABCDE, working diagnosis, management plan

Quality Education for a Healthier Scotland

Leadership Skills

• Speaking up assertively goes a long way• Sharing the goal/tasks/plan is the major role

Leader does not need to have all the answers – but needs to be able to draw them from the team

Leadership can appear daunting…

Quality Education for a Healthier Scotland

The story so far…

• 1st Pilot session completed• Further 6 refining sessions before August• Roll out with new intake medical staff in

August

Very open & unintimidating Theory prior to

this session was useful

Really good to work with the other people who answer the 2222