HEALTHCARE SIMULATION: Playing seriously
Medical simulation was the focus of the 14th Annual Symposium hosted by the Centre of Postgraduate Medical Research and Education (CoPMRE) at Bournemouth University. Professor Vanora Hundley, Deputy Dean, Research & Professional Practice welcomed the packed auditorium of 120 delegates from across the University, NHS Trusts, businesses and the healthcare community. Our keynote speaker, Andy Anderson, Chief Executive Officer, Association for Simulated Practice in Healthcare (ASPiH), took us on a journey of the past, present and future of simulation. The World Health Organisation June 2014 recorded that 1 in 10 patients is harmed while receiving hospital care and referred to a survey on attitudes to safety in aviation and healthcare which highlights dramatic attitudinal differences (Sexton et al 2000). One of the aims of ASPiH is to use simulation to change the culture of performance management in healthcare, leading to better patient outcomes. With rapid developments in technology there is an increased need for evidence-based simulation research.
Paul Davis MBE & Dr Tracey Herlihey from the Healthcare Safety Investigation Branch (HSIB)shared how simulation can be used in incident and accident investigation. Much of investigation to establish causation is aboutunderstanding what we should be doing, as set out in rules and regulations, however, it was discussed that in reality, our day-to-day work environment can be somewhat imperfect. where rules can be unworkable or equipment does not function as intended. Moreover, it was said that absence of evidence in incidents isn’t necessarily evidence of absence as factors,such as fatigue,cannot be reproduced by simulation. Paul urged organisations to invite the HSIB in if they have a reoccurring incident as the likelihood is that it is a national issue. Investigation is not about apportioning blame, nor replacing other investigation in the system but more about looking for national learning and targeting regulators and manufacturers with recommendations (
The audience were then invited to think about how simulation can be used to train better decision making and behaviours, by Suzanne Kellett, Consultant Major Trauma Anaesthetist at University Hospital Southampton NHS Foundation Trust. It was suggested by addressing our behaviours we can deliver better care and improve our working lives. The importance of emotional engagement and debriefing was highlighted because whilst the practical experience of simulation is invaluable, learning happens during the reflective period which follows. We were left with the thought ‘To grow is to change …….’
Following a short coffee break in the Exhibitors Area, Dr Karen Kirkham, Assistant Clinical Chair at NHS Dorset Clinical Commissioning Group gave an overview of Dorset’s Health and Care Sustainability and Transformation Plan (STP) with its three programmes of work (1) Prevention at Scale (2) Integrated Community Services (3) One Acute Network. There is an opportunity for health, care, industry and education to work in partnership for a better trained workforce to improve care quality and continuity of care for better health outcomes.
It was then time for the Morning Showcase. Professor Rob Middleton, Head of BU’s Orthopaedic Research Institute (ORI) gave us a history lesson on the role of robots in orthopaedics from the 1990’s through to the present-day Mako Robotic Hip Replacement. Virtual reality surgical simulators are now being used to train surgeons in the ORI labs. ORI also boasts a gait lab which allows researchers to study human motion to improve sporting performance and treat injury and arthritis. By contrast, Dr Emer Forde, GP Programme Director, BU and Dr James Bromilow, Consultant in Intensive Care Medicine at Poole Hospital delivered a presentation on ‘real-life’ simulation-based teaching in primary care emergencies. This successful programme, delivered by a GP and ICU Consultant, teaches participants how to manage time critical emergencies quickly and efficiently.
Next Mark Ainsworth-Smith, Consultant Pre-hospital Care Practitioner for South Central Ambulance Service (SCAS) gave a presentation featuringthe potential benefits of simulation mainly (1) Realistic training in a safe environment (2) Better use of time (3) Assessment/assurance of competence and use of Serious Incident Requiring Investigation (SIRIs)/remedial training. SCAS now has a Simulation Ambulance, a Simulation Centre and a dedicated Simulation Team. This was followed by John Tarrant, Senior Lecturer and David Halliwell, MSc Paramedic Fellow, BU who wowed with a showcase of how innovators around the world are transforming simulation using 3D printing, 360 degrees video and working with the latest rubbers! The mind boggles!
After lunch and networking, the afternoon session was opened with an inspirational keynote address by Lt Col Tania Cubison, Royal Army Medical Corps and Burns & Plastic Surgeon at Queen Victoria Hospital who discussed experiences from the military theatre and the value of simulation and team training pre-deployment. She painted a picture of exceptional teamwork in a highly pressured environment where each team member is valued and communication iskey.We were reminded of Dennis Mannering’s ‘Attitudes are contagious. Are yours worth catching’! Then Dr Chris Richardson, Head of Cyber Security Unit (BUCSU) BU reminded us of the dark side of digitization and the potential for hackers to disrupt industries and corporations such as the NHS. He spoke about significant cyber events in 2017 and the need for effective, collaborative cyber security, information assurance and risk management and how BUCSU is at the forefront of collaborative research in this area.
It was then time for the Afternoon Showcase which was opened by Professor Tahseen Qureshi who spoke about the evolution of the surgical robot, gave us a glimpse at the world of virtual reality, for example,X-ray glasses to look through skin! and DNA Nanobots designed to seek out and destroy cancer cells. We are indeed living in a world of change! Michelle Heward from the Ageing & Dementia Research Centre (ADRC) BU stood in at short notice to present the Dementia Education and Learning Through Simulation Programme(DEALTS).Health Education England (HEE) has commissioned ADRC to deliver this education programme nationally to train the trainers.This programme underlies the principle of understanding the lived experience by putting staff into the shoes of a person with dementia, facilitating a positive impact on practice. Then it was the turn of Morad Margoum, Clinical Lead, Dorset Healthcare University Foundation Trust to discuss the role of virtual reality in primary-care based psychological interventions. Evidence based research shows that simulation could be effective in Cognitive Behavioural Therapy treatment in areas such as specific phobias, OCD and panic disorder problems. The need for organisational change was highlighted. Finally, Helen Cross, Midwife and Practice Educator at University Hospital Southampton NHS Foundation Trust posed the question Simulation – Training Excellence or the machine that goes ping? Helen used the analogy of learning to drive, which begins with many simulated experiences from childhood to adulthood, however, we were cautioned that car accidents still happen! It was demonstrated how SIMis being used in midwifery and obstetrics training so that staff can learn touse equipment and practice in a safe environment.We were helped to appreciate that low technology can be as effective in simulation training. We were reminded that whilst machinesare amazing as demonstrated throughout the conference, we must never lose sight of the most important thing – the person.
The audience were able to participate through panel discussions held at the end of each session. What an inspirational day! Presentations can be found at
My thanks go to Professor Jane Reid for supporting with programme designand all the speakers for making the conferencesuch a huge success.
See you next year!
Audrey Dixon
CoPMRE Manager
6.11.17