Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach
There is clear evidence that simulation provides opportunities to enhance medical skills and experience in a safe learning environment, away from the patient.
Working with the Joint Royal Colleges of Physicians Training Board (JRCPTB) and with an expert group, work has been undertaken to look at how to effectively embed simulation into core medical training (CMT) curricula. The output of this work is detailed in the joint report Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach.
The recommendations in this document are based on a detailed review of the literature and expert opinion on best practice. It examines those aspects of the CMT curriculum that can be appropriately and effectively taught using SBE and provides recommendations for their mandatory implementation.
The key findings are as follows:
- There is good evidence (T3)1 that certain CMT practical procedures (central venous catheterisation, thoracentesis, abdominal paracentesis) and emergency presentations (cardiorespiratory arrest) can improve patient outcomes if taught using SBE. There is no obvious reason why additional CMT procedures should not also be taught using SBE, indeed the evidence points to it being desirable to do so
- There is reasonable evidence (T2) that non-technical and human factors skills required by CMT can be effectively taught using SBE
- The teaching of CMT essential and desirable procedures (see Appendix 2 for more details) and also non-technical skills using SBE is already widespread within the UK and CMT TPDs support this training.
The findings are intended to assist Training Programme Directors, Heads of Schools of Medicine, Foundation Schools, Local Offices of HEE, consultants and everyone else involved with the delivery of CMT, in understanding exactly how and where simulation can be used most effectively to improve educational outcomes and trainee experience.
The report and its findings were discussed at the Conference of Postgraduate Medical Deans (COPMeD) in February 2017 and received well. Following this, the JRCPTB will put the proposal for simulation to be included as a mandatory element of the new internal medicine curriculum, to be submitted to the General Medical Council later in 2017.
The supporting evidence for this action, plus additional recommendations, is discussed in the main report. It should be noted that all different types of SBE can be used to achieve the required learning outcomes. Examples include (but are not limited to) task training, manikin-based simulation, standardised patient approaches or virtual reality. This is subject to the availability of equipment and faculty.