ACCS Trainee Emergency Medicine Human Factors simulation day
October 24, 2019
Ben Short
The team dealing with the blocked tracheostomy scenario
This RCEM training day was aimed at providing ACCS trainees with a day of diverse simulation scenarios to explore and improve their understanding of Emergency Medicine Non-technical skills.
The day started with an introduction to EM non-technical skills with some examples of good and bad practice as well as exploring the four main domains:
Maintenance of standards
Teamworking and co-operation
Situational awareness
Decision making
The day then proceeded to go through a number of scenarios with feedback focussing on the non-technical aspects of performance and how they affected the care the patient received.
The scenarios were:
Acute Severe Asthma
Upper GI Bleed
Pneumonia with sepsis and fast AF
Severe COPD/end of life decision making
Tricyclic overdose
Silver Trauma with head injury and dropping GCS
Tracheostomy blocked with secretions from LRTI
The Salisbury SimWessex team facilitating the sepsis scenario
Some of the non-technical objectives covered in the scenarios:
Using a cognitive pause to update the team and save time later on – 10seconds to save 10minutes.
Use of closed loop communication.
The importance of situational awareness and trying to avoid becoming task focussed when leading the team
SBAR and other handover templates to improve handover and referral communication.
Graded assertiveness to prevent error – PACE and CUSS.
Using the Zero-point survey to prepare for resuscitation scenarios.
Using cognitive aids when available, e.g. ALS algorithms or Toxbase.
Effective leadership styles when working in resuscitation situations.
Techniques to deal with difficult colleagues/specialities.
ACCS delegates and SimWessex facilitators at the end of the day
There was also a short talk on graded assertiveness which showed a clip from a video by Martin Bromley documenting some of the human factor errors which led to his wife’s tragic death during a routine operation.
Thank you to the Salisbury simulation team for helping to facilitate a useful and thought-provoking day.
