Low Fidelity Simulation as a Mechanism to Enhance Midwifery Students’ Confidence in Relation to Emergency Obstetric Training

Simulation offers a safe opportunity for students to practice clinical procedures without exposure and risk of harm to real patients (Partin et al, 2011). Simulation is recognised to increase students’ confidence in their ability to make critical decisions (McCaughey and Traynor, 2010). Within Queen’s University Belfast, simulation for obstetric emergency training based on the ethos of ‘Practical Obstetric Multi-Professional Training[PROMPT]’ (Draycott et al, 2008) has been developed for midwifery students and is now uniquely embedded within the pre-registration curriculum. An important aspect of the PROMPT training is the use of low fidelity simulation as opposed to high tech support (Crofts et al, 2008). Studies have reflected that low fidelity simulation can be an effective tool for promoting student confidence (Tosterud, 2013; Hughes et al, 2013). Students are given the opportunity to experience obstetric emergencies within a safe environment and evaluation has indicated that students feel safe and have an increase in confidence and self-efficacy. The immediacy of the feedback offered by simulated situations encourages an exploration of beliefs and attitudes, particularly with peers, promoting a deeper sense of learning (Stoneham and Feltham, 2009).This paper will discuss why low fidelity simulation can effectively enhance the student experience and promote self-efficacy.

Vision and deaf awareness training is it app.ropriate?

Title
Visual and deaf awareness training is it app.ropriate
Purpose
Some of our most vulnerable patients have a sensory deficit. An app which focused on patients with a vision and/or hearing loss was developed for healthcare students. The intent was to embed the core values necessary for students to provide appropriate care for patients with a sensory deficit.
Setting
Queen’s University Belfast, School of Nursing and Midwifery.
Methods
Stage 1
A review of current sensory awareness training in the United Kingdom
Stage 2
Application for funding
Stage 3
Development of a teaching tool template with the essential aspects required for sensory awareness training
Stage 4
Collaboration with others: Royal National Institute for the Blind, Action on Hearing Loss, Computer technician.
Stage 5
Production and transfer of multimedia outputs onto a software application system.
Stage 6
App Piloted with a sample of lecturers (n=5), undergraduate nursing students (n=20), service users (n=5)
Stage 7
Editing
Stage 8
App made available to all undergraduate nursing students
Stage 9
App evaluation (n=300)



Results
Overall nursing students positively evaluated the app, 100% of students rated the app between good and excellent. Qualitative evidence from service users and practice partnerships was extremely positive:
"At last I feel listened too in respect to my hearing loss and empowered. I don't feel like I am complaining I am actually helping to create something which should benefit staff and all of us with a hearing or vision loss". Patient
“Very insightful into the lives of those with a disability will be so useful in practice as an aid to jog my memory". 1st year nursing student
Conclusion
It is hoped that further evaluation and implementation of the app will show an improved quality to the care delivered to those with a sensory deficit. We believe that by working in partnership with service users we have helped to create an innovative tool that benefits both staff and patients.
Financial disclosure Yes
Funding of £2700 was awarded in 2014 through the Martha McMenamin Memorial Northern Ireland Scholarship.

Realistic evaluation of EWS and ALERT: factors enabling and constraining implementation.

Realistic Evaluation of EWS and ALERT: factors enabling and constraining implementation Background The implementation of EWS and ALERT in practice is essential to the success of Rapid Response Systems but is dependent upon nurses utilising EWS protocols and applying ALERT best practice guidelines. To date there is limited evidence on the effectiveness of EWS or ALERT as research has primarily focused on measuring patient outcomes (cardiac arrests, ICU admissions) following the implementation of a Rapid Response Team. Complex interventions in healthcare aimed at changing service delivery and related behaviour of health professionals require a different research approach to evaluate the evidence. To understand how and why EWS and ALERT work, or might not work, research needs to consider the social, cultural and organisational influences that will impact on successful implementation in practice. This requires a research approach that considers both the processes and outcomes of complex interventions, such as EWS and ALERT, implemented in practice. Realistic Evaluation is such an approach and was used to explain the factors that enable and constrain the implementation of EWS and ALERT in practice [1]. Aim The aim of this study was to evaluate factors that enabled and constrained the implementation and service delivery of early warnings systems (EWS) and ALERT in practice in order to provide direction for enabling their success and sustainability. Methods The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews, observation and documentary analysis in a two stage process. A purposive sample of 75 key informants participated in individual and focus group interviews. Observation and documentary analysis of EWS compliance data and ALERT training records provided further evidence to support or refute the interview findings. Data was analysed using NVIVO8 to categorise interview findings and SPSS for ALERT documentary data. These findings were further synthesised by undertaking a within and cross case comparison to explain the factors enabling and constraining EWS and ALERT. Results A cross case analysis highlighted similarities, differences and factors enabling or constraining successful implementation across the case study sites. Findings showed that personal (confidence; clinical judgement; personality), social (ward leadership; communication), organisational (workload and staffing issues; pressure from managers to complete EWS audit and targets), educational (constraints on training; no clinical educator on ward) and cultural (routine task delegated) influences impact on EWS and acute care training outcomes. There were also differences noted between medical and surgical wards across both case sites. Conclusions Realist Evaluation allows refinement and development of the RRS programme theory to explain the realities of practice. These refined RRS programme theories are capable of informing the planning of future service provision and provide direction for enabling their success and sustainability. References: 1. McGaughey J, Blackwood B, O’Halloran P, Trinder T. J. & Porter S. (2010) A realistic evaluation of Track and Trigger systems and acute care training for early recognition and management of deteriorating ward–based patients. Journal of Advanced Nursing 66 (4), 923-932. Type of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

Evaluation of Restorative Dentistry Specialty Registrars’ Clinical Experience of Developmental Disorders: A Survey

Background

Specialty Registrars in Restorative Dentistry (StRs) should be competent in the independent restorative management of patients with developmental disorders including hypodontia and cleft lip/palate upon completion of their specialist training.1 Knowledge and management may be assessed via the Intercollegiate Specialty Fellowship Examination (ISFE) in Restorative Dentistry.2

Objective

The aim of this study was to collate and compare data on the training and experience of StRs in the management of patients with developmental disorders across different training units within the British Isles.

Methods

Questionnaires were distributed to all StRs attending the Annual General Meeting of the Specialty Registrars in Restorative Dentistry Group, Belfast, in October 2015. Participants were asked to rate their confidence and experience of assessing and planning treatment for patients with developmental disorders, construction of appropriate prostheses, and provision of dental implants. Respondents were also asked to record clinical supervision and didactic teaching at their unit, and to rate their confidence of passing a future ISFE station assessing knowledge of developmental disorders.

Results

Responses were obtained from 32 StRs (n=32) training within all five countries of the British Isles. The majority of respondents were based in England (72%) with three in Wales, and two in each of Scotland, Northern Ireland, and the Republic of Ireland. Approximately one third of respondents (34%) were in the final years of training (years 4-6). Almost half of the StRs reported that they were not confident of independently assessing (44%) new patients with a developmental disorder, with larger numbers (72%) indicating a lack of confidence in treatment planning. Six respondents rated their experience of treating obturator patients as ‘poor’ or ‘very poor’. The majority (56%) rated their experience of implant provision in these cases as ‘good’ or ‘excellent’ with three-quarters (75%) rating clinical supervision at their unit as ‘good’ or ‘excellent’. Less than half (41%) rated the didactic teaching at their unit as ‘good’ or ‘excellent’, and only 8 StRs indicated that they were confident of passing an ISFE station focused on developmental disorders.

Conclusion

Experience and training regarding patients with developmental disorders is inconsistent for StRs across the British Isles with a number of trainees reporting a lack of clinical exposure.

An Evaluation of the Drug and Alcohol Service User Network in NI

Objectives:
The process evaluation will consider the views of the appointed SUN workers and representatives from selected service user groups as regards the setting up and maintenance of the SUN network. This component of the evaluation will also examine the perceptions of stakeholders from a number of relevant organisations.

The outcome evaluation will assess the effectiveness of the SUN project in achieving the intended outcomes as outlined in the original Action Plans.
The following outcomes will be evaluated:
To ascertain the level to which the SUN has provided support, information and advice to existing service user groups.
To examine the SUN co-ordination of Trust and regional networks of service user groups.
To consider how the SUN assists organisations to establish and maintain service user groups.
To examine the level of current and future membership of service users on relevant groups, with a particular focus on engagement of hard to reach populations.
To gauge service user perceptions of the Service User Network.
To examine the levels of training provided and consider the efficacy of training.