Abstracts: Meeting of the Society in Europe for Simulation Applied to Medicine (SESAM), 10-11 May 2002: Santander, Spain
The Bristol Medical Simulation Centre (BMSC) has undertaken 7 General Practitioner (GP) half-day refresher courses between January 2001 and February 2002 (Table 1).
Setting the scene: The adult METI Human Patient Simulator was positioned lying face-up fitted with a cannulation arm on a couch reading a book in front of a television to set the scene for a home visit or doctor's surgery. The GPs were briefed with some patient details before each scenario and were equipped with a 'black bag' (Table 2).
Course content: The programme comprised four scenarios interspersed with debriefing.
Scenario 1. After climbing the stairs at home, the patient develops a myocardial infarction leading to cardiac arrest.
Scenario 2. The patient falls in his home and develops an intra-abdominal bleed and simple pneumothorax, which progresses to a tension pneumothorax.
Scenario 3. The doctor is called by the practice nurse to the treatment room to assess a patient who has developed a systemic reaction to a routine inoculation, which results in anaphylactic shock.
Scenario 4. The patient is rushed to the surgery after eating a chocolate covered peanut developing anaphylaxis leading to a 'can't intubate can't ventilate' scenario.
Course feedback: From 50 attendees 32 GPs completed standard BMSC questionnaires. Results were as follows (Table 3).
A selection of comments:
'An enjoyable and extremely useful afternoon. Very realistic scenarios and well acted';
'Excellent, unthreatening atmosphere. Very clear, relevant explanations';
'Much better way of remembering. Staff non-threatening. Thanks';
'Very good. Not as frightening as I thought it would be';
'Useful as both an individual and a group observer';
'Excellent method of teaching, made more aware of what is available to the average GP'.
Conclusions: General practitioners unanimously think: there is a role for the simulator in teaching and that it greatly improved their practical skills (more so than other groups of delegates); confidence in dealing with patients (in critical situations; more so than other groups of delegate); familiarity with equipment (such as tracheostomy kits) and understanding of basic sciences (using the latest BLS/ALS protocols).
94% of GPs thought that the session was best covered in the simulation centre environment and indicated it as the most useful method of teaching.
Comments: The BMSC has diversified this course by piloting two variations in the GP refresher course for (a) Cardiac GPs and (b) drug specific courses such as a ketamine GP course for BASICS trauma GPs (trauma first responders).
The senior author of each article has confirmed that the ethical aspects of these studies have been approved (a) for clinical studies by the Institution or an Ethics Committee and, if applicable, that informed patient consent has been obtained, (b) for experimental studies, involving the use of animals, by the institution and that the animals have been treated according to good practice.