International Journal of Healthcare Simulation

Background:

The physician associate (PAs) profession is a relatively new profession to the NHS. As such, there is no official national or regionally agreed further training to support PAs transitioning from PA school into clinical practice once they have graduated. Simulation training has proved to be an effective tool for developing clinical and non-clinical skills in other groups of clinicians ^[1,2]. We have adapted an already implemented simulation programme for junior doctors to make it suitable for the PA profession with the aim of improving the confidence and skills of PAs working in primary and secondary care. We have evaluated the perceived beneficence of our initial work and have so far observed a perceived positive impact.

Aim:

We aimed to describe the development and implementation of a novel PA-specific simulation training programme and present the evaluation of our initial work.

Method:

We designed and implemented a bespoke simulation training programme based on existing training for junior doctors. This model has three separate simulation sessions, spaced over 2 years, each session has three different clinical scenarios. Seventeen PAs have undergone the first two sessions. The first session contained three scenarios that highlighted important local protocols such as the major haemorrhage protocol and the sepsis ^[6]. The second session contained three clinical scenarios which followed the same patient’s journey: diagnosis of myocardial infarction, cardiac arrest scenario and breaking bad news. We then collected feedback from candidates’ written feedback and Likert-scale questions.

Results:

At this point in time, we have feedback from 16 candidates from session 1 and 11 from session 2. The results are overwhelmingly positive showing improved confidence, better team-working skills and a perceived perception of improved patient safety following the simulation training, as shown in graphs 1 and 2. The majority of candidates partaking in the session found the simulation training beneficial to their practise. The main negative feedback given was the lack of ‘senior support’ (i.e. from a senior doctor) in the scenarios that were unrealistic to actual practice.

Implication for practice:

The introduction of a novel PA simulation training programme has demonstrated improvements in clinical and non-clinical skills. This supports our aim of improving post-graduate PA training. Work continues to further develop our PA simulation programme and further evaluate its effectiveness with the aim of making this as a regional simulation programme that PAs can undertake when joining the healthcare workforce.