International Journal of Healthcare Simulation

Background:

The Simulation Centre, in a largest district general hospital, provides a large portfolio of scenario-based courses, for all staffing groups, including the development of modified rapid cycle deliberate practice (RCDP) simulation. Modified RCDP is a model of simulation where learners repeat a scenario, with micro-debriefings, allowing for improvement upon each cycle, in a dynamic learning experience [1]. The centre developed a hybrid style of RCDP and simulation to create a model called Die, Debrief, and Develop, with a focus on the initial response during a cardiac arrest, based upon safety learning events and staff confidence during these emergency events. The aim of the sessions was to improve learner confidence, focusing on technical and non-technical skills in a safe learning environment. The simulation approach was delivered within the clinical environment, utilizing a manikin and equipment on the ward, including the cardiac arrest trolley. A clear pre-briefing was provided to ensure transparency around the expectations within the scenario, for example, the patient will be in cardiac arrest. Due to the repetitive nature of the simulation, there was also the freedom to fail [2].

Methods:

Each cycle was 5 minutes and repeated 3 times, with a micro-debriefing between each cycle. The improvement between each cycle included patient assessment, ergonomics, human factors, critical thinking, communication, clinical skills and latent threats using elements of gamification. The micro-debriefing between each cycle allowed candidates to reflect on the experience to allow for improvement during each cycle.

Results:

As well as learning personal safety in the pre-briefing, patients and relatives in the clinical area were informed that the session would be taking place. The feedback from learning following the simulation sessions included:

‘I enjoyed cardiac arrest practice it made much more sense and more relatable than talking through what you would do!’

‘Was valuable learning and very relevant to our ward’

‘Has helped me understand cardiac arrest’

‘I feel empowered!’

‘Now I know where things are on the crash trolley’

Conclusion:

As a result of the RCDP model of training, this has been replicated in simulation sessions for Preceptorship and Internationally Educated Nurses. The outcome from this training has demonstrated the impact of RCDP in learner confidence and in technical and non-technical skills, that can be replicated in other forms of scenario-based training.

References

1. Peng CR, Schertzer, K. Rapid Cycle Deliberate Practice in Medical Simulation. Treasure Island, Florida: StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK551533/

2. Erickson A, Lundell J, Michela E, Pfleger PI. Gamification. In: Kimmons R, Caskurlu S (eds.) The Students’ Guide to Learning Design and Research. EdTech Books; 2020. https://edtechbooks.org/studentguide/gamification