Clearly, for the Junior Doctor of 2015 real-life clinical experience in the wards is second to none in terms of learning and professional development. However, for training to manage time critical emergencies effectively using clear clinical communication and effective teamwork simulation has an increasingly important role. We believe that you need the “big” flagship simulation courses (e.g. ALS and ATLS) as well as regular “bite sized” simulation (e.g. in-house team training). Major courses along with everyday reflective practice help develop the Junior Doctor’s ‘Crisis Management‘ skill set and regular brief simulations help refresh and maintain these skills. Indeed, a combination of flagship courses and in-house / in-situ simulation are probably the best way to maintain clinical credentials and crisis management skills for all busy healthcare professionals.
With more interns than ever being trained in Australian hospitals (and in turn our trainees having less and less responsibility in their early training especially in major teaching hospitals) regular simulation ensures our team is continually ready for action.
To highlight the best use of Simulation Training we use the analogy of the ‘Pharmacokinetics’ of Simulation Training and the use of Multi Dose Activated Simulations (MDAS):
Single Simulations – A Suboptimal Dose Response
Multi-dose Activated Simulation (MDAS) – Optimal Dosing
In conclusion, when planning your future training (or the training of others) consider the need for gaining skills in managing critically unwell patients in the context of increasing trainee numbers. In addition, consider ‘MDAS’ as a good way to maintain these skills by using regular in-house refreshers for all staff focusing on the key components of Crisis Resource Management.