CLINICAL SKILLS Managed Educational Network
Excellent Skills for Excellent Care
Newsletter 18: September 2012
NHS Scotland Event 2012 - Driving Quality through Innovation
This year’s event was held on 21st and 22nd June at SECC, Glasgow and showcased a
range of new technologies and novel approaches to healthcare. The CS MEN Team were
delighted to be back again and helped to facilitate one of the parallel sessions –
Improving Patient Care Through Human Factors.
This interactive session, chaired by Professor Philip Cachia, NES Clinical Skills and
Patient Safety Lead, introduced participants to the human factors experts who were able
to share evidence from high reliability organisations and Health Service colleagues who
have used human factors principles to reduce harm and improve safety and effectiveness
of care.
Mr Malcolm Wright, CEO NES, opened the session looking at the gentle change that is
taking place across NHS Scotland towards reducing harm. Dr Rona Patey gave a
stimulating talk on human factors and how health care can learn from other industries.
She provided examples of good practice that had already been adopted into health care
showing how a human factors approach makes it easy for staff to do the right thing every
time, every patient.
This was a truly interactive session using student responders – a quick and easy way for
the audience to participate with the speakers.
From the questions Dr Patey asked we found our audience was truly multi-professional –
the biggest groups were medicine (35%) and nursing (15%). There was also a fairly large
contingent from healthcare management (10%) and postgraduate health care education
(10%).
Over a third of the audience were already working on a human factors initiative and most
of these were across institutions. Another third of the audience were keen to start a
human factors initiative. Interestingly, almost half of the audience felt they had never had
any human factors education or training.
The floor was then opened up for questions with our expert panel – Professor Rona Flin,
Dr Michael Moneypenny, Dr Rona Patey and Professor George Youngson - providing
advice and examples of best practice. This included where human factors training had
already had an impact on both the technical and non-technical skills of a number of health
professions across Scotland.
Sadly our session ran out of time too quickly but NES along with the human factors
experts, will continue their work to develop human factors training for healthcare staff
across Scotland.
A copy of Dr Patey’s presentation can be found on the CS MEN website
(www.csmen.scot.nhs.uk).
Paris in the Spring –
International Forum on Quality and Safety in Healthcare 2012
17-20 April 2012, Le Palais des Congres de Paris, France
This year 79 countries were represented with around 2500 delegates in attendance.
Maureen Bisagnamo of Institute for Healthcare Improvement, Massachusetts US, in her
keynote address suggests that to have an impact on the patient experience of care we
should ask patients and families, ‘What matters to you?’ instead of ‘What’s the matter’?
Often patients and families are unable to focus on their immediate health needs because
‘life’ just gets in the way.
This resonated with me and many of the delegates I spoke to during the conference as a
very powerful driver for changing our perception of ‘the patient’. The healing power of
being happy and feeling respected and cared for with your individual needs met is one
that I have carried into my day-to-day thinking around the development of educational
resources for patient safety education.
Lyn Halley and I presented a poster showcasing our work around patient safety education
in the Training Development Support Team as part of our contribution to the NES Patient
Safety Group. The poster gave me an opportunity to interact with people from around the
UK and beyond who have a shared interest in such work. Learning from others and
sharing knowledge is one of the very useful things I take from attending these
conferences. The spark of new ideas for myself in the design of training courses and
associated resources is often provided by engaging with others.
I wanted to share my thoughts on one presentation in particular:
‘Transformation by Design: How design thinking can revolutionise healthcare
improvement’ was presented by Lynne Maher and Mark Mugglestone (NHS Institute for
Innovation and Improvement).
The main thrust of this presentation was that design methodologies offer us useful
insights into improvement ideas designed to impact on patient safety.
We spend a lot of time and effort designing a process but then forget to update it,
consequently we end up with processes that become ‘the way we do things around here’,
instead of a process, accounting for changes in people, technology and resources, that
delivers the outcome.
An example of re-design driven by qualitative narrative was given:
‘On a stroke ward patients were often de-hydrated; when the patients were asked
why they were not drinking fluids to keep themselves hydrated an interesting issue came
to light: the toilet roll holder in the toilet cubicle was on one side as you would expect, so
patients who had a deficit in leaning over to one side would often fall over in trying to
reach the toilet roll. This led to fear, which resulted in minimising their fluid intake to
reduce the need to go to the toilet’.
As a result of capturing the narrative of patient experience instead of measuring
satisfaction levels with outcomes, the stroke ward was able to understand what was
required to improve experience that had a large impact on many different outcomes.
Mark Johnston
Patient Safety Training and Research Officer, NES
Scottish Clinical Skills Network Conference
The 12th Annual Scottish Clinical Skills Conference was held on 30 and 31 August at
Edinburgh Napier University, Sighthill Campus. The theme of the Conference this year
was “Human: Clinical Skills in Person Centred Care”. The Conference was a great
success with over 90 delegates in attendance. Keynote presentations came from a variety
of speakers with our very adaptable Chair, Graham Nimmo stepping in at the last minute
when a keynote speaker had to cancel. Graham and Jerry Morse also ran a workshop
“Integrating Simulation and Patient Safety: From Pedagogy to Practice” which was
enjoyed by all those who attended.
At the AGM, held on the first day of the Conference, Helen Henderson was nominated as
the new Chair. Helen has been a member of the Steering Group for a number of years
and is a Lecturer in Adult Nursing at the University of the West of Scotland.
For further details of the Network and the Conference go to:
http://www.knowledge.scot.nhs.uk/scottish-clinical-skills-network.aspx
Lynne Egan
Scottish Clinical Skills Network Administrator
2012 CS MEN Annual R&D Conference
When: 19 November 2012
Where: Stirling Management Centre, University of Stirling
We are very pleased to announce that the keynote speaker at our conference will be
Charlotte Rees, Professor of Education Research and Director of the internationally
renowned Centre for Medical Education at the University of Dundee. Charlotte has
developed a programme of research about patient-centred professionalism in medical
education and her talk is sure to be stimulating and informative.
This will be followed by presentations from the 2010 and 2011 Award Winners. The 2010
completed projects will showcase the demonstrable benefits their research has made to
patient experience and/or patient safety. The 2011 Award Winners will showcase the
aims and objectives of their research along with the progress they have made so far.
This Conference will be of interest to all healthcare professionals involved in clinical skills
practice and education.
Attendance is free of charge and lunch is provided – book early as places are limited!
To register, email: csmen@nes.scot.nhs.uk
Building a toolkit for interprofessional clinical skills education
in the practice placement setting: Why reinvent the wheel?
The Fife Interprofessional Clinical Skills Model for Education (FICSME) was developed
and implemented to provide structured interprofessional learning opportunities within the
practice placement setting for students from a number of different health care
professions. Working collaboratively with NHS Fife, NHS Tayside, the Universities of
Dundee and St Andrews, Veronica O’Carroll has been developing and implementing the
model over the past three years, working with existing interprofessional initiatives in NHS
Fife and developing and coordinating further opportunities for all students who pass
through Fife on their practice placements. Currently, students have the opportunity to
participate in a variety of interprofessional learning opportunities during their placements
which include Teamwork and Patient Safety Workshops and learning activities involving
patients.
“Don’t reinvent the wheel”….that was the sound advice many of Veronica’s colleagues
gave her when it came to planning learning activities that would be relevant to students
from a variety of health and social care programmes of study.
Focusing on teamwork and patient safety provided the opportunity to work with reliable
existing teaching resources and to adapt them to enhance the interprofessional learning
experience, for example, using resources from the WHO Patient Safety Curriculum
Guide, from CS MEN’s own clinical skills toolkit and also working with educators in NHS
Fife to adapt teaching material that they would normally use for teaching single
professional groups of students or staff. The Interprofessional Clinical Skills Education
community site on the Knowledge Network, NHS Education for Scotland website
www.knowledge.scot.nhs.uk/ipcse.aspx provides a platform and a toolkit through which
resources can be shared with educators, to help in planning, delivering and evaluating
interprofessional education within the practice placement setting.
From scenarios which have been used within interprofessional workshops to examples of
ways in which interprofessional learning can be evaluated, these have been developed
using already existing tried and tested resources which can be adapted to suit different
educational environments. Setting up and sustaining interprofessional education is
challenging enough, so why reinvent the wheel?
Veronica O’Carroll
Nurse/Lecturer
St Andrews Medical School
Report from the Mobile Skills Unit
The Mobile Skills Unit (MSU) continues to travel the length and breadth of Scotland
facilitating clinical skills teaching across a broad range of topics.
Since May the MSU has visited Orkney and Shetland and the SORT Team in Aberdeen
who trained on the Unit in July. There have been two very successful weeks in Barra and
Benbecula with the Highlands tour continuing with visits to Tiree, Lochgilphead, Islay and
Mull in October. From there it will visit NHS Borders in November and Ninewells Hospital,
Dundee in December.
Courses run cover a wide range of topics including ALERT, BLS, Obstetric Emergencies,
Sepsis, ECG interpretation and Vital Signs. The EMRS and PAEDs courses continue to
be a strong feature of our training.
So far this year, over 180 staff have attended courses - once again the feedback has
been very positive. Here is some we have received so far:
“participating in the scenarios and receiving in depth explanation which enhanced my
learning and comprehension”
“Friendly, approachable staff, feedback given constructively.”
“Informative and interesting, highlighting my need to develop my drug knowledge, actions
and counter reactions”
“The course was very interesting and I feel I have learnt new skills”
“These sessions are always very useful”.
We are now taking bookings for the MSU for 2013 so please call the Mobile Skills Unit
Project Officer on 01382 425735 or email csmen@nes.scot.nhs.uk to ensure you get your
slot!
We are pleased to announce that further Faculty Development Courses are being
planned for the rest of the year, so if you would like to use the MSU in your area and
would like to learn how to use the simulators and audiovisual equipment on the MSU,
please contact the CS MEN office for further information.
New Simulation Equipment for 2012
We have recently purchased a SimJunior manikin for use on the MSU which
complements SimMan and SimBaby. Together these three simulators form a
comprehensive life support system.
We also have two simulators for intramuscular injections (the Ventrogluteal Intramuscular
Injection Simulator and the more basic Intramuscular Injection Simulator). The
ventrogluteal intramuscular injection model has an alarm if the wrong site is selected and
the more basic model can be used for three different types of IM injections – Gluteus
medius, ventrogluteal and Vastus lateralis. Due to space constrictions these are not
routinely held on the MSU – however they can be added on request. These models will
also be available to hire in conjunction with piloting the new CSMEN e-learning resource
on IM injections. If you are interested in running a pilot, contact us at:
CSMEN@nes.scot.nhs.uk
Workshops
“Safe Communication Skills”
Rona Patey and Jean Ker delivered a one -day workshop on behalf of CS MEN at
Ninewells Hospital on 1st August for 17 participants who came from all of the regions of
Scotland. The focus of the workshop was safe communication with colleagues.
This was very much a hands-on workshop building on the experience of participants in
their own workplace. It gave everyone the opportunity to share their experiences in a nonhealth care context in relation to speaking up, safe handover and learning to apologise
and then applying these in a simulated health care context through role play. All
participants went away, having worked through most of the exercise and activities in
teams, with a certificate and a planned intervention for their own workplace.
Further workshops are planned; contact the CS MEN Office for more details.
“Giving effective feedback”
A very successful half-day workshop on giving effective feedback was held at the Centre
for Health Sciences in Inverness on 18 June 2012, led by Jean Ker as part of the faculty
development workshop series promoted by CS MEN. Participants came from all over the
north region and included those with minimal experience of using simulation and those
with experience of running national resuscitation and Advanced Life Support courses.
This was part of a three-workshop series related to developing, delivering and debriefing
scenarios.
One participant VC’d in and this worked well as she was able to engage seamlessly with
all the small group activities. Experiences of both giving and -receiving feedback were
shared and explored with various models used to practise in role play situations. The
Centre staff were most supportive in ensuring things ran smoothly and it was good to
meet both new and familiar faces. The Workshop series has received excellent reviews
so if you would like it run in your region, please contact the CS MEN office.
Collaborative Working
Simulation Development Officers
A health science simulation-based education project has been developed by the Higher
Education Academy (HEA) in partnership with the Association for Simulated Practice in
Health Care (ASPiH). The purpose of this UK-wide initiative is to build added value to the
Department of Health’s Framework on Technology Enhanced Learning and will enable
several of the education bodies in the new NHS in England to learn about each other’s
organisation. This will also complement the excellent work of the CS MEN over the past
four years.
The first phase is the establishment of approximately eight Simulation Development
Officers (SDOs) across the UK who will have a shared regional remit to bring together
capability between HEIs and the NHS to develop a workforce with appropriate skill
capabilities. This will in turn allow the delivery of consistently high standards of patient
care. One of the key focus areas will be evaluating the best evidence for the use of
simulation to support the delivery of the strategic workforce plans across the UK.
Jean Ker, as NES Clinical Lead, has been appointed to the Project Strategy Group which
will ensure the CS MEN programme is built on and developed. A joint meeting between
the SDOs and Regional Champions is being planned once the appointments are
completed.
The Faculty of Surgical Trainers
This faculty was established in November 2011 to promote excellence in surgical training
and support of the surgical trainer, and is being led by Craig McIlhenny, a consultant
urological surgeon in NHS Forth Valley. They will be introducing a tiered membership
system of Associate Member and Fellow of the faculty. This is a trail-blazer which
prepares the way for the GMC revalidation for doctors as trainers which in due course will
apply to all professional health care practitioners.
There are opportunities for collaboration with CS MEN which will be explored at one of
our upcoming Regional Champions Meetings. The CS MEN is already supporting
developments of the ‘surgical boot camp’ through our R&D awards, thereby developing a
track record of working successfully with our surgical colleagues. The support of the
RCSEd for the Simulation Development Officer programme will enhance the added value
we can achieve through networking standards.
South and East Consortia
From Janet Skinner
Thanks to everyone who took part in Anna’s feedback workshop in June, it was a really
good session and I think we all got a lot out of it. We also had a good session at the end
of June on writing better scenarios for simulation. We had a really great mixed group and
worked in small groups to set learning objectives for an acute adult and paediatric
scenario and a palliative care communication scenario. Thanks to the group for being so
enthusiastic. We’re planning to run more workshops in the SE in the Autumn on running
scenarios on SimMan - more news to follow regarding dates and times. There are lots of
speakers from the S E due to present at the CS MEN Research and Development
Conference on 19th November. It’s excellent to see the region represented so well and I
am really looking forward to the day. Hope to see you all there!
Janet Skinner
West Consortia
From Anna O’Neill
I thoroughly enjoyed taking the workshop “Exploring Principles and Practice around
Effective Debriefing and Feedback” to the South East region with Janet Skinner. It was a
busy workshop with 29 people attending.
The draft programme for our own R&D Conference on 19 November looks really
interesting with talks from the popular Podcast Group lead by Alna Robb at Glasgow
University as well as new 2011 award winner Sofia Chaudhri on Evaluation of Skills
Based Training Progress for Critical Care (Difficult Airway)
I am planning to run more workshops later in the year; more details to follow
North Consortia
From Jerry Morse
We have had another busy and valuable session in the North Region.
In June we delivered the third in our series of workshops on multidisciplinary scenarios. I
am extremely grateful to Jean Ker who stepped in at the last moment to deliver this
workshop in Inverness where we had 17 people attend “Debriefing Multidisciplinary
Scenarios to assist in ongoing Inter-Professional Education”.
Jean also delivered a workshop on “Safe Communication Skills” in Dundee with Rona
Patey. This was also a very successful day with excellent feedback and it is running again
in October. Due to the high demand for this course we hope to run it again next year.
Later this month I am off to Lochgilphead, to deliver a workshop on “Developing
Scenarios” aboard the Mobile Skills Unit. Then in December I will be in Dundee to help
demonstrate the breadth of training that the MSU can facilitate to Allied Health
Practitioners at their education conference (Tayside).
I hope to see you on my travels – please come and say hello. If you would like to know
more about what is going on in the region, feel free to contact me at:
jerry.morse@abdn.ac.uk
Contact
tel: 01382 425 735
e-mail: CSMEN@nes.scot.nhs.uk
web: www.CSMEN.scot.nhs.uk
© NHS Education for Scotland 2012. You can copy or reproduce the information in this
document for use within NHSScotland and for non-commercial educational purposes. Use
of this document for commercial purposes is permitted only with the written permission of
NES.