Meet the team: Simulation In Psychiatry #SimInPsych
Associate Director for Quality Improvement
Sussex Partnership NHS Foundation Trust
- England - Kent Surrey Sussex
- Richard Kerslake - Project Lead, Psychiatry Higher Trainee and Brighton & Sussex Medical School Simulation Fellow
- Jane Bruce - Associate Director of Nursing, Sussex Partnership NHS Foundation Trust
- Taryn Paten - Darzi Fellow and Community Mental Health Nurse
- Jo Mitchell - Physical Healthcare Lead Nurse, Sussex Partnership NHS Foundation Trust
- Karen Burch - Project Manager, Sussex Partnership NHS Foundation Trust
- Louise Patmore - Patient Lead, Sussex Partnership NHS Foundation Trust
- Cavita Chapman - Senior Project Manager, Strategic & Commercial Development, Sussex Partnership NHS Foundation Trust
- Devon Puttick - Project Officer, Health Education England Kent Surrey and Sussex
- Fraser MacNicoll - Psychiatry Core Trainee and Simulation Facilitator
- Craig McEwan - Psychiatry Core Trainee and Simulation Facilitator
Funding from this Q Exchange bid will allow for the development and delivery of a simulation training programme, with a focus on training mental health nurses, alongside auxiliary professions, to address the physical health needs of patients with severe mental illness (SMI). This will form part of a wider simulation training syllabus (Fig.1) which is being developed in Kent, Surrey & Sussex (KSS).
NHS England has highlighted the “striking figures” show that SMI patients die on average 20 years earlier than the general population due to preventable physical health problems – a life expectancy similar to the 1950’s. Mental health staff, most notably the nurses, represent a key stakeholder in the lives of people living with SMI. However the training that these professionals receive to address physical health issues is not sufficient to address this inequality in morbidity and mortality. This is why we believe that mental health staff must be engaged with the latest in evidence based adult learning techniques, so that they can be empowered to address their patients’ physical health alongside their mental health needs. We believe that simulation training can be the catalyst for a cultural shift, away from compartmentalised health care, towards achieving the parity of life-expectancy that should be expected in 2018.
Simulation training is an approach to training in health care, whereby a group of learners are engaged in a realistic replication of work scenario, with actors playing the part of patients. The majority of meaningful learning then occurs through peer-to-peer debriefing. After the learners have been immersed in the simulation, they are debriefed by a trained facilitator who will enable peer supported learning, to develop a new and shared understanding of how such events can be applied to improve their daily clinical work. The strength of simulation training is that it harnesses adult learning models to ensure that learning becomes an active process, where human factors can be closely scrutinised to deliver improvements to clinical practice that can be evidenced. This type of learning cannot be achieved through didactic lectures or online courses. This type of learning is the key to delivering meaningful training to an established NHS workforce.
‘Simulation in Psychiatry’ is planning to use the funding from Q-Exchange to deliver the ‘Stream 2: Nursing staff’ and ‘Stream 3: Auxiliary staff’ of a 3 streamed syllabus approach (Fig.1) to develop simulation training in Kent Surrey & Sussex (KSS). Fig.1 illustrates the overlapping of disciplines in training events, with scenarios carefully designed to allow for learners to participate from a range of disciplinary background, including paramedics and police officers, taking into account the range of professions that support mental health services users. This allows for peer learning to be achieved through understanding of the competing needs that each profession experiences at the interface of hospital and community health care. This creates an environment where different professions can support each other as peers, to identify a shared understanding of how their work with service users must evolve and what direction that cultural evolution should take.
Each stage of the syllabus will deliver training on a topic identified as necessary for improving the lives of mental health service users. The learning objectives for these stages will be designed using an evidence based approach to improving the physical health of people living with SMI.
An example of a simulated scenario for mental health nurses would involve a patient with diabetes who has poorly controlled blood sugars. This style of learning explores the human factors that influence access to medical services and the motivational interviewing techniques that enable service users to negotiate psychosocial factors that influence their care.
An example of a simulated scenario for auxiliary health care workers would be a patient with SMI who requires police and paramedics input to attend the Emergency Department for a combination of physical and mental health needs. This scenario lends itself ideally to develop cohesive inter-professional working and ensure the best outcome with the patient at the centre.
We consider service user involvement to be a crucial element to ensure that realistic simulation scenarios are created. Scenario development will be directly influenced by the Service User Networks embedded in KSS. Furthermore, there is a growing body of Peer Support Workers within KSS who will be encouraged to participate in the Stream 3: Auxiliary staff, with the intention that they will themselves become facilitators for the simulation debriefs. The final stage of the syllabus will be a simulation training facilitator course. This will deliver sustainability of the model, as new staff are enrolled to facilitate the debriefing exercises to future cohorts of learners, providing true fidelity to the model of service user and peer support engagement.
How you can contribute
- Ideas on extended ways we can analyse of the effect of the training to the level of the service user.
- Ideas for reducing costs for running the course, eg. links to acting schools.
- Ideas to increase the likelihood of staff being released from daily clinical duties to attend the training.