Q Exchange
Multi-professional Simulation-Based Education : A Critical Tool for Managing Preterm Birth
- Proposal
- 2024
Meet the team
Also:
- Samantha Fleming
- Anda Bowring
- Tara Gradwell
- Carla Avery
- Jo Lawrence
What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?
60,000 babies are born prematurely in the UK annually. Preterm birth is a leading factor in childhood morbidity and mortality responsible for 69% of deaths within the first year of life. A major precursor to neonatal death and lifelong disability caring for a preterm baby has significant short- and longer-term financial impacts on health services, education services and the family involved.
There is an increasing body of evidence highlighting the disproportionately poor maternity outcomes including incidence of preterm birth for mothers and babies from minority ethnic backgrounds (MBRRACE -UK 2023).
Addressing these challenges are the focus of the the BAPM Framework on Extreme Preterm Birth and the MatNeo Safety Improvement programme and implementation of the evidence based pathway to optimise outcomes for preterm babies is recommended. The challenge is that this requires a highly skilled multiprofessional team with specialist knowledge, skills and importantly a culture of perinatal and multiprofessional working.
What does your project aim to achieve?
Our multi professional simulation-based education workshops enable multiprofessional teams to develop the skills to deliver effective in situ simulation training scenarios focused on the optimisation and stabilisation of preterm infants including the sensitive management of comfort-based scenarios. The workshops will focus on the importance of a psychologically safe environment where teams can have hands-on experience working through a variety of preterm birth scenarios.
The aim is to build confidence, enhance decision making abilities and reduce errors which are all factors we have identified as barriers to the successful delivery of the evidenced based perinatal optimisation care bundle.
We worked with a wonderful actress/role player in our pilot developing the script in collaboration with our experienced team of participants.
How will the project be delivered?
Our project is a series of one day workshops designed for maximum impact with minimum time away from clinical care.
A series of videos recorded by clinical experts and a service user on each element of the optimisation bundle is encouraged as pre course work .
Pre and post course evaluation to continuously refine and improve the project.
A successful pilot took place in December 2023 with one of our trusts . Gaining confidence from the positive evaluation our next phase is to refine the programme based on the feedback from the pilot. The remaining trusts are eager to participate, we will facilitate this over the coming months.
We will offer regular virtual action learning sets where teams who have completed the workshop can come together in a safe space to trouble shoot and share ideas, form a simulation-based education and learning community and a supportive network of expertise.
How is your project going to share learning?
Learning will be shared locally, regionally and nationally through our established networks of Local Maternity and Neonatal Systems ,clinical networks, with the National Patient Safety Collaboratives and Maternity & Neonatal Safety Improvement networks.
We will use blogs, a podcast ,case studies , webinars , submissions to newsletters and social media to help us disseminate learning .
We will present the project at Simulation and Education conferences and are invited to present at the Royal College of Midwives Conference in May .
We have excellent connections within the pre hospital, paramedic and Helicopter Emergency Service Air Ambulance teams and will avail of all opportunities to share learning with them.
We have partnered with Buckinghamshire New University who will complete a formal evaluation and offer academic reach and support us with publishing our work.
We are working closely with our maternity and neonatal voice partnerships to ensure the project is co-produced and informed by lived experiences.
How you can contribute
- We would like to develop the project further enabling us to achieve a wider reach across the UK and Ireland
- Can you suggest /introduce us to people and networks that we perhaps have not yet considered?
- We invite the Q community to share your expertise insight and critical friendship with us on this journey
- Help us to develop and refine our project idea by sharing it within your networks and with interested colleagues
- Share your experience in the design and development of professional materials including digital learning resources, an optimisation app and link us with people who may be able to advise us
- Tips on facilitating successful Action Learning Sets would be really useful
Plan timeline
| 31 Jul 2024 | Share successful bid information with key stakeholders |
|---|---|
| 31 Aug 2024 | SIM based-education workshops evaluation completed |
| 30 Sep 2024 | Project team review intelligence from the evaluation of the workshops |
| 31 Oct 2024 | Development of the curriculum content with academic, clinical, MNVP's partners |
| 28 Feb 2025 | Develop digital learning and multi-media resources |
| 30 Jun 2025 | Launch of final project outputs & full evaluation report completed |
| 31 Jul 2025 | Final budget and report to the Health Foundation |
Comments
Katie 20 Mar 2024
Hi Eileen,
Yes I can now see the video from Eleri Adams.
best wishes
Katie
Eileen Dudley 20 Mar 2024
Thank you Katie that great my IT skills are improving all the time it seems!!
sascha smith 20 Mar 2024
What a fantastic example of immersive MDT learning and reflection. I can see how the opportunity to 'practice' and learn with a team who you regularly work alongside in this simulated environment can bring about a depth of learning opportunities and develop practice to enhance outcomes. Also, enhancing the experience for service users and building positive working relationships amongst a team.
It is an exciting prospect that this project could be developed further and shared wider geographically. The resources are rich and diverse so a wide range of learning styles can benefit which is great.
Preterm birth optimisation is a key national and local priority for perinatal teams, and this sim tool is a fine example of how reports and recommendations are actioned practically.
Carrie Hamilton 19 Mar 2024
This project, from the outset, has been of exceptional calibre.
After the initial approach from the project team, for the supply of actor role players, we collaboratively worked through careful actor selection, actor preparation for role portrayal, actor understanding of learning outcomes, actor debriefing and actor de-roling, all of these being essential components when considering quality and psychological safety. We work through the principles of biomedical ethics (autonomy, justice, non-maleficence, beneficence) when working with actor role players in simulation; in every context this is essential, and critically important for roles within preterm neonatal care. Part of provision of our actor role players was to work with the project team and consider scenario authenticity, the ‘low-tech – high fidelity’ presentation and consent procedures.
It has been a true pleasure to provide ongoing support for this project. The attention to detail during preparation, liaison, and project planning through to delivery, has been impressive. We, at SimComm Academy wish to congratulate the project team and hope that this important work can be expanded. You are an astonishing team, totally focussed on the ultimate benefit - for families and for healthcare professionals delivering care.
Eileen Dudley 20 Mar 2024
Thank you Carrie and Sim Comm team
It is of crucial importance to the project team that the work is informed by experts where possible and I think you and your wonderful team genuinely understood the ethos of what we are trying to accomplish. Sophie the actor/role player is now an integral member of our team and her parting comment to me on the pilot day was she would like to be a midwife!
Emma Johnston 19 Mar 2024
As a mum of pre-term twins born some years ago, I have been working closely with the team behind this amazing project, and I can't express just how much of a difference it will make to families. The psychological impact of these experiences in the short and long term for these families is extreme. Any joined up training with the whole team, and parents, that find themselves in these situations, delivering our most vulnerable babies, has the potential to be life changing. Not just in saving more babies lives than ever before, but in understanding the impact this trauma has on parents and how this can be managed at the most precious time of their life, whilst giving birth to their child.
Chairing an amazing group of neonatal parents that volunteer their time to input in to projects of this nature, to help shape our neonatal services of the future, I know how well received this project would be. They are on hand to support this great work.
To me in these situations, my own experience, and listening to staff and neonatal parents over the last 15 years, culture is everything. Having an open, honest and safe environment to learn from each other, and experts in these fields, you just can't put a cost on. Confidence can make the difference in this life changing situation. If we have the ability to improve this confidence to deliver these tiny babies in the ways we now know offers them the best chances of survival, and long term quality of life, we should so everything we can to make it happen. This type of training bridges many barriers, taking the precious limited time we have to train, and learn together (maternity & neonatal professionals that wouldn't normally train together) as one, in the most enriching ways, empowering both staff at all levels, and thus parents.
Well done to the team for all this amazing work so far.
Eileen Dudley 20 Mar 2024
Thank you Emma
Co-production is essential to inform the development of this work and hearing the voices of parents and families who have experienced preterm labour and birth and the stress of a neonatal journey through experienced Parent Advisory groups and Maternity & Neonatal Voice Partnerships will ensure that the education content and design of the simulation scenarios s appropriate and relevant and informed by lived experiences.
Angelo Cavallaro 19 Mar 2024
This is an incredibly exciting project which could help in preventing and improve management of preterm birth. Preterm birth is the leading cause of perinatal morbidity and mortality. Optimal management at the time of delivery is crucial to ensure best outcomes. I hope this project will receive funding to be carried out as it will be game changing.
Dr Angelo Cavallaro
Consultant in Obstetrics and Fetal Medicine
Eileen Dudley 20 Mar 2024
Good to see and hear that senior obstetricians are supportive of this project . It is vital that we support multi-professional learning and working together to optimise outcomes and give each and every preterm baby and family the very best possible care. We know that improvements in working relationships are possible when teams work and train together with a lessening of the impact of hierarchies and the creation of a more positive kinder culture . We have seen this in our earlier work and within the pilot. Thank you for the positive support.
Katy Hoare 19 Mar 2024
This is an incredibly exciting piece of work, which has already had overwhelmingly positive feedback. Whilst teaching midwives on the annual mandatory training day, I have seen first hand that simulation-based education is rated far more highly by staff compared with the lecture-based approach. Simulation based learning provides a safe space to learn from each other within the MDT, and update even very experienced practitioners with the latest evidence-based practice. Additionally, practitioners value being able to become familiar with equipment in a hands-on way, alleviating anxiety when the equipment is used in a real-life scenario. As a Preterm Birth Specialist Midwife, I wholeheartedly support this project and hope it gets the traction and support it deserves!
Eileen Dudley 20 Mar 2024
Hello Katie
Exactly what we want to hear and absolutely what we have observed in our site visits in the earlier phase of supporting MTP clinical teams to implement the evidence based perinatal optimisation care bundle and pathway of care
Alison Provins 19 Mar 2024
This is a really interesting piece of work with a well thought out solution to a very important area of concern for many of us. It is clear that everyone who has been involved so far can see the need for this learning and it seems that you have taken a very pragmatic approach to providing training in a realistic and achievable way. I can see that you already have lots of interest for future training but I guess that the barrier to releasing staff will always be staff shortages, cost etc. I was wondering how you will be providing ongoing feedback to senior leaders in terms of success stories from the training combined with financial savings, improvements to staff morale, patient satisfaction etc. It is a shame we have to think like this but with so many conflicting needs it is important to ensure that managers and even colleagues can see tangible benefits even when instinct tells us that this is a brilliant use of staff time.
Eileen Dudley 20 Mar 2024
Hello Alison many thanks for your insightful observations . We are committed to pre and post course evaluation and refinement of the content as the project progresses and seek every opportunity available to us to ensure that we report back to our Local Maternity & Neonatal Systems Boards and Safety & Governance Groups and Regional MatNeo Clinical networks which have senior representatives from a wide range of disciplines . We will also share thematic analysis of the learning at the end of the 12 month programme .We also do quarterly review of exception reports for all preterm babies who are not born in a centre with Level 3 neonatal care facilities(i.e born in the wrong place) and can use that intelligence to share with senior teams learning from excellence but also where MTP teams can improve and include that learning in the simulation scenarios
Katie Lean 18 Mar 2024
Many congratulations that you have already undertaken a pilot and have evidence to this working well. Videos that can be uploaded onto a platform are a great way to spread learning and the workshop to consolidate learning is beneficial.
I like that idea of building a network of support for clinicians.
Good luck with the venture which can only be of benefit to staff and patients alike.
Eileen Dudley 19 Mar 2024
Thanks for the support for this project Katie and completely agree regarding the value of videos and the use of visual media to support and share learning.
Can I ask if you are able to see the url link which should take you directly to a recording by one of our Consultant Neonatologists?
Jo Lawrence 18 Mar 2024
I am honoured to have been invited to be involved in this project with my specialist interest in debriefing. This dedicated team have built, shared and developed this project over time to give their learners this wonderful opportunity to develop their simulation and debriefing skills. Being able to come together and reflect on the importance of psychological safety in simulation and debriefing, is a significant step forward in developing safe, non threatening learning environment for all involved. It’s important that this group find ways to continue and expand their amazing work towards optimisation of the preterm birth pathway.
Eileen Dudley 19 Mar 2024
Thank you Jo. We feel very fortunate to have your expertise in delivering high quality education which recognises the complexities clinical teams grapple with working in challenging systems. Your special interest in debriefing is invaluable.
We know that preparing both the pre brief and the debriefing are crucial to support teams to feel able to be open and honest feeling safe psychologically and therefore able to take the learning and new knowledge with them back to clinical practice to improve outcomes for babies born too soon.
Hayley Trueman 18 Mar 2024
The project sounds like really worthwhile and effective work to expand from a successful pilot.
I was just wondering what the learning outcomes of the simulation sessions were around, are they specific clinical skills or non-technical skills like communication etc?
Also in terms of the evaluation, are there specific measures related to addressing disproportionately poor maternity outcomes including incidence of preterm birth for mothers and babies from minority ethnic backgrounds?
In terms of action learning set facilitation, the best feedback I've witnessed around this was where skilled facilitators have supported people to ask questions in different ways and refrain from experience sharing and advice giving. Setting the boundaries and expectations around this as a group from the beginning.
Eileen Dudley 18 Mar 2024
Thanks Hayley for the support for the project and for the insightful questions.
Learning objectives are:
understanding of the preterm optimisation bundle https://www.bapm.org/pages/perinatal-optimisation-pathway
Consider the local challenges and opportunities faced by multi-professional teams seeking to optimise outcomes for preterm babies and support healthcare professionals to implement appropriate intervention in a timely manner
And how to set up and facilitate high quality simulation.
The time spent in the pre-brief and the debriefing are critical elements and allow the MTP team to have a discussion in a safe environment and address the multiple human factors that typically emerge in situations of high stress and which teams who do not regularly work and train together find very challenging.
The workshops offer time and a safe friendly space for the team to reflect on both clinical and non technical skills all of which play an important part in informing the successful management of preterm birth. Learning together across disciplines in a non hierarchical environment is a positive experience in our experiences to date.
To address this part of your commentary:
Also in terms of the evaluation, are there specific measures related to addressing disproportionately poor maternity outcomes including incidence of preterm birth for mothers and babies from minority ethnic backgrounds?
This is a much broader question and not within the scope of the evaluation of this project .
It is the subject of a much wider national debate to understand the reasons why outcomes are disproportionately worse for the population group you highlight. There are many national initiatives focussed on further research such as the NIHR who have launched a £50 m 'Challenge ' funding to tackle inequalities in maternity care ; this is part of the Department of Health & Social Care 's women's health priorities for 2024. The consortium will include experts across the UK to specifically address the inequalities experienced by black and Asian women.
Rebecca Monk 13 Mar 2024
It is great to see simulation based learning being promoted in this project, and in a way that is psychologically safe for teams to work through difficult scenarios together without fear of negative appraisal, being judged or making mistakes. It sounds like a great way to encourage a safe and supportive workplace culture.
Michelle East 15 Mar 2024
Thanks Rebecca - this was certainly the feedback from the team that attended the pilot. Having access to an expert in debrief, coupled with the clinical expertise across the rest of the faculty in supporting preterm optimisation makes this course quite unique we think.
Desislava Koleva 12 Mar 2024
This sounds great! Practical MDT training would be very beneficial for all of us and hopefully will help to alleviate the stress for those who are not involved in preterm deliveries in a regular basis.
I would love to attend this training!
Eileen Dudley 12 Mar 2024
Hello Desi
Thank you for engaging with this project and we are grateful for your support.
We are offering each of the trusts in Health Innovation Oxford & TV region an opportunity to attend a full day multi-professional workshop with a view to taking the learning and both new and refreshed knowledge and skills back to their own organisation. We hope to support sustainability and build on the incredible improvement in outcomes for preterm babies and families using this model
Fran Butler 8 Mar 2024
This looks like a very exciting project; using simulation in training is such an effective way of making the learning 'stick' particularly for team working. You have clearly thought of all of the elements for a successful implementation.
I did have a couple of queries as I read through your description.
I know you are limited for space but I wonder if a brief description of what the simulation consists of might help people to picture the training? Does it have actors? Technology?
When you say 'our trusts' how many trusts this is?
Best of luck with this important work which I think will result in really useful learning for simulation training in other specialties as well. The thorough evaluation will allow others to learn from the findings and hopefully have confidence to implement themselves.
Michelle East 11 Mar 2024
Hi Fran - many thanks for your comment and interest in our project. Great suggestion of adding more detail to our project description. We do use actors but other than that keep it fairly low tech. It is important to us that attendees feel that what they learn on the course can be achieved by teams when back in their own organisation. So far we are working with Trusts in our region, which is five in total.
Sam Fleming 7 Mar 2024
Hi,
The MDT simulation during the pilot day created such juicy discussion and learning. We witnessed the candidates learning from each other in various ways. For example:
1) Discussing the events of the sim and debrief, and then trying again [experimental learning at its best].
2) Not only did the team learn from each other how to run and debrief effective simulation. They explored with each other how they overcome barriers to achieving pre-term optimisation in practice. The team shared their success, and the little things they do everyday to cope with the unpredictable nature of pre-term labour.
Such a positive way to learn. Really looking forward to the next sim day.
Eileen Dudley 8 Mar 2024
Thank you for those that reflections Sam and they will indeed inform the development of scenarios for our next day which is the beauty of teams having protected time together to explore the output and learning from simulations in depth
Geri Briggs 7 Mar 2024
Simulation has been used successfully in a number of other specialities and it is good to see it being developed as a package for this very important cohort of vulnerable babies - the impact for them is potentially lifesaving and lifelong
Eileen Dudley 7 Mar 2024
Thank you for taking the time to engage with the SIM based education project and we know that staff confidence and knowledge in the delivery of all elements of the evidence based optimisation bundle improves when explored through simulation.
In addition the time spent exploring pre brief and debriefing to support psychological safety helps teams extract meaningful learning from the scenarios and which we encourage application directly into clinical practice
Rachael Garrett 7 Mar 2024
Great work, look forward to hearing more.
Eileen Dudley 7 Mar 2024
Thank you Rachael- I enjoyed the opportunity to present a snap shot of the work at the SE neonatal conference recently and that has led to further requests to share so we absolutely believe there is a wider reach and appetite for this project
Hesham Abdalla 6 Mar 2024
Thrilled to see this groundbreaking project taking shape! It's a game-changer in neonatal care, merging multi-professional collaboration with cutting-edge simulation training to dramatically improve preterm birth outcomes. The potential to enhance both neonatal survival rates and family experiences is immense.
To further elevate this, I suggest exploring virtual reality technology for simulations, adding a dynamic layer to training and expanding reach.
Eileen Dudley 7 Mar 2024
Great suggestions Hesham thank you for your encouragement and definitely an area we want to explore as we develop the project further.
I am connected with Andi Buttery at CCCU and their SIM community and with OxSTaR so will be making use of their expertise as we go forwards
Dr Patrick Bose 6 Mar 2024
Eileen Katherine and Michelle,
Thank you! Multi-professional teaching/training has long been considered an effective vehicle to enable midwives, nurses and doctors to develop the complex skills and confidence required deliver best practice on our Delivery suites. Introducing these workshops will play a key part in building confidence and improving team decision making - both essential in reducing human error and improving neonatal outcome.
Michelle East 6 Mar 2024
Thank you Patrick - we are hopeful that we not only improve knowledge and skills but start to develop a culture that sees teams truly working together to deliver better care by reducing barriers to good communication.
Emma Taylor 6 Mar 2024
This is such an important project that will make a hugely positive impact on the lives of women and their babies and wider families. Being able to save babies' lives, and reduce the equity gap, is vital and this work is so needed. Professionals in this field are very excited about this project and would like to see it come to fruition to make this immeasurably important difference to families that would otherwise lose their babies, especially as the differences in outcomes for different ethnic groups is stark and unacceptable.
Michelle East 6 Mar 2024
Thank you Emma - we agree that there is so much opportunity in this area. Having engaged with service users in the development of this education programme it is paramount that we ensure we are equipping our multi-professional teams with the knowledge and skills to deliver not only safer care but a better experience.
Douglas Findlay 5 Mar 2024
This is such an important piece of work and I have seen how the judicious use of in-situ simulation training scenarios can positively impact both clinician awareness and patient outcomes. This project, which aims to create a psychologically safe environment where teams can have hands-on experience working through a variety of preterm birth scenarios, will be such an important addition to the education and continuing professional development of all staff involved in maternity & neonatal care.
Eileen Dudley 6 Mar 2024
Thank you for the positive comments Douglas . They add strength to the project idea and articulate the ethos of the project.
Paul Durrands 5 Mar 2024
Great package of expert support for healthcare professionals to help the NHS tackle significant health inequalities and give babies the best start in life.
Eileen Dudley 6 Mar 2024
Thank you Paul
It is absolutely critical that we continue our efforts to reduce the morbidity and mortality associated with being born too soon and this is particularly reflected in the data available related to health inequalities
Tara Gradwell 5 Mar 2024
A huge amount of work has gone into this project and so far has received great interest and engagement from multi-professional teams.
It would be amazing if we could get this training package disseminated wider within the UK and provide maternity & neonatal teams the resources to be able to integrate this into their own training days & have the confidence to be able to run in-situ simulation based training amongst their local teams.
Eileen Dudley 5 Mar 2024
Thank you for the vote and the positive message Tara enormously helpful to know that we are working in a space where there is such interest and engagement form multi-professional teams and those who care for this very vulnerable group of women in threatened and /or actual preterm labour and birth.
Our project has developed to address this fact recognising that that there are currently no robust wraparound education and improvement programmes available which ensures that the multiprofessional teams who have a duty to optimise outcomes for babies born preterm receive high quality evidence-based simulation-based education.
Moreover, we have compelling intelligence from several experiences which overwhelmingly indicate that our project is addressing a real need.
Firstly, we undertook a series of co-produced stakeholder events, surveys and in person events which took place across the Southeast of England during the months of May and June 2022 with the final listening events concluded in February 2023.
The aim of this scoping work was to gain insight into the expectations of families who experience extreme preterm labour and birth and to increase our understanding of the barriers to safe care as perceived by the multiprofessional teams.
Healthcare professionals identified the need for bespoke education and training to equip them to confidently manage the challenges of preterm birth which is often highly complex and requires well-trained multiprofessional working to ensure positive outcomes for the preterm baby and family.
This need has been further confirmed during a series of site visits to our partner organisations where our MatNeo safety improvements leads were invited to support teams to deliver simulation-based education to help them on their improvement journeys.
We are regularly invited to facilitate simulation-based education workshops for prehospital teams and emergency services including the Thames Valley Helicopter Emergency Services (HEMS) Air Ambulance and the Oxford School of Emergency Medicine.
I am excited to engage with the Q and wider communities to refine and develop the project idea
Comments are now closed for this post.