Current provision of simulation in the UK and Republic of Ireland trauma and orthopaedic specialist training: a national survey

Hannah K James; Robert J H Gregory; Duncan Tennent; Giles T R Pattison; Joanne D Fisher; Damian R Griffin

doi:10.1302/2633-1462.15.BJO-2020-0011

Current provision of simulation in the UK and Republic of Ireland trauma and orthopaedic specialist training: a national survey

Bone Jt Open. 2020 May 13;1(5):103-114. doi: 10.1302/2633-1462.15.BJO-2020-0011. eCollection 2020 May.

Authors

Hannah K James^{1

2}, Robert J H Gregory³, Duncan Tennent⁴, Giles T R Pattison², Joanne D Fisher¹, Damian R Griffin^{1

2}

Affiliations

¹ Clinical Trials Unit, Warwick Medical School, Coventry, UK.
² Department of Trauma & Orthopedic Surgery, University Hospitals Coventry & Warwickshire, Coventry, UK.
³ Department of Trauma & Orthopaedic Surgery, University Hospital of North Durham, Durham, UK.
⁴ Department of Orthopaedics, St. George's NHS Trust, London, UK.

Abstract

Aims: The primary aim of the survey was to map the current provision of simulation training within UK and Republic of Ireland (RoI) trauma and orthopaedic (T&O) specialist training programmes to inform future design of a simulation based-curriculum. The secondary aims were to characterize; the types of simulation offered to trainees by stage of training, the sources of funding for simulation, the barriers to providing simulation in training, and to measure current research activity assessing the educational impact of simulation.

Methods: The development of the survey was a collaborative effort between the authors and the British Orthopaedic Association Simulation Group. The survey items were embedded in the Performance and Opportunity Dashboard, which annually audits quality in training across several domains on behalf of the Speciality Advisory Committee (SAC). The survey was sent via email to the 30 training programme directors in March 2019. Data were retrieved and analyzed at the Warwick Clinical Trials Unit, UK.

Results: Overall, 28 of 30 programme directors completed the survey (93%). 82% of programmes had access to high-fidelity simulation facilities such as cadaveric laboratories. More than half (54%) had access to a non-technical skills simulation training. Less than half (43%) received centralized funding for simulation, a third relied on local funding such as the departmental budget, and there was a heavy reliance on industry sponsorship to partly or wholly fund simulation training (64%). Provision was higher in the mid-stages (ST3-5) compared to late-stages (ST6-8) of training, and was formally timetabled in 68% of prostgrammes. There was no assessment of the impact of simulation training using objective behavioural measures or real-world clinical outcomes.

Conclusion: There is currently widespread, but variable, provision of simulation in T&O training in the UK and RoI, which is likely to expand further with the new curriculum. It is important that research activity into the impact of simulation training continues, to develop an evidence base to support investment in facilities and provision.

Keywords: education; simulation; surgical training.