Spotlight On - Simulation Training Team

Posted by Devon Partnership Trust in News on 5th June, 2023

We spoke to Steve Haupt, Paul Spiring, Daisy Osborne and Sam Kirkwood from the Simulation Training Team about what the training involves, what they enjoy most about being part of this team and some of their key achievements. 

What is the main purpose of your team? And what does a typical day look like?

Steve: To help improve quality of care and patient safety. Our training helps increase staff confidence by giving an opportunity to face challenges in a safe, realistic space, which they may come across in clinical placements.

Sam: Simulation is a very unique method of training as it’s very hands-on. There is good evidence that simulation is better than classroom-based training for teaching clinical skills, as well as non-technical skills (things there aren’t protocols for). You can use simulation to teach how to do a particular task but you can also use it to teach people how they interact with each other and their environment.

Steve: Running a training day is just one aspect. There’s a lot of background work, including liaising with people with expert experience, as well as people from different directorates. A typical day for us involves discussing what a training day will cover, what the learning objectives are, and who will do what role. There is a big emphasis on safety too. If we’re making something clinically realistic, we need to make sure we’re keeping each other safe.

Daisy: We have a culture of shared learning. Whether that’s learning from experts from experience, wider teams, wider services, or from the training participants themselves. This allows us to be open with the participants and hopefully make them feel able to talk about a variety of issues.

What happens during a simulation training session?

Steve: Generally a simulation involves recreating a scenario that lasts around 10-15 minutes. Either Paul, Daisy or I would act as a patient and we would give the staff a task to go in and deescalate the patient (if that was the training required). After the scenario we would then debrief with the participants. We would check everyone is ok, ask what happened and then encourage people to explore the thought process behind their behaviours. We look at the challenges and then create a plan on how to transfer the learning into practice and the key messages people are going to take away.

Paul: Steve and Daisy are kind of like film directors - they identify a learning objective every time a training opportunity presents itself. My job is to be the stage manager. I try to make the environment feel, smell and sound like a real situation on a ward. This can be done in a number of different ways; using acting skills, modelling wounds, sounding alarms, clothing, odours, etc. Very quickly people forget they’re in a training environment and they become immersed in the situation. We reach out to people in the Trust with specialist knowledge or from external people with lived experience. We may have characters that talk a different language where the reaction of the nursing team will be very much based on their nonverbal communication. I can speak Dutch– but twice someone in the training could speak the language!

Steve: The majority of nurses are kinaesthetic learners – they’re hands on. With simulation, people get the opportunity to learn through experience in a realistic way. They can make as many mistakes as they want in our simulated environment. We encourage them to try things they haven’t tried before. There’s no judgement.

Paul: The beauty of simulation training is that it’s not competence based, it’s confidence based. We try our best to put people at ease and give them assurance that they’re not being assessed and that there’s no right or wrong way.

Sam: Something that I remember finding really interesting when we first started doing simulations was that it wasn’t always about us being the experts and the learners learning from us. It was more about the participants seeing each other doing things well, or not so well, and then sharing their own ideas of best practice.

What qualifications and training do the team have? And what career paths have people taken?

Daisy: I’m a mental health nurse by background. My experience is working in older adults inpatient services. Last year, I got a secondment to develop training around reducing restrictive practice. It was a project working with DPT and Livewell and we piloted it on one ward in each care providing area. Within my permeant position with the simulation team, I’m looking at how we can try and embed that training into DPT.

Paul: I used to work for the police and the fire brigade, where simulation was used often. I also worked in teaching for 26 years. When you go into a classroom it’s very didactic. The learners are quite passive and you have something in your head that you want to impart. Simulation training is different as it allows you to draw out the knowledge that’s within the participants already and get them to reflect.

Steve: I left school with no GCSE’s, no qualifications and worked in a care home. From there, I developed a passion to help people and decided to re-sit my exams and go to university to do mental health nursing. I’ve worked for the NHS since 2010. I worked on inpatient wards for a while and then in liaison psychiatry which was brilliant. I still do it on the bank. Over the last two and a half years I’ve been studying patient safety at Masters Level.

What are some of the challenges the team faces?

Steve: One is trying to find training locations. You can’t just rock up anywhere. If we turned up somewhere with lots of public around they would be very confused as to what is happening! It needs to be in a private space which really limits our choice in venues. Another challenge is resource. We’re not a big team. However, we know the benefits of this training and we’re trying to get more people invested. A large challenge from when I first set this up was trying to raise awareness of simulation and its benefits. Moving forward, we need more people involved who are passionate about training.

What do you enjoy most about the role?

Steve: Working with some really fun, innovative and motivated people who are passionate about patient safety, training and giving people a safe and immersive experience. We look after each other well too. Even though we all have different roles and responsibilities, we’re not a hierarchal team and compassion is really important.

Daisy: We are definitely a very compassionate and supportive team. We’re also able to be creative and focus on what is important for improving patients care.

Paul: I think it’s a really exciting time to be involved in simulation. It’s so innovative and we get a lot of other Trusts coming to us to look at what we’re doing. For example, our ligature training has been nationally recognised and commended. Daisy’s reducing restrictive practice training has been really well received. One of the best things for me has been the opportunity to work with people from all across the Trust. We meet hundreds of people and it’s clear that they’re all united in a desire to help their patients as much as they can. They’re very inspiring and I take a lot from that.

What motivates your team?

Steve: I’ve always had a real passion for training and think it is really important to any job. Training can be boring, and the thing that engaged me with simulation was the fact that we’re doing something different. It’s really nice to be part of something that’s quite new and innovative, especially for the South West. We’re leading the way and helping to be a centre of excellence. That’s what makes me proud of what we do. We’re also motivated by continuing personal development opportunities. Some of us go on acting courses, moulage courses (where we made fake wounds and makeup), it’s not your run of the mill training!

Paul: I’m passionate about this training because I can see from an education perspective that this is efficient. It’s so immersive and engaging. It’s powerful because the learning comes from within.

What achievement is your team most proud of?

Steve: One of our biggest achievements is the training we’ve been doing for the new Salus Ward. We found there was over 72 concerns after doing our simulations throughout three days. I was able to do an analysis and link patient safety for a quarter of them. That shows simulation does have a purpose when it comes to testing new environments.

Paul: Salus was a massive undertaking because the ward was very sterile and essentially a building site when we moved in. We had to make every bedroom, the communal areas, staff offices and quiet rooms all look like they were used by patients. We had to get clothing, cutlery, cups etc. I think it’s fair to say that people soon forgot it was an unopened ward and bought into the idea that this was an operational acute ward.

Sam: We did some work on the Place of Safety (POS) suite when that was new and one of the things that came to light from our training was that one of the patient bedroom doors could be barricaded to lock from the inside. So that was fixed before any patients were exposed to any potential risk of harm.

What is the best bit of feedback you have received from a patient or service user?

Paul: In our surveys, 99% of the 600 people who have done this course would recommend it to a colleague and almost all of them have asked to do the ligature training again, even though there’s no requirement. That in itself shows people feel invested in this and it boosts their confidence. People often say this is the best training that they’ve received in DPT and that it’s so meaningful.

Steve: We had feedback from a patient who had been ligaturing in and out of hospital and she was really passionate about meeting us. She said that although it was hard to open up about this difficult time in her life, our training is a really positive way to help people understand patient perspective. We also had feedback from a training participant who had lost a family member to suicide. We were aware that it must have been really difficult to come to our training but they said we handled the subject really delicately and with dignity. What we’re doing can be triggering. So all the time you’re watching people and making sure they’re ok. We often signpost people onto other support services.

Daisy: We’ve also had feedback from people on wards where reducing restrictive practice has been piloted saying they’ve seen improvements to care. They’ve seen the attitudes of the staff change and everyone’s really promoting it. To hear the impact we’re having is amazing.

What do you and your team do to unwind?

Steve: Within a work context, after every simulation we debrief to check everyone is ok and if there’s anything we need to develop. When the participants have left we get the crumpets out! Outside of work, I play Nintendo Switch to relax. I also go to the gym a lot as this role can be quite physically demanding.

Daisy: We’re due to start monthly reflective practice sessions as a team. We’re sometimes dealing with difficult subject matters so we need to ensure we have support too. I love a bit of DIY to unwind outside of work, as well as spending time with my daughter.

Paul: I listen to a lot of Radio 3 while commuting. Classical music helps me a lot. I also write to relax. Last year I had an audio book published and I’m working on another version of one of my books, this time in French.

And finally... how would you sum up your team in one word?

Steve: Kind

Daisy: Innovative

Paul: Pioneering