Simulation and skills training are types of learning that require engagement and considerably more active participation from the course participants than has traditionally been usual in lecture-based courses. Many students may find this unaccustomed and challenging initially. It is also our experience that doctors in particular are sceptical about exposing themselves professionally and personally to colleagues and course arrangers. We have therefore attempted to build up the course in a pedagogical manner, so that the participants get a gradual introduction into what simulation and skills training are, and what is expected of the individual. The purpose of this is to establish a sense of reassurance around the concept and a confidence that the individual’s performance in the simulation rooms will not be the subject of conversation in the next coffee break.
In order to be able to evaluate and continually improve the course, we have developed a detailed evaluation form for each of the course days. All simulations, skills stations, interactive lectures and the overall impression of the whole course are awarded points on a ten-point Likert scale with space for comments. The forms are required to be completed anonymously and continuously to increase their validity.
After each course, the course committee has systematically analysed and compiled the information that has emerged in the evaluation forms. On the basis of the feedback, we have actively attempted to improve the course with respect to the medical content, pedagogical tools, logistics and social programme.
The first courses that were arranged covered for example training in both basic heart-lung rescue with the aid of the life-saving manikin Little Anne and advanced heart-lung rescue (A-HLR). Most of the participants regarded this as elementary knowledge of limited value, and many had already had experience of organised training in both basic and advanced heart-lung rescue in their respective departments. We therefore decided to drop basic HLR training from the course programme. We have retained the A-HLR training, but with the emphasis on diagnosis and treatment of more specific causes of cardiac arrest, such as pulmonary emboli, drowning and intoxication with local anaesthetics. In addition, the participants have the opportunity to practice A-HLR with the addition of disruptive elements such as noise and emotionally unstable bystanders, which is a relatively common pre-hospital scenario. In the aftermath of the simulation, the potential effects of so-called socioemotional stress on the quality of the resuscitation are discussed (6). All the scenarios are supposed to be realistic and are based on the facilitators’ own clinical experience.
BC 2 is an extensive and intensive course, for both facilitators and, not least, course participants. The logistics are particularly demanding because there are a number of simultaneous simulations and skills stations. On each course day, a number of persons are engaged as facilitators and operators, and several of the stations require a great deal of preparation and equipment. As well as releasing several doctors from our own Anaesthetics Department in Stavanger, cooperation has also been established with other hospitals, both to raise the professional quality and to ease the personnel situation locally. All these factors make BC 2 a relatively expensive course to arrange, as previously mentioned, but we believe nonetheless that the gains in the form of greater learning returns more than outweigh the resources invested.