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Background We recognise that in order for simulation training to have the maximum impact upon the workforce we need to educate health professionals in Human Factors and Team Resource Management (TRM) allowing the benefits of simulation to become embedded in their clinical practice. Staffing and financial constraints often present the biggest barriers to teaching, hence we have designed a number innovative short training sessions to facilitate acquisition of this important knowledge throughout our trust. Prior to the development of these sessions hospital staff received minimal exposure to Human Factors training and the benefits of embedding this learning within the organisation in order with regards improving the safety of patient care were clear to us. Summary of programme and results First we designed an ‘Escape Room’, offered to staff groups across the trust. Teams are locked in a room for 60 min and need to work together to solve clues and complete tasks to find the codes to allow them to exit the room. Following completion there is a concise debrief concentrating mainly upon Human Factors and TRM. Subsequently a ‘Taste test challenge’ was also developed, which explains 6 areas of human factor training in 30 min. Participants are asked to taste 3 samples of Cola and decide which cup the ‘Branded’ cola is in. The truth is that they are actually all the same. Human factors including situational awareness, confirmation bias, decision making and leadership and followership can be succinctly explained with reference to their impact on different stages of the test. Recognising the benefits of digital media in education, we have created an interactive video experience that can be delivered to a range of different professionals in order to stimulate learning, demonstrate Human Factors and refine clinical judgement skills. The first video has been based around Sepsis, with plans for a whole series of videos to be filmed in the near future. In addition, the design of the escape room is evolving to ensure that we continue to stimulate and inspire those learning with us. Conclusion Human factors and TRM are incredibly important topics and it is vital that we deliver this knowledge in an exciting and stimulating way in order to maximise retention and therefore benefit to clinical practice.

Background Simulation-based learning has become a mandatory component of Foundation Training across the North West of England. Over the past twelve months we have noted a recurring pattern within feedback from trainees, who often feel embarrassed and under scrutiny during sessions, and therefore reluctant to participate in simulation. Frequently this manifested itself as disinterest and withdrawal from sessions and had a knock-on effect on other trainees. We felt that having large group sizes (12–14 trainees) was contributing to this problem – giving more boisterous trainees a captive audience, and providing those less confident somewhere to hide. Summary/results We subsequently ran a number of sessions with reduced numbers (Six or fewer trainees) as part of a deanery-wide simulation training initiative. This was the only change to the otherwise standard delivery of scenarios comparable to those previously experienced by our trainees. We noted significantly better engagement from trainees, better performance within scenarios, enhanced team-working and overall improved feedback from our Foundation Trainees. They described the atmosphere in these smaller groups as more private, and therefore conducive to them demonstrating a more honest performance without worrying about being ‘under the spotlight’. Members of the Simulation Team facilitating these sessions were energised by the participant’s engagement with scenarios and found the post-simulation debrief to be a much more candid discussion of events, with trainees openly discussing the ‘softer’ aspects of their performance including fears, emotions and demonstrating the ability to critically analyse events during each scenario. Discussion Reducing group size does increase administrative and facilitator workload. We had to deliver the same simulations across three sessions in order to accommodate smaller group sizes, however the perceived benefits for trainees and simulation facilitators completely justifies this additional workload in our opinion. In addition, smaller group simulation means fewer Foundation Trainees need be released from their clinical work at the same time, and hence the impact of training upon the provision of safe patient care can be mitigated. With a bit of thought and rigorous planning we feel that it is possible to deliver simulation based learning that is vastly more impactful for all involved, and this has become the new standard for the delivery of simulation training for Foundation Doctors in our trust.

Background We recognise the significant benefits of in-situ simulation for whole team training and development, as well as for the identification of latent threats to patient safety within healthcare systems. Like many smaller NHS trusts, we operate under financial constraints and hence have created our own mobile solution in order to deliver this high-impact educational activity. Prior to the development of our mobile simulation station it took around 45 min and a box full of tangled cables to set up for in situ simulation. In environments like the Emergency Department where workload fluctuates minute-to-minute, this inevitably meant last minute cancellation, after spending a long time setting up. Summary of project Our mobile simulation station started life as one of the hospital’s mobile computer carts which had abandoned because of a failed battery unit. Around this we have constructed a full HDMI mobile command centre, from which we run the full spectrum of in situ simulation activity. GoPro Hero 4 cameras feed into a high-definition wireless video transmitter sending video to a Macbook Pro on the mobile simulation station running StudioCode with a Blackmagic Intensity capture box. The HDMI signal is split, with one signal feeding into the facilitator’s monitor on the mobile simulation station and the other feeding into the HDMI out in order to connect a larger display for in depth video debrief. Results/discussion The setup allows complete control of different mannequins, observation monitors (Typically used standalone with simulated people) and seamless switchover from video recording to playback. Video bookmarking via an iPad app linked to StudioCode means faculty can construct their debrief in real time. Our mobile simulation station has had a significant impact on our ability to facilitate in-situ simulation, cutting setup time down to around 10 min and means scenarios can be run from another location up to a range of around 20–30 metres. This means staff do not see us coming, enhancing fidelity and allowing us to capture real-life clinical practice. Conclusion Our setup demonstrates that with a little knowledge and off-the shelf A/V kit, it is possible to run high impact simulation activity across a hospital site (and beyond) without investing thousands in an all-in-one system or fixed installation.