International Journal of Healthcare Simulation

Background:

With reducing rates of COVID-19 transmission, Health Education England (HEE) recognises the importance of re-establishing simulation-based education programmes that halted during the early phase of the COVID-19 pandemic [1]. After a 17-month hiatus, the Foundation Doctor’s simulation programme is one of several to re-start in a face-to-face format at the Royal Cornwall Hospital (RCH). However, during the first four months since restarting, attendance rates amongst doctors were noted to be significantly reduced at 19% (9 of 48) compared with 77% in the four months prior to the pandemic (34 of 44). The authors sought to establish any logistical or cultural changes that explained this.

Methods:

A four-month period of attendance to foundation simulation teaching was reviewed retrospectively. For every absence noted, a survey was sent to the absentee requesting an explanation for this. After subsequent implementation of a new online system for self-booking onto sessions, comparison of attendance rates was made for a further four-month period.

Results:

Over 6 teaching sessions delivered during the initial four-month period, there were 39 absences, for which 27 survey responses were received. In explanation of a given absence: 7 (25.9%) reported having been on a scheduled off-day or post-night rest-day, 4 (14.8%) had been working a night shift, 1 (3.7%) had been on annual leave, 11 (40.7%) had been unable to leave their clinical area due to poor staffing levels or high clinical workload, 1 (3.7%) had an alternate teaching commitment, and 3 (11.1%) had been unaware the teaching was taking place. None had attributed their absence to feelings of anxiety, concern over the transmission of COVID-19, or perceived lack of benefit in the teaching. After subsequent implementation of the new self-booking system, attendance rates improved to 69% (18 of 26).

Conclusion:

Poor planning and failure to coordinate with working rotas provides an explanation for a large proportion of absences initially seen. The newly implemented system enables doctors to self-allocate sessions at short notice to work around their rotas. Although this has improved overall attendance rates, the absolute number of attendees still remains relatively low compared to pre-pandemic levels. Concern remains around the 40.7% of absences that arose as a result of doctors feeling unable to leave their clinical areas to attend teaching. Ongoing efforts are therefore being made to improve local cultures in relation to releasing staff for mandatory training and ensuring staffing levels are bolstered to account for this.

Reference

1. Health Education England. COVID-19: National guidance on the safe delivery of simulation-based education. 2022.