International Journal of Healthcare Simulation

Background:

A recurrent theme from child safeguarding practice reviews at a local and national level where a child has died or suffered significant harm has been the failure of practitioners to exhibit professional curiosity, challenge and have difficult conversations with children and their families about their concerns [1]. In 2015 the local safeguarding children partnership developed multi-agency/professional classroom training on ‘difficult conversations’. What was missing was practitioners having the opportunity practise theory/strategies for having difficult conversations in a safe learning environment. Although there is a history of Simulation education being integral to experiential learning of hospital-based staff this is not the case for community practitioners [2].

Activity:

The aim of the training was to enable senior health visitors (HVs)` to understand why having difficult conversations is key to keeping children safe, reflect on practice build confidence, knowledge, and competence. The scenarios were based safeguarding concerns identified from clinical practice. The training was held in the Education Centre Simulation Suite which was set up for one clinic scenario and four home visits. The use of visual and audio equipment enabled all participants to watch the simulation in another room. Actors were used to play the roles of an older and young mother. This added to the realism of the scenarios

Results:

Feedback was collected pre- and post-simulation. Prior to the session all seven participants said they felt confident having a difficult conversation. Nevertheless, post-training all said they enjoyed the session and would like simulation to be part of their ongoing professional development because it provided an opportunity to identify communication blind spots, reflect on practice, tips, and tricks to move conversation forward and future practice changes.

‘Improving (our) communications skills. Regular feedback to improve service.’

‘Having feedback from the actors provided honest feedback and advice’

Conclusion:

This was the first simulation training, areas for improvement were identified during and after the session. For example, the debriefing after the third scenario was altered as the facilitator felt some participants were defensive. As a result, participants were less defensive when feedback was given. The HVs found simulation provided a safe learning environment to develop and hone their skills on holding difficult conversations which keep` children safe. The intention is to develop a proposal to have simulation training as part of the multi-agency/professional difficult conversations training offer and to create a Simulation Facilitator role for community staff.

References

1. National Society for the Prevention of Cruelty to Children (NSPCC) 2022 Recently Published Case Reviews: Case Reviews published in 2022. https://learning.nspcc.org.uk/case-reviews/recently-published-case-reviews [Accessed on 21/06/2022]

2. NHS Health Education England. Simulation. 2016. https://www.hee.nhs.uk/our-work/simulation [Accessed on 21/06/2022]