key: cord-1056398-28s8pqqi
authors: Bakewell, Zoe; Davies, Danielle; Allanby, Lucy; Dhonye, Yasin
title: Pandemically challenged: developing a ward‐based cross‐skilling programme
date: 2020-05-21
journal: Med Educ
DOI: 10.1111/medu.14252
sha: 28867e7ed7a502558dc337dff2a110d20709253e
doc_id: 1056398
cord_uid: 28s8pqqi

Due to the COVID‐19 pandemic, North Bristol NHS Trust (NBT) doctors were redeployed to unfamiliar clinical teams, where they would work at the level of a fully‐registered Foundation doctor. As undergraduate clinical teaching fellows, we were re‐purposed to rapidly produce a training programme to refresh the medical knowledge of doctors who were from a wide variety of non‐medical specialities and grades. Building on our experience of facilitating medical students, wedevised medical ward‐based scenarios in an informal Objective Structure Clinical Examination (OSCE) style to promote focused active learning and prompt further independent study.

North Bristol NHS Trust -North Bristol Academy Westbury on Trym, Bristol

What problem was addressed? Due to the COVID-19 pandemic, North Bristol NHS Trust (NBT) doctors were redeployed to unfamiliar clinical teams, where they would work at the level of a fullyregistered Foundation doctor. As undergraduate clinical teaching fellows, we were re-purposed to rapidly produce a training programme to refresh the medical knowledge of doctors who were from a wide variety of non-medical specialities and grades. Building on our experience of facilitating medical students, wedevised medical ward-based scenarios in an informal Objective Structure Clinical Examination (OSCE) style to promote focused active learning and prompt further independent study.

What was tried? OSCE stations included interpretation of arterial blood gases, chest X-rays and ECGs as well as COVID-19 treatment escalation planning and palliative care guidance. A further station provided up-to-date information regarding local Personal Protective Equipment (PPE) guidelines and resuscitation policies 1 

This article is protected by copyright. All rights reserved individual stations. We piloted training with a small group of eligible consultants before commencing optional training trust-wide to 289 doctors..

Notably, delivering face-to-face training while adhering to social distancing proved challenging.

Training was carried out in a large room, with each station over three metres apart, with each chair set two metres apart.Candidates were asked not to move furniture. To comply with infection control measures, we laminated all materials and wiped with Clinell® wipes between use. Regular handwashing was strongly encouraged for faculty and candidates with supplemental alcohol gel available at each station. The feedback received was widely positive, with 85% (n=134) of respondents finding the medical scenarios an adequate refresher. 15% noted they would have found additional scenarios useful. Insitu assessment by faculty suggested improvement of candidates' abilities and confidence for redeployment, although this was not formally evaluated. Sessions acted as formative assessments, to signpost adult-learners to areas which required further study; and they were given access to an NHS approved e-learning package.. As trainers, we have rarely developed a training course for significant numbers at such short notice. Essential to ensuring this programme's success was effective communication between trainers and redeployment team leaders, facilitated by the Royal College of Physicians' chief registrar. Initially, this delivered clear aims and objectives of training and regular dialogue thereafter allowed multiple challenges to be resolved comprehensively..

Resuscitation Council UK Statement on COVID-19 in relation to CPR and resuscitation in acute hospital settings