Background The UK Joint Royal College Of Physicians 2010 rheumatology curriculum states that “trainees should be able to diagnose, choose appropriate investigations, formulate an appropriate management plan, communicate effectively and involve appropriate specialities where necessary” .
However rheumatology emergencies are rare, and trainees may not get adequate exposure to be able to develop these competencies. A survey performed in the Yorkshire region (UK) showed that up to 62.5% of trainees were not confident in dealing with some emergency presentations.
Currently there are no simulation courses covering this aspect of training for rheumatology trainees.
Objectives Our objective was to develop and run a pilot simulation course for rheumatology trainees that will provide education in the identification and management of rheumatology emergencies, and aid development of non-technical skills.
Methods Scenarios were developed and mapped against the curriculum requirements. They were run in a simulated ward environment using a high fidelity simulator. Faculty included one actor acting as ward staff, 2 senior simulation fellows, 1 technician, and 3 senior rheumatology Consultants.
5 scenarios were used in the pilot one day course run on the 1st May 2015. These were; Scleroderma renal crisis, methotrexate pneumonitis, acute lupus myocarditis, catastrophic antiphospholipid syndrome and ANCA positive vasculitis presenting with pulmonary haemorrhage. The running of the scenarios lasted 20 minutes, with debriefing taking between 30–40 minutes.
Delegates were provided with a reading pack at the end of the course, consisting of literature. Post course questionnaires assessing confidence scores, session rating, as well as general feedback were used to assess the course.
Results Post course feedback was provided using a 5 point Liket scoring sheet, with a rating of 5 – extremely confident in managing independently, and 1 – unable to manage:
Delegates rated between 3–5 in their overall ability to identify and manage rheumatological emergencies (50% giving a rating of 5, and 40% rating a 4, 10% rating a 3), and between 3–5 in their ability to manage the five emergency scenarios. With the majority rating a 4, one delegate rated a 3 in two scenarios, while one delegate rated a 5 in four of the scenarios.
All delegates felt that the session had added to their knowledge and rated the course as either very good or excellent.
Conclusions The pilot course was felt to overall improve trainee confidence in identifying and managing these rheumatology emergencies. It also highlighted non-technical skills and was felt to be a satisfactory teaching method by all the participants and trainers.
This course has obtained training programme director support for the Yorkshire and Humber region (UK) as well as funding and will run on a yearly basis in the region.
Specialty Training Curriculum for Rheumatology. Joint Royal College of Physicians Training board 2010
A framework for technology enhanced learning. A DOH report 2011
Disclosure of Interest None declared