Evaluating multisite multiprofessional simulation training for a hyperacute stroke service using the behaviour change wheel

Ross, A.J. , Reedy, G.B., Roots, A., Jaye, P. and Birns, J. (2015) Evaluating multisite multiprofessional simulation training for a hyperacute stroke service using the behaviour change wheel. BMC Medical Education, 15, 143. (doi: 10.1186/s12909-015-0423-1) (PMID:26330134) (PMCID:PMC4557755)

Abstract

Background Stroke is a clinical priority requiring early specialist assessment and treatment. A London (UK) stroke strategy was introduced in 2010, with Hyper Acute Stroke Units (HASUs) providing specialist and high dependency care. To support increased numbers of specialist staff, innovative multisite multiprofessional simulation training under a standard protocol-based curriculum took place across London. This paper reports on an independent evaluation of the HASU training programme. The main aim was to evaluate mechanisms for behaviour change within the training design and delivery, and impact upon learners including potential transferability to the clinical environment. Methods The evaluation utilised the Behaviour Change Wheel framework. Procedures included: mapping training via the framework; examination of course material; direct and video-recorded observations of courses; pre-post course survey sheet; and follow up in-depth interviews with candidates and faculty. Results Patient management skills and trainee confidence were reportedly increased post-course (post-course median 6 [IQ range 5–6.33]; pre-course median 5 [IQ range 4.67–5.83]; z = 6.42, P <.001). Thematic analysis showed that facilitated ‘debrief’ was the key agent in supporting both clinical and non-clinical skills. Follow up interviews in practice showed some sustained effects such as enthusiasm for role, and a focus on situational awareness, prioritization and verbalising thoughts. Challenges in standardising a multi-centre course included provision for local context/identity. Conclusions Pan-London simulation training under the London Stroke Model had positive outcomes in terms of self-reported skills and motivation. These effects persisted to an extent in practice, where staff could recount applications of learning. The evaluation demonstrated that a multiple centre simulation programme congruent with clinical practice can provide valuable standard training opportunities that support patient care.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ross, Dr Alastair
• Authors: Ross, A.J., Reedy, G.B., Roots, A., Jaye, P., and Birns, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: BMC Medical Education
• Publisher: BioMed Central
• ISSN: 1472-6920
• ISSN (Online): 1472-6920
• Copyright Holders: Copyright © 2015 Ross et al.
• First Published: First published in BMC Medical Education 15:143
• Publisher Policy: Reproduced under a Creative Commons License