Shropshire's military, NHS, and volunteer community collaborate to provide an innovative training course for medical registrars.

Abstract

Introduction: •The position of Medical Registrar is one of the most important for the delivery of safe and effective emergency care in the acute hospital. It is also one of the most challenging physically and mentally.•Health Education England West Midland's School of Medicine commissioned Shrewsbury & Telford Hospital NHS Trust (SATH) to deliver a 3-day residential course specifically designed to cover a wide range of competencies and clinical skills, but specifically to help equip the medical registrar with strategies to better manage the complexity, the cognitive load, and psychological stress of the role in a fun and interactive way. Materials and methods: •The course was codesigned by SATH Volunteers, 202 Multi-role Medical Regiment (202MMR), NHS England OP COURAGE, SATH Clinical Simulation team, and RCP Chief Registrar.•Feedback during the course meant that delegate's individual learning needs were identified and addressed in Course. Faculty provided feedback in person and a survey monkey was sent to the delegates on completion of the course. Results and discussion: The following course was delivered to 16 Internal Medicine Year 3 doctors.•Deteriorating Patient Clinical Simulation Course: Delegates managed simulated clinical scenarios of deteriorating patients. Complexity called upon prioritisation, delegation, escalation, and communication skills. Simulated relatives were used calling on skills of breaking bad news, duty of candour, best interests’ decision making, and providing compassionate end of life care.•Human Factors Course: 202MMR Army Reservists and permanent staff delivered a course utilising the Centre of Army Leadership training packages. Using several engaging activities, the delegates gained a greater understanding of self and how their emotions, behaviours, and perceptions play an important role in their ability to be a safe and effective clinician, leader, and follower.•Hospital Cardiac Arrest Clinical Simulation Course: All scenarios led onto cardiac arrest and included additional complexity requiring discussion with relatives including breaking bad news and making end of life decisions.•Mental health session: This session provided a safe space for the delegates to talk about their experiences working in the NHS. Sustaining mental health and coping strategies and concepts were explored.Written feedback from the delegates was very positive and included:‘It was the best simulation course I have ever attended’.‘Role play by volunteers from the community was a unique experience which I have not observed in previous such training. This provided excellent opportunity to receive feedback on various aspects of our performance’.‘Focus on teamwork, leadership and followership is rarely spoken about in other training. Very dynamic and engaging’.‘Training in army barracks with command tasks correlating with leadership, teamwork and human factors. Interactive sessions, everyone was involved, valued, and listened’.‘The arrest scenarios were much truer to life than ALS courses eg relatives, debrief, bleed, thrombolysis’.‘Very useful feedback. Great to have the opportunity to try this before starting on the reg rota. Hugely appreciated thank you’. Conclusion: Utilising the skills and experiences of the NHS, military, and wider community significantly enhances the quality of clinical simulation and human factors training for the medical registrar.