Several studies on simulation as a method of teaching have identified advantages- on attitudes, skills, knowledge and behaviours, and non-technical skills such as situational awareness, team working, interpersonal interactions with improved confidence. Use of simulation in Psychiatry is growing, but studies are limited. We decided to evaluate our own delivery of simulation in trust and align this to the national strategy to identify gaps and further work

What are we offering now?

• • Core trainees- Emergencies in Psychiatry- seclusion, suicide risk assessment and fracture neck of femur. Communication skills course, mock CASC, ILS.

• • Higher trainees- Tribunal preparation and providing evidence, Induction- Out of hours supervising 1st on call, Managing serious incident

• • In development-Immersive technology- Higher trainee supervising a junior doctor OOH

Challenges and solutions

• • Participant anxiety-Performing in front of peers can be demanding and reduces take up. ‘What to expect’ pre-session workbook, small group numbers (3), reiterating the focus of session on learning and confidentiality has improved participation.

• • Resource (scenario development) - Takes time and effort to achieve high quality, piloting and continual adjustments to tailor to the learners' needs. We appointed 3 SIM leads and hold regular meetings.

• • Resource (trainers)- Hard to resource trained trainers. Developed an in-house training programmes for trainers, but persistent difficulties in maintaining consistency and time commitments with same group of ‘trained trainers’. Included brief training pre-session in morning for facilitators.

• • Resources (finance)-Expensive to support Simulated patients. We used COVID-19 recovery funds and constructed purpose-built SIM rooms in education centre, which adds to fidelity

Feedback: Excellent feedback received with positive comments about supportive learning, SIM facilities and debriefing.

Despite being highly resource intensive, simulation is a powerful, unique, and valuable method of training in Psychiatry. Availability of resource will continue to pose challenges, but use of digital Immersive technology and focussing on relevant areas in line with National vision strategy and with identified groups- Induction, SuppoRTT, new to NHS, Remediation, CASC preparation and enhancing capacity of learning environment where there are gaps may be a good starting point. Use of MDT integrated scenarios can offer more fidelity.

Future identified areas will be

• • CT1s-Physical health skills (refresher), history taking, MSE, handover. Emergency scenarios- NMS, lithium toxicity, cardiac complications due to clozapine

• • Higher trainees- Mental health act assessments, supervising doctors in training/members of MDT. Chairing team meeting, handover, breaking bad news, presenting in a coroner's court