Leading heart expert calls for better access to simulation training

A leading doctor based at Southampton’s teaching hospitals has called for better access to simulation training for heart specialists to improve patient safety.

Dr James Wilkinson, a consultant cardiologist at University Hospital Southampton NHS Foundation Trust, said the specialty should follow the aviation industry in establishing simulation training as the “gold standard”.

"There are now very advanced simulation machines that, for the first time, allow people to train in doing heart procedures in very realistic settings and circumstances without having to learn on patients on the job," he said.

"This enables team training in what are otherwise very stressful procedures and gives trainees the chance to develop skills in high-risk and dangerous procedures in a safe environment, reducing the risk to patients.

“However, as things stand, there is no formal and properly funded simulation programme in place, which means such training is delivered sporadically and to pockets of trainees – it is patchy.”

Although recent guidance from the General Medical Council and Health Education England states simulation training should now be offered to newly-appointed cardiac trainees and it has been incorporated into the national curriculum, only six two-day training courses will have taken place over the year by the end of 2016.

“While simulation training has been incorporated into the curriculum and is now deemed to be mandatory, it will continue to be a struggle to meet that requirement as there is no structured funding system in place for providers or trainees – it’s really a half-hearted approach at the moment,” explained Dr Wilkinson.

"The aviation industry has used simulation training successfully for a long time and that has led to the development of international standards in order to ensure consistency for operators, regulators and manufacturers.

"There is an extremely strong argument for wider adoption of this technology within healthcare to improve safety for patients and we need to look at the formal system developed by the aviation industry to put the best possible system in place."

Dr Wilkinson spoke out during a two-day simulation course being held at Southampton General Hospital for trainees from across the UK which involves a range of heart procedures carried out on hi-tech machines which mimic catheter lab and theatre environments with full body mannequins, 4K resolution monitors and HD touch screen controls.

Delegates at the event, which began today (Thursday) on World Heart Day, will be given the opportunity to observe and take part in simulations covering coronary angiograms to look at blood supply to heart, invasive study to measure pressures in the heart and lungs, placement of temporary pacing wires and the draining of fluid around the heart when a life-threatening amount has accumulated.

Dr Wilkinson, who has helped to develop national simulation training courses for the British Cardiovascular Society, and his team will be joined by Flybe captain and flight simulation expert Graham Salmons, who will highlight the role and advantages of simulation training in the aviation industry.

“It is excellent news our specialty is starting to move towards more simulation-based training, such as this event in Southampton, but we should be aiming for it to become the gold standard rather than an added extra,” added Dr Wilkinson.

“Within the aviation industry, simulation training has led to international standards of excellence which help to ensure quality and consistency and that is certainly something we could benefit from hugely in medicine.”

Posted on Thursday 29 September 2016