ORCID

Abstract

Capability is the ability to perform clinical skills in ever-changing real world contexts, adapting to challenges and integrating technical and non-technical skills and competencies, for example, cannulating an uncooperative patient at night. Going beyond teaching competency and ensuring capability is imperative, as recommended by the national outcomes for medical graduates. A course on intravenous cannulation was developed with e-learning modules and high-fidelity complex simulation scenarios, aiming to promote capability in practice. The course delivered an intravenous cannulation e-learning package between two practical simulations to 10 final-year medical students. The hybrid simulation design consisted of an actor with a bespoke cannulation part-task trainer strapped to their arm. Each simulation delivered a challenging scenario, requiring the integration of procedural and behavioural skills to succeed. Simulations were video recorded, and participants reviewed their performances before completing semi-structured interviews. Transcribed interviews were thematically analysed. Interview analysis demonstrated two overarching themes: ‘Impact on Capability’ and ‘Preparedness for Practice’. There was consistent recognition of improved capability from the interviews. Simulation exercises were described as the most valuable tool for developing capability. The e-learning helped with structure, facilitating students' adaptation to scenarios. Participants felt that training in medical school was largely competency-based and did not tackle complex interactions. Following e-learning and simulations, students felt more prepared for clinical practice. The course structure has value for medical professionals in developing capability and preparing for clinical practice, helping to reach standards expected of graduates. Plans to assess capability across multiple undergraduate programmes through Entrustable Professional Activities are in progress.

Publication Date

2024-01-17

Publication Title

Clinical Teacher

Volume

21

Issue

4

ISSN

1743-4971

Acceptance Date

2023-12-20

Deposit Date

2024-08-16

Funding

The e-learning resource was developed as a partnership between University of Plymouth and Becton Dickinson (Europe). Becton Dickinson funded the development of the modules and this research as part of the evaluation. Professor Tom Gale (Director of Clinical Skills and Simulation) and Robert Johnson (Senior Clinical Skills Tutor), at the University of Plymouth, devised the educational content for all four modules with input from Becton Dickinson. We would like to thank our final-year student participants, student nurse and simulated patients for their time and engagement in the study. The staff in the Clinical Skills Resource Centre at the University of Plymouth were invaluable in developing the simulation technology and providing a professional space for the study.

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Revised_Manuscript_-_The_Clinical_Teacher_pre-print_version.pdf (402 kB)

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