Case study

Bringing scenario-based, simulation training to the bush

The Rural Simulation Training Centre is a safe learning environment where everyone is comfortable and able to learn. In fact, it’s where you want to make and learn from your mistakes.

Steve Trood, Paramedic Educator for NSW Ambulance, participant and trainer in HETI's mobile Simulation Centre.

Since 2012, our award-winning Rural Simulation Training Centre has travelled throughout rural and remote NSW educating NSW health staff through simulated training exercises. The Centre is designed to prepare teams to handle real-life medical situations safely, with competence and confidence.

The purpose-built semi-trailer is equipped with two simulation areas (an emergency room/hospital ward and a birthing simulation room), a control room and a range of manikins that can be programmed to provide realistic patient presentations.

The Centre uses high and low-fidelity and high and low-tech manikins and task trainers to support the clinician's experiential learning. A smaller outreach van also travels with the Centre to reach remote areas not accessible by the semi-trailer.

Steve Trood, Paramedic Educator for NSW Ambulance, is based in Wagga Wagga and has been both a participant and trainer in the Mobile Simulation Centre. He knows first-hand how effective simulated clinical training is for rural-based health staff at all levels.

“The Centre delivers high-end simulation training to those who don’t always have access to this level of scenario-based training. All health staff can be involved in a simulation and that’s a real bonus in rural communities,” he says.

“Traditionally, people were frightened of simulation because it was used as an assessment tool and, at times, resulted in participant humiliation when they felt they had underperformed in front of their peers. The scenarios were often unrealistic and participants would fail. Now the focus is on creating a safe learning environment for everyone," Steve explains.

“In the Centre, all simulation is graduated, from first time participants to very experienced participants. The idea is to have the clinicians at their healthy peak stress levels. When they see that they can perform under such conditions, when a real life event happens, they can reflect on this learning, draw from it and have the confidence to deal with the situation.”

Thorough briefings and de-briefings are crucial in all simulated training exercises in the Centre, which include a range of scenarios from birthing simulations to emergency situations.

“The briefing is where we set ground rules and decide what the goal and learning objectives of the simulation are. It doesn’t always have to be a high-fidelity scenario. We might focus on team work and crisis resource management (CRM), such as training paramedics in giving a succinct and accurate handover. After the briefing, we do the simulation which is controlled by a facilitator observing through one-way glass from another room. Once the learning objectives are achieved, the simulation is stopped and we debrief.

“It’s all about everyone being comfortable in the simulation and learning from it. The key thing is not to be afraid and just have a go!”

Key benefits

• Access to simulation/scenario-based training otherwise not available in rural and remote areas
• Crucial crew resource management training with no risk to patients
• User-focussed training and scenarios to meet a specific need
• Promotes a learning environment where participants are safe to make mistakes
• Enhanced patient outcomes and improved clinical expertise, competence and confidence

We work in partnership with nursing, medical and paramedic educators from Local Health Districts, NSW Ambulance Service and Justice Health and Forensic Mental Health Network to deliver simulation training programs via the MSC.

• The Centre provides simulation-based education to at least five rural Local Health Districts per annum
• 887 participants/health professionals trained in 2017 in 1,231 episodes of education
• Breakdown of types of professionals trained in 2017:
  • 483 Registered Nurses/Midwives
  • 142 Enrolled Nurses and Assistants in Nursing
  • 85 Doctors/GPs/VMOs
  • 32 Clinical Educators (nursing, medical, paramedic, allied health)
  • 49 Paramedics
  • 1 Justice Health and Forensic Mental Health Network staff
  • 3 Allied Health
  • 53 students
  • 29 others