LAUSR

Aims A wealth of evidence demonstrates that in situ simulation reduces adverse events. Although monthly high-fidelity in situ simulations are embedded in the Paediatric Emergency Department (PED) education programme only small numbers of staff benefit due to rota constraints. We aimed to maximise departmental learning from simulation across all disciplines of staff by introducing weekly First Five Minutes simulation: unannounced five minute simulations starting with a crash buzzer or a ‘parent’ shouting for help. Binary technical and non-technical expected actions (e.g. did/did not administer anticonvulsant, team leader clearly identified/not identified) are explored in focussed debriefs. To maximise departmental learning the simulation is repeated weekly for a month following which an infographic newsletter is sent to all staff and displayed in staff areas. Scenarios are designed to embed new guidelines, address clinical incidents or by request. Methods First Five Minutes is currently in its fifth month. Scenarios include: a child fitting in minors; an apnoeic baby in the waiting room; a child with a tracheostomy with sudden onset respiratory distress in majors; and an adolescent in triage complaining of neck pain after falling from a tree. Written feedback is obtained after each simulation. Participants are asked to rate enjoyment, organisation and learning on 10-point Likert-scales and to provide free-text comments. Results To date 53 members of staff have provided feedback. Likert-scores are high across all domains with mean scores of 9 out of a maximum of 10 (table 1). Scores are similar across disciplines (table 2). Qualitative feedback has been very positive, following three themes: self-identified technical learning; human factors learning; requests for increased frequency. Conclusions First Five Minutes has become a valued part of multidisciplinary PED education with excellent buy-in from staff. Repeating simulations to maximise whole department learning has been key to its successful implementation. Next steps include evaluation of First Five Minutes as a departmental-level educational tool by evaluating time to expected actions and assessing whether these times improve and are sustained.Abstract G605(P) Table 1 Composite Likert-scores (1=very poor; 10=brilliant); n=53, mean (standard deviation) Enjoyment Organisation Learning Combined 8.50 (±1.39) 9.26 (±1.06) 9.23 (±1.03) 9.00 (±0.97)Abstract G605(P) Table 2 Composite combined Likert-scores split by role; mean (standard deviation) Doctor (n= 15) Nurse (n= 17) Student Nurse (n= 8) Unknown (n= 13) 9.27 (±0.66) 8.70 (±1.11) 8.96 (±1.13) 9.10 (±0.98)