Student Simulated IV Fluid Management and Prescribing - A SaFEr way to learn together

Oral Presentation 7
Dr Daniel Hollington, Dr Neal Morgan

Student Simulated IV Fluid Management and Prescribing - A SaFEr way to learn together   

Introduction
IV fluids are high risk medicines with a reported risk of morbidity or harm of 20% when used incorrectly. A 2020 RQIA report identified significant non-adherence to NICE guidance (CG174: IV fluid therapy in adults in hospital) and a Regional Education and Training Task and Finish Group was established, tasked with producing a training package capable of competency assessment of doctors, nurses and pharmacists managing fluids. The SIVMAP (Simulated IV Fluid Management and Prescribing) program was developed to focus mainly on prescribing. Content was carefully mapped to the key learning themes of CG174 across a 6 station circuit and whilst educationally successful its 2:1 faculty to learner ratio was unsustainable.

Objectives
To provide a sustainable, effective simulation-based learning programme to support IV Fluid training with a model that could be adapted to numerous high risk prescribing themes, empowering learners and supporting inter-disciplinary team working.

Methods
Recognising euvolaemic simulated actors added minimal fidelity we developed Student SIVMAP. This utilised SIVMAP’s case materials (admission booklet, charts etc.) alongside detailed GoogleForms that hosted faculty-prep, assessment and debrief. Model answers and specialist insight were embedded within each form. This facilitated Student SIVMAP’s “Student as Faculty Educator (SaFE)” dynamic, whereby participants alternate between stations as faculty and learner. Participants were sent links to prep for their faculty roles in advance, one senior faculty led the simulation. After successful undergraduate pilot work Student SIVMAP was delivered at 2022 Southern Trust F1 induction with all 40 Foundation Year1 trainees and numerous nurses participating in three half-day sessions. Feedback on changes to “self-reported confidence” and “sense of preparedness for independent practice” was recorded throughout.

Outcomes
Pilot work showed 75% of students preferred the Student as Faculty Educator dynamic; citing it was more engaging, less tiring, helped consolidate their learning and provided useful insights into their peers thought processes. Both pilot and induction sessions successfully empowered semi-autonomous interdisciplinary team learning and were delivered with a faculty to learner ratio between 1:12-21. Averaging results from all 6 induction stations 89% of medics reported feeling more/much more confident (range 77-100%) and 87% of nurses reported feeling more/much more confident (range 86-90%). Preparedness for independent practice scores averaged 7.0/10 for medics and 6.8/10 for nurses. The model helps direct further educational focus and sharing all faculty links post-simulation supports real-world clinical practice.

Conclusions
Student SIVMAP presents a novel effective sustainable model for multi-disciplinary education and training, especially high risk medication management.