Clinical Skills Managed Educational Network (CSMEN ... · Web viewClinical skills training impacts...
Transcript of Clinical Skills Managed Educational Network (CSMEN ... · Web viewClinical skills training impacts...
Quality Assurance System
for the Use of Simulation in Clinical Skills Education
What is Quality Assurance (QA)?
Quality Assurance in education is a system of ensuring that quality management and
quality control processes are in place within an organisation which can demonstrate
training and monitoring of standards. These processes also ensure there is a quality
evidence base. QA identifies where organisations are not meeting standards for
simulation based education and training and outline options for promoting improvement.
The development of a national strategy for clinical skills education in Scotland required a
quality assurance system to be in place for simulation based education to set up a
continuous improvement culture of clinical skills practice by individuals or teams of
health care practitioners. A Quality Assurance system ensures that standards of simulation
based education are accessible to all health care practitioners wherever they practice and
whatever their professional background. The following information is framed around
three questions
What QA frameworks have contributed to the development of a QA system for
Simulation Based Education?
What is the Scottish Simulation Based Education QA System?
How was the QA System for Simulation Based Education developed?
What QA frameworks have contributed to the development of a QA system for
Simulation Based Education?
The following sources have informed the development of a QA system for Simulation
Based Education. Each recognises the need to ensure educational standards are being
continuously improved and updated for all health care practitioners.
1. The Nursing and Midwifery Council (NMC)
The NMC updated their QA framework for education in 2016. The principles for the
framework include Transparency, Clarity, Utility, Accountability and Improvement. The
standards for the approved programmes (over 100) it runs informs their role as a
professional regulator rather than an educational regulator which links into the Quality
Assurance Agency (QAA) for higher education. The NMC regulates within a ‘right touch’
regulation system set out by the Professional Standards Authority (PSA). Right touch
regulation is defined as being proportionate, consistent, targeted, transparent,
accountable and agile. In order to provide public protection as a professional regulator it
delivers QA through four areas, as follows:
Approval against standards
Education reviews
Responding to concerns
Reporting and sharing evidence
NMC QA Framework for nursing and midwife education
2. The Health Professions Council (HPC)
The HPC is a regulator which keeps a register of health care practitioners who practice to
an agreed standard. It is a statutory body which approves educational programmes
necessary ‘to achieve standards of proficiency’. It currently approves 94 education
providers providing 424 separate programmes. The following professions are included:
arts therapists, biomedical scientists, chiropodists/podiatrists, clinical scientists,
dietitians, hearing aid dispensers, occupational therapists, operating department
practitioners, orthoptists, paramedics, physiotherapists, practitioner psychologists,
prosthetists/orthotists, radiographers, social workers in England and speech and
language therapists. The HPC is currently responding to the latest Enhancing Quality In
Practice Framework (EQuIP).
HPC Healthcare Education QA Framework
3. The General Medical Council (GMC)
The GMC QA Framework covers both undergraduate and postgraduate education and
links into Promoting Excellence the standards for medical education and training
GMC Promoting Excellence
The QA system clarifies the role of NHS providers, Higher Education Institutions (HEIs)
Postgraduate providers and Royal Colleges in Quality Assurance, Quality Management and
Quality Control.
GMC QA Framework
4. The Higher Education Academy (HEA) UK
The HEA UK Professionals Standards Framework links standards of educational activity to
core knowledge requirements about education and professional values with a focus on
continuous improvement.
HEA UK Professionals Standards Framework
5. The Academy of Medical Educators (AoME)
The AoME set out to become the standard setting body for medical educators in the UK. In 2009, it
achieved this aim with the publication of the Professional Standards that define the level of
competence that medical educators should achieve at each point in their careers. The core
domains they identified include
Designing and planning learning
Teaching and facilitating learning
Assessment of learning
Educational research and scholarship
Educational management and leadership
AoME Professional Standards
6. Skills Development Scotland
SDS has developed an action plan template which is linked to improvement; the headings of which are shown below.
SDS Quality Action Plan Template
Organisation: Period of Action Plan:
StandardsAreas for
Improvement to be Implemented
Individual responsible for
Action
Date ActionStarted / Finished
Resources Required
Review of Actions
The organisation covers a wide variety of opportunities to enhance the workforce.
SDS What We Do
7. The Association for Simulated Practice in Healthcare (ASPiH)
This UK organisation was established in 2012-13.
It has developed a standards Framework using an expert panel which was published in
2015 and focuses on four themes with 21 associated standards:
Resources
Faculty
Activity and
Technical personnel
ASPiH Standards for SBE in Healthcare
How was the Scottish QA System for Simulation Based Education (SBE) developed?
In implementing the Scottish Clinical Skills Strategy in 2008 it was essential to ensure that
health care practitioners from different disciplines and from different geographical areas
had access to the same standards of SBE whether delivered on the mobile skills unit, in
fixed facilities or in situ in the workplace.
In 2009, the Clinical Skills Managed Educational Network began to explore a system for
defining key quality standards for clinical skills education using simulation. A modified
Delphi approach was used to develop consensus.
The development of a Scottish QA system for on line Clinical Skills resources to enhance
SBE was developed in parallel with the delivery of faculty development and in relation to
national skills programme priorities building on the relevant frameworks highlighted in
the previous section.
What is the Scottish SBE QA System?
This SBE QA Framework was developed to reflect the following educational process:
Brief
Faculty
o A three-tiered approach was developed to identify key improvement
outcomes
Tier 1 - practitioner educators of SBE,
Tier 2 - leaders of SBE and
Tier 3 - researchers of SBE (available to download)
This outcome framework has been matched vs AoME, ASPiH and GMC
frameworks
Technical support
o A modified Delphi approach is being used to identify nationally agreed
capabilities for all Simulation technicians (available download in
development)
Facilities
o A national database of facilities and their capabilities in terms of specialist
equipment has been developed
o A mobile skills unit (MSU) with the same access to video debriefing and
standard simulators and part task trainers is operational
o Resources
A generic approach to on line development of clinical skills has been
agreed and utilised in the development of evidence based on line
resources CS MEN online resources
Immersion
Programmes
o A self-assessment questionnaire to be used for Quality Assurance of
educational programmes
o A one-page questionnaire for use with individual skills sessions where
simulation is used
o Provision of QA programmes on MSU e.g. BLS, ALS, PROMPT
Scenarios
o A scenario template for designing a SBE session has been developed to
ensure standards of design are considered in the development of new
scenarios
Specialist equipment
o standard manikins and part task trainers in all SBE facilities
o one way mirror and video debriefing capability in all SBE facilities
Debrief
o System of review and improvement
o On line resources currently updated biannually
o System of visits to remote and rural venues by MSU
o A national course for the MSU has been implemented
o A national faculty database is being developed
The common quality standards, educational resources and training programmes
developed and delivered through the Scottish QA system for SBE are subject to an
independent, robust and open review process. This will give the public and health service
managers confidence in the quality of clinical skills education and delivery and enable the
skills training to be explicitly linked with UK and Scottish competency frameworks.
Clinical skills training impacts directly on the quality of care patients receive. Patients are
the ‘touch point’ of the service. Consequently, the quality assurance process must
encompass not only educational governance but clinical and staff governance issues as
well. In Scotland, Quality Improvement Scotland (QIS) is responsible for promoting
patient safety through ensuring clinical standards of care. NHS QIS is committed to
working collaboratively on the development of the Clinical Skills Managed Educational
Network as we seek to promote best practice and improve the quality of healthcare.
NES has responsibility for providing and promoting education to all NHS staff and has
developed an educational governance framework for ensuring that educational resources
and processes can be measured against explicit quality standards and criteria. The
Scottish QA system for SBE underpins the implementation of the Scottish Clinical Skills
Strategy.