Enhancing UK Core Medical Training through simulation-based education (SBE): an evidence-based approach:

8 Feb 2017

A report from the joint JRCPTB/Health Education England (HEE) Expert Group on Simulation in Core Medical Training

Simulation-based education (SBE) is increasingly becoming a vital component of postgraduate medical education. Its adoption is supported by national policies and an expanding body of literature. Although pioneered in anaesthetics and surgical training in the UK, SBE is an important element of physician training that is widely recognised as a means of improving patient outcomes through enhanced learning of evidence-based standards.
Working with the joint JRCPTB/HEE expert group on simulation in core medical training (CMT) work has been undertaken to look at how to effectively embed simulation into core medical training (CMT) curricula for all four countries of the United Kingdom. The output of this work is detailed in the joint report Enhancing UK Core Medical Training through simulation-based education: an evidence-based approach.
The recommendations in this document are based on a detailed review of the literature and expert opinion on best practice. It examines those aspects of the CMT curriculum that can be appropriately and effectively taught using SBE and provides recommendations for their mandatory implementation.
  • There is good evidence that certain CMT practical procedures (central venous catheterisation, thoracentesis, abdominal paracentesis) and emergency presentations (cardiorespiratory arrest) can improve patient outcomes if taught using SBE. There is no obvious reason why additional CMT procedures should not also be taught using SBE, indeed the evidence points to it being desirable to do so 

  • It also found that there is reasonable evidence that non-technical and human factors skills required by CMT can be effectively taught using SBE

  • The teaching of CMT essential and desirable procedures and also non-technical skills using SBE is already widespread within the UK and CMT training programme directors (TPDs) support this training.
The findings are intended to assist training programme directors, Heads of Schools of Medicine, Foundation Schools, Deaneries, Local Offices of HEE, consultants and everyone else involved with the delivery of CMT, in understanding exactly how and where simulation can be used most effectively to improve educational outcomes and trainee experience.

Next steps

This report and its findings were discussed at the Conference of Postgraduate Medical Deans (COPMeD) in February 2017,
Professor David Black, JRCPTB Medical Director said: "The positive feedback we have received from Postgraduate Deans from all four nations supports our commitment to harnessing technology to continue the development of excellence in physician education, drive up the quality of core medical training and the implications for better patient outcomes". 
Following this, the JRCPTB will propose for simulation to be included as a mandatory element of the new internal medicine curriculum, to be submitted to the General Medical Council later in 2017.
Read the full report  below.
Read the full systematic review results.
Principal authors:
Dr Makani Purva, Director of Simulation and Deputy Chief Medical Officer, Hull and East Yorkshire Hospitals NHS Trust (formerly Director of Medical Education, Hull and East Yorkshire Hospitals NHS Trust)
Dr Graham Fent, Specialty Registrar in Cardiology, Health Education Yorkshire and the Humber (formerly Educational Leadership in Simulation Fellow, School of Medicine, Health Education Yorkshire and the Humber)
Dr Anoop Prakash, Consultant in Respiratory Medicine, Hull and East Yorkshire Hospitals NHS Trust (formerly Educational Leadership in Simulation Fellow, School of Medicine, Health Education Yorkshire and the Humber)
Principal editor:
Dr Miriam Armstrong, Senior Policy Adviser, JRCPTB