Highest fidelity simulation: frail simulated patients in community education

A. Barkham, Caroline Jane Hamilton

Research output: Contribution to conferenceAbstractpeer-review


Background: Integrated care is vital for the wellbeing of frail older people and a well trained workforce is essential.¹ One component of proactive integrated care is the development of personalised care planning. The individual can determine what matters most to them and their wellbeing. Care planning describes a structured conversation which can take place over several visits resulting in a completed plan owned by the individual. This is best done by applying a non-directive approach with the individual acting as an equal partner in the interaction. This ‘coaching’ approach requires knowledge and skill, largely new, but crucially relevant, in the health care workforce in the community.

Project Description: Frailty educators, were taught how to engage with frail simulated patients (fSPs) and involve them in the planning, implementation and evaluation stages of the programme. The selected fSPs, were experienced in role depiction and debrief. Collaboratively, an education programme was developed, including simulated scenarios reflecting situations that community advanced practitioners (APs) experience. Immersing themselves in these scenarios enabled the APs to practice health coaching conversations with fSPs. Twenty-five day programmes have been delivered to APs with backgrounds in district nursing, mental health, therapy. The quality assurance components of this training were guided by the ASPiH standards.

Outcomes: All 250 AP attendees reported an improvement of their knowledge and understanding of frailty care: 90% reporting they are now confident in individualised care planning conversations and motivational interviewing techniques, having practiced with the fSPs and are able to embed these skills in practice. The fSPs incorporated their ‘lived experience’ of frailty into their roles, adding authenticity and realism to the simulation. An unanticipated outcome was the fSPs stated their understanding of care in the community and care planning had increased. The impact has been far reaching; individuals in the South of England can now determine their own goals for wellbeing.

Conclusions: Community APs are faced with unique challenges with regard to their work ‘setting’ presenting environmental, social or psychological challenges. To equip staff with the best skills, simulation-based education with fSPs, replaced and amplified real experiences with guided ones. These were ”immersive” in nature, and the experience, ‘evokes or replicates substantial aspects of the real world in a fully experiential fashion’.² This ongoing training has provided APs with the skills and confidence to complete person centred care planning with the fundamental aspect of training, to involve the patient in ‘what is important to me’.
Original languageEnglish
Number of pages1
Publication statusPublished - 5 Nov 2017
Externally publishedYes
EventAssociation for Simulation Practice in Healthcare Annual Conference 2017 - Telford, United Kingdom
Duration: 6 Nov 20178 Nov 2017


ConferenceAssociation for Simulation Practice in Healthcare Annual Conference 2017
Abbreviated titleASPiH 2017
Country/TerritoryUnited Kingdom


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