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Advanced patient simulation applied to the selection of professionals for the National Health Service in Spain
Good morning Ladies and Gentlemen
It’s a pleasure to be here.
Please bear with me for five minutes — after me there will be some interesting presentations!
I am going to present the experience of the IAVANTE Foundation in the use of Advanced Patient Simulation in the selection process of specialist doctors in critical care and anaesthesiology for posts in hospitals of the Andalusian Public Health System in Spain.
IAVANTE, the Foundation for Technological Advancement and Professional Training is an organisation dedicated to Knowledge Management in Health CREATING, TRANSFERRING AND SHARING KNOWLEDGE.
It was created by the Ministry of Health for the Andalusian Regional Government, and its objective is to facilitate and promote the development of professionals and organisations in order to place their activity at the highest possible level.
On the occasion of the public advertisement of post vacancies for specialist doctors in the Andalusia region, a complex selection process was carried out at our Granada Medical Simulation Center during the months of January, February and March 2008.
The region of Andalusia is situated in the south of Spain. It has a surface area of eighty-seven thousand, six hundred square kilometres and a population of more than eight million inhabitants. It has its own regional government. In Andalusia there are thirty three hospitals belonging to the Public Health System, of which five are level one.
The Regional Government began this selection of specialist physicians for the Public Health System in October 2007. A total of five thousand four hundred and forty-seven professionals applied from forty-four different specialist areas.
The selection process consisted of two consecutive phases; previous experience was also taken into account.
In the first phase the candidates did a multiple-choice theory test based on their specialty. Those who passed this test went on to do the second phase.
The Second phase involved solving a case study or carrying out a specific technique.
All the tests in the Second phase were carried out in the Granada Medical Simulation Center and involved different simulation methodologies such as:
virtual reality simulation
partial task simulators (trainers)
case studies using multimedia systems
experimental surgery…
A total of 3892 professionals completed these practicals.
Previous candidate experience was not taken into account in the use of simulation methodology.
Advanced Patient Simulation was used to evaluate candidates in the specialties of Critical Care, Anaesthesia, and Plastic and Reconstructive Surgery.
Simulation was employed for the first time in the National Health Service of Spain, in order to evaluate and select candidates.
Three hundred and ninety-one candidates carried out the practical tests for critical care and anaesthesia.
The scenarios consisted of three individual rooms for critical patients equipped with a HPS METI™, advanced monitoring, ventilators and a carefully constructed scenario.
Each candidate could choose between a case study related to a haemodynamic disorder and one related to a respiratory pathology. However, candidates were not given any information prior to the test.
Candidates were provided as required with:
- Clinical records
- Laboratory results
- Complimentary test images
Candidates had the assistance of a nurse specialised in critical patient care.
The time of simulation was 30 minutes.
Content validity and similarity in case complexity was ensured by the analysis of these factors by renowned clinical experts.
Closed software was used which prevented any changes during or between exercises.
The examination board used a check list with the different skills to be evaluated. 12 items were assessed for each candidate.
The Applicants had:
To identify the patient syndrome
To order complimentary tests
To apply treatment and carry out specific actions
We do not yet have the results of the tests:
«The recruitment assessment outcomes and the official results of job placements will be published by the NHS»
Data taken from the METI simulator event log were used as a supplementary control on the practical exam: these included physiological parameters and administered drugs and fluids.
At the end of the examination the candidates completed a satisfaction questionnaire to provide feedback on their opinion on the inclusion of simulation in the selection process.
The candidates evaluated the selection test using a scale from 1 to 10.
As regards the use of advanced clinical simulation methodology, the score obtained was 6.9; as regards organisation of the event, the score was 7.9 and 8.2 for facilities.
There were no incidences of note during the evaluations:
- There were no complaints from any of the candidates.
- There were no calls for nullification of any part of the process.
Conclusions
The use of advanced patient simulation in the selection of professionals in the NHS is an innovative use of simulation methodology in Spain.
Positive aspects:
- The acceptance by candidates of advanced patient simulation was excellent.
- We believe that both the Multiple choice questionnaire and the Advanced patient simulation, gave the examination board a more realistic and objective view of candidates competencies.
This selection process did not evaluate Communication skills or team work.
Thank you for your attention!
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