Hospital at home - developing a simulation induction programme for junior doctors.

Area of Science:

• Medical Education
• Healthcare Delivery Innovation
• Simulation-Based Training

Background:

• Hospital at Home (HaH) models are expanding, necessitating specialized training for healthcare professionals.
• Existing medical curricula lack adequate preparation for junior doctors in delivering hospital-level care within a home environment.
• A London-based HaH service identified a need to enhance early-career doctor preparedness.

Purpose of the Study:

• To develop and evaluate a simulation-based training program, HaH-SIM, for junior doctors working in Hospital at Home settings.
• To assess the impact of HaH-SIM on doctors' confidence and competence in practical, clinical, and communication skills.
• To identify key areas of improvement and participant satisfaction with the simulation training.

Main Methods:

• A multi-cycle Quality Improvement Project (QIP) was used to develop HaH-SIM.
• Pre- and post-simulation surveys assessed confidence, concerns, and skill acquisition.
• The training incorporated six low-fidelity and three high-fidelity simulation stations.
• 41 junior doctors participated over a two-year period.

Main Results:

• Significant improvements in confidence were observed, particularly in end-of-life care, admission decisions, and IV medication administration.
• High-fidelity scenarios, practical skills stations, and prescribing modules received the highest ratings.
• Qualitative feedback indicated positive participant experiences and perceived skill enhancement.
• Confidence increased across practical, clinical, and communication domains.

Conclusions:

• Hospital at Home simulation (HaH-SIM) is a feasible and effective method for enhancing early-career doctors' skills and confidence.
• The program addresses critical gaps in training for the expanding field of home-based hospital care.
• HaH-SIM offers a transferable model for improving physician readiness in diverse Hospital at Home services.