Training competencies

Competencies addressed in Synthetic Learning Environments

[reproduced or adapted form the Australian Society for Simulation in Healthcare (ASSH)]

Synthetic learning environments enable practical experience-based training to occur without involving patients. This reduces risks to patients. Training is aimed at preparing learners adequately before patient encounters; to refresh learners who have not had specific types of clinical experience in recent times, or learners at any time to enhance the quality and accelerate learning which occurs from clinical experience.

A wide range of competencies can be addressed in SLEs. A list of these is provided below, along with an explanation of terms. The specific competencies that will be addressed in any particular course will be listed on the course fact sheets.

Courses conducted at the centre are frequently referenced to established curriculum frameworks and clinical guidelines, including the Australian Resuscitation Council Cardiopulmonary resuscitation guidelines; The Australian Junior Doctors’ Curriculum Framework, The Australian National Patient Safety Education Framework and Specialist Medical Colleges’ training curricula. Check the course accreditation details on the course fact sheet for this information.

1. Clinical skills* refer to domain specific components of clinical practice including:

• Patient assessment: history, clinical examination, and clinical diagnostic reasoning (including interpretation of diagnostic tests)
• Procedural task training: knowledge and technical skills relevant to execution of procedures
• Case management: clinical judgement and decision-making regarding therapy

2. Non-technical skills (NTS)* refer to cognitive functioning and observable behaviours that underpin safe and effective clinical practice. They include:

• Patient-Doctor Communication: establishing a therapeutic relationship; obtaining consent; undertaking complex consultations; facilitating family conferences; breaking bad news; disclosing preventable adverse events; and managing complaints
• Inter-professional Communication: teamwork, leadership, communication, negotiation, graded assertiveness and conflict resolution
• "Within-procedure" patient communication: an important competency for practitioners when performing procedures on awake patients. This competency combines basic interactive skills; assisting patients to stay calm; assisting patients to cope with claustrophobia and remain in certain positions, ensuring they have adequate analgesia, and sedated if required
• Crisis Resource Management (CRM) and emergency leadership and teamwork are relevant to practitioners who engage in time critical responses
• Handover methods including the SBAR method and others
• Self-management competencies: insight and judgement, emotional intelligence and regulation, time management and stress management
• Ethical reasoning
• Facilitating end-of-life decisions: a highly integrated competency requiring clinicians to integrate high level patient-doctor communication and team skills with procedural knowledge relating to the clinical, legal and ethical principles of this topic
• Career planning and practice management

3. Patient Safety competencies refer to knowledge attitudes and behaviours that have been identified to strongly impact upon the safety of patient care. Clinical skills and NTS, as listed above, underpin patient safety along with knowledge of Human Factors and Organisational or Systems safety. A definitive and practical guide is available in the Australian National Patient Safety Education Framework.

4. Human factors, using the Wikipedia definition, is a term that covers:

• The science of understanding the properties of human capability (Human Factors Science).
• The application of this understanding to the design, development and deployment of systems and services (Human Factors Engineering).
• The art of ensuring successful application of Human Factors Engineering to a programme (sometimes referred to as Human Factors Integration). It is also called ergonomics.