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AimsTechnology-enhanced learning, specifically the use of mobile devices by Healthcare professionals has transformed many aspects of clinical practice.1Some healthcare organisations are reluctant to advocate the staff use of mobile phones due to the risks associated with interference of medical equipment, infection control concerns, and reported parental complaints.Mobile devices provide a multitude of benefits for clinical staff including increased access to useful apps such as drug-dose calculators, and other validated point-of-care tools, which are of high educational value and have been shown to support better clinical decision making and improved patient outcomes.2MethodsWe designed a survey assessing parental and staff perception on the use of mobile phones, using a five point Likert scale. 40 staff and 40 carers participated in the questionnaire.Following this, we designed two clinical scenario’s assessing administrator and prescriber performance for healthcare professionals. We assessed length of time to complete task and degree of accuracy. Scenario 1 participants were prohibited from using mobile phones. Subsequently, participants were granted access to mobile phones for assistance in Scenario 2.Results38/40 (95%) parents surveyed felt that healthcare professionals should be allowed to use mobile technology in a clinical environment. Similarly, of the 40 staff members surveyed, 39/40 (97%) felt access to mobile phones for clinical reasons was appropriate.For the drug administration scenario (performed by nursing staff), all participants were quicker using mobile phone for assistance. The average length of time was 1 min 22 s quicker. Task accuracy was maintained at 100% with and without mobile phone use.For the prescriber scenario (performed by medics and non-medical prescribers), again all participants were quicker using mobile phone aide, with an average length of 1 min 26 s quicker. Accuracy of 100% was maintained in both cohorts.ConclusionDespite previous reported parental concern, this survey highlights the strong carer support for healthcare professionals appropriately using mobile phones in clinical areas. Staff members were similarly keen for the use of mobile technology to aid their practice.We have demonstrated an improvement in efficiency of performing clinical tasks with the assistance of mobile phones, ensuring accuracy was maintained. The appropriate use of mobile phones promotes well-informed, safety-conscious, technology-assisted, effective clinical care.References. Wallace S, Clark M, White J. ‘It’s on my iPhone’: Attitudes to the use of mobile computing devices in medical education, a mixed methods study. BMJ Open2012 August.. Divali P, Camosso-Stefinovic J, Baker R. Use of personal digital assistants in clinical decision making by health care professionals: A systematic review. Health Informatics J2013;19(1):16–28.

AimsClinicians collect, prioritise and respond to visual cues when making decisions about patient care. This is of particular importance in the resuscitation environment where they are required to absorb and process large volumes of complex visual information in a time critical manner. Eye tracking technology allows for the measurement of an observer’s point of gaze based on where their pupil is focused. Eye tracking technology has been used in aviation and surgery to describe differences in the gaze behaviour between experts and novices. The aim of this study was to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency.MethodsTwenty-seven clinicians from different clinical areas within a tertiary children’s hospital undertook a standardised, six minute, high fidelity simulated paediatric emergency. Participants wore SMI Eye Tracking Glasses. We measured the number of times participants looked at predefined key areas (fixation count) and the duration of time spent looking at each of these areas (dwell time). The time taken to key clinical interventions was also recorded.ResultsParticipants from all groups looked more frequently and for longer at the patient (chest and airway) than any of the other key areas of interests. Paediatric Intensive Care Unit (PICU) consultants focused longer on the chest and airway than any other groups. The gaze behaviour of paediatric consultants and trainees was similar. Both groups spent longer looking at the defibrillator and algorithm (51,180 ms and 50,551 ms respectively) than the PICU consultants and consultants in paediatric emergency medicine (19,804 ms and 28,095 ms respectively). The PICU consultants were quickest to perform key clinical interventions.ConclusionsThis study is the first to describe differences in the gaze behaviour between clinicians from different backgrounds during a simulated paediatric emergency. Differences observed between experts and novices are similar to those described in aviation and surgery. Further research is needed to evaluate the potential use as an educational tool in the resuscitation setting.

AimsAcute Paediatrics is a stimulating and challenging training programme. The Royal College of Paediatrics and Child Health (RCPCH) provide a comprehensive curriculum for trainees during these years. In Level 1 Training (ST1–3), there are a number of core practical procedures trainees are expected to perform prior to progression to Level 2 training. These skills include Neonatal Intubation, Lumbar Puncture (LP) and Intraosseous (IO) Access.1Often it may be difficult for trainees to gain significant experience in these skills and achieving competence can be challenging. Reasons for this include lack of opportunity, lack of experience, and low procedural confidence. The RCPCH advocates the delivery of Simulation and Technology Enhanced Learning (TEL) including in the area of technical skills training.2By creating a technical skills simulation training day, we aimed to increase trainee exposure and confidence to core college procedures.MethodsWe created a simulation training day for Level 1 Regional Training focused on 3 core procedures. We asked Paediatric ST1–3 trainees about previous teaching, experiences and confidence levels with these skills.Results24 ST1–3 trainees were surveyed. Prior to the teaching, 2 (8%) trainees felt their Intubation skills were adequate, 12 (50%) described their LP skills as satisfactory and 4 (16%) trainees labelled their IO access skills as acceptable.Following the training session, 23 of the 24 trainees (96%) felt significantly more confident in approaching all 3 of the core practical skills. All 24 Trainees (100%) felt that simulated practice helped improve their technical skills and all (100%) felt it would be useful in their daily job.ConclusionSimulation-based training for procedural skills has been shown to be effective for trainees and has been widely used in many training programs.3By integrating this into the Deanery’s Regional teaching programme, we have presented junior trainees the opportunity to gain vital hands-on experience on high-fidelity models, which has improved procedural exposure, enhanced user-confidence and may potentially develop procedural competence.We hope to extend this programme to higher level trainees and incorporate other core procedural skills in a bid to further promote a safe, trainee-friendly, patient-centred simulated learning environment.References. Curriculum for Paediatric Training. General paediatrics: Level 1, 2and 3 trainingAugust 2016. http://www.rcpch.ac.uk/training-examinations-professional-development/postgraduate-training/general-paediatrics-training/ge#curriculum. Strategy- Simulation and TEL. Royal College of Paediatrics and Child HealthJanuary 2015. http://www.rcpch.ac.uk/training-examinations-professional-development/postgraduate-training/simulation-and-technology-enh. Barsuk JH, Cohen ER, et al. Simulation-based education with mastery learning improves residents’ lumbar puncture skills. Neurology2012;79(2):132–7.

AimsHierarchy and leadership are essential within any multidisciplinary team. However, to err is human and team leaders can make mistakes irrespective of seniority. It is important that everyone within the team feels confident in raising concerns to ensure patient safety. This can be particularly challenging for new staff joining established healthcare teams. The Advanced Paediatric Life Support (APLS) Group recommend the PACE approach as a structured method for raising concerns.Abstract G49 Table 1StageLevel of ConcernP - ProbeI think you need to know what is happeningA - AlertI think something bad might happenC - ChallengeI know something bad will happenE - EmergencyI will not let it happenWe aimed to improve the confidence of new children’s nursing staff in raising concerns by introducing teaching on this topic into their induction simulation session.MethodsNew nurses undertook a simulated clinical scenario in which the doctor was deliberately hesitant and reluctant to administer appropriate treatment. Teaching was then provided on the PACE approach. Each nurse then participated again in a similar scenario. Using pre and post questionnaires we asked the 23 participants to suggest on a Likert scale how confident they would feel in challenging a nursing colleague or doctor if they had concerns about their practice before and after the session. During the debrief of the first scenarios we asked participants how they had felt.ResultsThere was no difference in participants’ confidence between challenging a nurse or doctor (3.4/5) prior to training. Following the initial scenario the nurses reported feeling ‘frustrated’ and ‘scared’.One stated ‘this is my worst fear.’ After the PACE teaching and subsequent scenarios nursing staff stated that their confidence in challenging nurses and doctors had increased to 4.3/5 and 4.2/5 respectively. Free text comments included:‘Hearing from doctors that they would rather be challenged was reassuring.’‘Improved my confidence to speak up when querying a decision’ConclusionNursing staff reported improved confidence in their ability to raise concerns. This can only serve to improve patient safety. We have subsequently embedded PACE training within all our medical and nursing induction programmes.