Combined Infection Bootcamp
Combined Infection Bootcamp
The requirements of post-graduate infection training in Scotland have recently undergone a radical change. The new Combined Infection Training programme is now the common stem for all infection based subspecialties where they learn the foundations of microbiological testing and practice all within a short time frame before moving on to their subspecialities. This needs substantial resources particularly time commitment from trainers. It’s no secret that the NHS is short staffed, and still recovering from the added burden of the pandemic. This additional training workload was adding pressure to the Microbiology and Virology departments and threatening the quality of training. The older model of individual training for each trainee delivered in a functioning clinical environment was, hence, no longer feasible.
This improvement opportunity prompted a core team of trainers from NHS Lothian Medical Microbiology and Virology to review other existing models of training within medicine and a few ideas emerged. They started with a mind map and used the Lean Six Sigma method to develop an SBAR for a new model. Unused existing resources were mobilised, existing processes adapted and change management methods incorporated to produce the Infection Bootcamp.
This bootcamp was first delivered in 2019 but some significant gaps were found. Although disheartening, a PDSA (plan-do study-act) approach was taken to deliver a revised version in 2021. This consisted of 10 intensive training days in a simulated environment where the patient journey was followed from start to finish. Clinical presentations, laboratory tests, antibiotic choices and other aspects of patient management were interweaved. This included hands-on wet lab training with simulated samples and simulation practise of the of work of an infection doctor led by a multi-professional team doctors, clinical and laboratory scientists and academic researchers. Simple, written anonymous feedback was taken daily from trainees and trainers which allowed immediate improvement actions as well reinforcement of good practice. Anonymised surveys were taken 3 months later to assess whether the intended function was being fulfilled within the overall induction programme.
Feedback was astounding. Trainees commended it as their career’s best induction experience and trainers were delighted by trainees’ functioning practical knowledge within such a short time. In 2022, the Induction Bootcamp was offered to Combined Infection trainees from Glasgow to similar reviews but with the added experience of networking with fellow members of their cohort. Some quotes from the trainees:
"Tutorials on microscopy appearances were very representative of duty room scenarios. Practical sessions involving laboratory techniques and their relation to clinical cases - very helpful for understanding and communicating with the laboratory regarding provisional results. Almost all sessions tied back to clinical/laboratory practice which was extremely useful and made the material easier to learn."
"The bootcamp was excellent. We learned a huge amount of material over the course of 10 days, but it was entirely manageable with the timing allocated to sessions and the different teaching methods. It was also a fantastic opportunity to get to know our future colleagues."
"This should be mandatory for all trainees. It was excellent, incredibly well run with enthusiastic helpful staff, organised perfectly and has been immeasurably useful for my time in Microbiology thus far."
The event was, however, a very intensive exercise for Lothian trainers who juggled clinical duties while delivering the training, raising the concern for future delivery. It was also too expensive to access for trainees from further afield. To address this, in 2023, NES funded this event to provide equity for all Scottish trainees and to bring in skilled specialist trainers from other Health Boards. The Royal College of Pathologists recognised this initiative in their 2023 Achievement Awards for teamwork.
Current severe staffing challenges across Scotland make future delivery uncertain. Hence wider issues must be addressed before initiative such as these can truly make a difference.
Combined Infection Bootcamp