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Purpose Individuals health with intellectual disabilities (ID) experience comorbid physical and mental health needs and have poorer outcomes resulting in early mortality. Currently, many training provisions based on ID exist; however, limited research supports their effectiveness. High-fidelity simulation is an innovative training mechanism with promising preliminary results. This study aims to evaluate the longitudinal impact of simulation training on clinical practice in ID. Design/methodology/approach A mixed-method approach was used in this study. A one-day simulation course using actors who had ID was delivered to 39 health-care professionals from across London hospitals. Nine semi-structured interviews were conducted 12–18 months post training. Findings High-fidelity simulation training is an effective training modality, which has a sustainable impact on participants, their clinical practice and patients. Core features of the training including debriefing, the use and type of actors, scenario design and the facilitators are crucial learning mechanisms which impacts learning outcomes and changes to behaviour in clinical practice and settings. Originality/value To the best of the authors’ knowledge, this study is the first to longitudinally evaluate high-fidelity simulation training designed to improve the physical and mental health needs of those with ID. The research begins to bridge an important gap in the current literature, with a need for more research.

Healthcare, BMJ Simulation and Technology Enhanced Learning, and BMC Advances in Simulation) were examined from the first published issue of each journal until the final issue of 2018. Data extracted related to authorship of papers published in each of the three journals (i.e., type of article; gender of first and last authors; country and affiliation of first and last authors) and editorialship at each journal (i.e., the gender of each member of the journal's editorial board). Summary of results A total of 873 studies (49.5% original research, 50.5% non-research) met the inclusion criteria. Table 1 presents the gender comparison of first and last authors, and editorial board members for each journal. First and last authors were predominantly male across all journals. Further, with the exception of a female Editor-in-Chief of one journal, and a greater proportion of female than male associate editors in another, gender disparities across the remaining categories of editorial boards existed. Discussion and conclusions Male overrepresentation in authorship and editorialship was evident across the included journals, with female representation rates similar to those of previously conducted studies across a range of medical fields such as psychiatry, surgery and paediatrics. Recommendations Considering publication in peer-reviewed journals, and serving on editorial boards, is considered an important indicator of academic productivity and success, and serves as a means of influencing discourse and practice in a field, future efforts should focus on actionable strategies to improve rates of female authorship and editorialship.

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2. Cramped text boxes enlarged 3. Introduced boxes to describe post-event observations and management A second in-situ simulation of pulseless electrical activity cardiac arrest was undertaken on PCCU during a normal working day. Further improvements were: 1. Text boxes rearranged for ease of usefree space to record interventions during resuscitation moved to the first page and nearer to the column recording the time. 2. Space to record adrenaline doses increased A third ward-based simulation tested the efficacy of these changes for clinical use, documentation of events, and NCAA data collection. Discussion, conclusions and recommendations Trialling a CA documentation proforma through simulated clinical events in a range of settings made it fit for purpose: enabling contemporaneous and comprehensive documentation of events, ensuring accurate data collection for NCAA and providing prompts for resuscitation as per APLS guidance. The use of simulation streamlined the process of new proforma development, allowing previously unforeseen glitches and inadequacies to be addressed before use with patients, adding to safety and improving quality.