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.

Human factors are essential to patient and staff safety, particularly during the COVID-19 pandemic with redeployment of staff to different roles in unfamiliar environments The aim of the study was to ascertain the efficacy of converting face-to-face simulation and debriefing into online asynchronous video-based scenarios and debriefing, to enhance understanding of human factors skills.In October 2020, a half-day simulation course commenced. Due to suspension of face-to-face teaching in December 2020 with COVID-19 cases rising, this was converted into a half-day online format through filming faculty participating in the existing scenarios. These films were shown to participants, followed by asynchronous online debriefing via Microsoft Teams. Both formats had e-learning as a pre-requisite. Data were collected using pre- and post-session questionnaires containing the Human Factors Skills for Healthcare Instrument (HuFSHI) Post-training, staff demonstrated improvement in self-efficacy of human factors skills for healthcare. There was no statistical significance between mean improvements for both formats; the greatest improvement was split equally (Table 1). 100% found the face-to-face (N = 24) useful, versus 98% online (N = 54). Communication was the skill most learnt (face-to-face 58%, online 65%), with teamwork (face-to-face 50%, online 48%), escalation (face-to-face 42%, online 57%) and self-care (face-to-face 38%, online 19%) also frequently mentioned. Aspect’s learners’ thought were good included the discussion-based element (face-to-face 50%, online 37%), interactivity (face-to-face 13%, online 31%), multi-disciplinary team involvement (face-to-face 13%, online 20%) and videos for the online format (19%). 21% wanted the face-to-face longer, 15% wanted the online shorter. 9% would rather the online was face-to-face.Online asynchronous debriefing produced similar outcomes to face-to-face for teaching human factors. We posit that this was because the videos were not ‘best practice’ – thus stimulating learning conversations, which accessed learners’ frames and past experiences. Challenges for faculty included: pace and volume of sessions, managing psychological safety, emotive discussions, screen fatigue, and technical aspects. A 6-month follow-up survey is planned and will be included in the presentation. Further work is required to understand why the results were similar.

Following a rise in COVID-19 cases and hospitalizations in autumn 2020, the resultant pressures on general medical wards galvanized the simulation education team at a London teaching hospital to create a multi-disciplinary educational programme aimed at ward staff caring for the surge in COVID-19 patients. This was especially important in the context of rapidly evolving clinical guidance and recognition of the importance of human factors in re-deployment of staff, thus a multimodal educational project was initiated to develop ward staff knowledge and human factors skills.The aim of the study was to ascertain the effectiveness of the multimodal COVID-19 educational project in improving ward staff knowledge and human factors skills.In October 2020, the team began creating the project – comprising e-learning to improve staff knowledge, e-Learning surveys were completed by 108 learners with a significant difference (p < 0.01) in self-reported pre- and post-survey scores across the six domains. Learners demonstrated mean improvements across all areas of the HuFSHI for the In a limited time frame, the simulation education team implemented a multimodal educational project that improved both ward staff knowledge and human factors skills amidst the second wave of the COVID-19 pandemic. Moreover, following restriction of face-to-face delivery, the project was successfully converted into a purely online format. This ability to be flexible and adapt accordingly is one that needs to be widely adopted going forwards, especially during these unpredictable times. Further challenges included staff release for training, time pressures, managing emotive discussions using the online modality and COVID-19 safety measures. A 6-month follow-up survey is planned to evaluate the benefit to staff’s clinical work and will be included at the presentation.