Endocrine Abstracts

One of the key skills doctors in training need to develop is the ability to recognise and manage the acutely deteriorating patient and this is incorporated into the curriculum of Foundation and Internal Medicine Training Programmes. Simulation is an effective methodology to achieve this aim, with trainees encouraged to attend programmes such as Advanced Life Support. Opportunities for specialty-specific emergencies teaching is limited, which can lead to reduced confidence in managing endocrine and diabetic emergencies which may be less frequently encountered in clinical practice in a district general hospital setting. The Endocrine Emergencies course was therefore created to meet this demand, with use of endocrinology-specific simulation not previously encountered by any of the resident doctors who participated. The programme was delivered over 6 sessions and covered 12 emergencies including: diabetic ketoacidosis, hypoglycaemia, hyponatraemia, hyperglycaemic hyperosmolar state, adrenal crisis, thyroid storm, hypercalcaemia, myxedema coma, diabetic foot attack, euglycaemic ketoacidosis, pituitary apoplexy and phaeochromocytoma crisis. Pre- and post-course data enhanced teaching methods including a combination of case-based discussions of real clinical encounters and emergencies in the simulation suite. A total of 106 learners attended 2 cycles of the programme (13 sessions) ranging from healthcare students, clinical fellows, foundation and internal medicine trainees working in medical and non-medical specialties. Recommendation of 4.96 [out of possible 5] was given as an average score by resident doctors of various grades who attended the course. Rise of 1.58 in confidence rating in managing diabetic emergencies was seen [3.3 out of 5 pre-course, 4.88 out of 5 post-course] and 2.18 increased confidence rating in managing endocrine emergencies [2.7 out of 5 pre-course, 4.88 out of 5 post-course]. Further cycles are planned locally with endocrinology-specific simulation demonstrated as an effective and easily replicable method of postgraduate training in endocrinology and diabetes in other settings.