title: Sequential Simulation (SqS): an innovative approach to educating GP receptionists about integrated care via a patient journey--a mixed methods approach.
abstract: BACKGROUND
  An evaluation of an effective and engaging intervention for educating general practice (GP) receptionists about integrated care and the importance of their role within the whole system was conducted.
  
  
  METHODS
  Workshops took place in North West London, one of England's 14 'Integrated Care Pioneers.' Three training days featuring Sequential Simulations (SqS) were held. Forty GP receptionists attended on each day, as well as 5-6 patients and 8-9 healthcare professionals. The SqS developed was from a collection of patient stories, the key scene of which featured a GP receptionist. The scenes were designed to show the consequences for the patient of professionals working in silos. This provided the focus for facilitated table discussions. The discussants suggested ways in which an unfortunate series of events could have been dealt with differently. These suggestions were then incorporated in a re-designed SqS. Evaluation was conducted through questionnaires, field notes and analysis of video material. Descriptive statistics and thematic analysis were applied.
  
  
  RESULTS
  Ninety three participants responded to the questionnaire out of 131 attendees. All (93/93) respondents reported that the event was a powerful learning experience and that they had gained confidence in improving patient care. 98 % (91/93) reported that their knowledge of integrated care had improved. The simulation was rated highly as a learning experience [60 % (57/93) - excellent, 39 % (37/93) good]. Further evidence of educational benefit was expressed through comments such as: 'The simulations really got me thinking about the patient as a human with many problems and situations.'
  
  
  CONCLUSIONS
  SqS is an innovative and practical way of presenting current care pathways and health care scenarios in order to create a shared focus, engage the emotions of the participants and bring the principles of integrated care to life. Facilitated table discussions are an opportunity to see events from multiple perspectives, share reactions and ideas, and practise co-producing service reforms with patients. We believe this approach is a useful way of preparing front-line staff to participate in integrated care.
authors: Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK. s.weldon@imperial.ac.uk.
authors: Sharon-Marie
authors: SM
authors: Weldon
authors: Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK. s.ralhan@imperial.ac.uk.
authors: Shvaita
authors: S
authors: Ralhan
authors: Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK. lispaice@googlemail.com.
authors: Elisabeth
authors: E
authors: Paice
authors: Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK. r.kneebone@imperial.ac.uk.
authors: Roger
authors: R
authors: Kneebone
authors: Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK. f.bello@imperial.ac.uk.
authors: Fernando
authors: F
authors: Bello
mesh_terms: D001291:Attitude of Health Personnel; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004496:Education, Continuing / Q000379:methods*; D058006:General Practice / Q000458:organization & administration*; D006270:Health Facility Administrators / Q000193:education* / Q000458:organization & administration; D006801:Humans; D008131:London; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires