| Structure |
Instructor training, course development and mentoring was provided by a multidisciplinary project team in the UOA. The overall programme was supported by a comprehensive national educational programme, an instructor programme, a communication strategy, an implementation strategy and an evaluation plan. Local project groups identified instructors to attend the training programme and developed a local plan for implementing NetworkZ training in their DHB. Meetings with DHB executive and middle management groups were used to ensure understanding of the programme, develop shared goals and seek agreement for the programme to run in their DHB. DHB executive commitment to NetworkZ was formalised through a letter of agreement to support implementation, signed by the chief executive officer.
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| Infrastructure |
Each DHB was provided with a Laerdal 3G SimMan (Stavanger, Norway) simulator and access to surgical models. A bespoke set of models was developed to encourage buy in and task fidelity for all members of the OT team. Detailed instructions were provided on local implementation, including instructor training materials, detailed instructions on setting up the theatre, running the course and managing the risks of in situ simulation.
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| Politics |
High-level support from national committees of chief executives, nursing, medical and financial officers, and influential bodies, including the professional colleges. Collaboration with HQSC established and linked NetworkZ with an existing national programme for Safe Surgery.
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| Culture |
Each DHB was encouraged to develop their own plan for how they would run the programme in their own institution. We included quality assurance leads in meetings to link NetworkZ with existing quality improvement programmes.
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| Learning |
Selected DHB staff were trained as instructors and simulation technicians. NetworkZ used a blended instructor training model comprising a 2 day face-to-face workshop, an online programme of 20–30 hours of readings, videos, exercises and discussion boards and apprenticeship-style on-site training during courses. UOA faculty provided the initial NetworkZ training sessions for DHB staff in their own OTs so no travel was required to attend the training. De-briefing was facilitated to encourage participants to identify their own learning and action points for the future.
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| Motivation |
Key staff offered a positive ‘can do’ attitude to delivery and support for the courses. NetworkZ staff worked to maintain senior management support, and build the interest of OT staff through newsletters to senior managers, posters, staff presentations and regular update. Feedback from course evaluations, reports, in-theatre observations and surveys were used to inform the staff and management team. Accreditation was sought for continuing professional development from the relevant professional bodies.
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