Development and evaluation of a high-fidelity, multi-disciplinary simulation training course for high-consequence infectious diseases using fluorescence visualization.

Background: High-consequence infectious diseases (HCIDs) include contact-transmissible viral haemorrhagic fevers and airborne-transmissible infections such as Middle Eastern Respiratory Syndrome. Assessing suspected HCID cases requires specialized infection control measures including patient isolation, personal protective equipment (PPE), and decontamination. There is need for an accessible course for NHS staff to improve confidence and competence in using HCID PPE outside specialist HCID centres.

Aim: To produce and evaluate a training course for National Health Service (NHS) staff on recognition and assessment of patients with suspected HCID infection.

Methods: We developed a multi-disciplinary course blending online learning with in-person, high-fidelity simulation using a manikin which employs fluorescent tracers to simulate airborne, contact, and fomite transmission. This facilitates visualization of contamination pre- and post-PPE removal and supports team-based debrief of performance. Training culminated in competency-based assessment. Educational effectiveness was evaluated through curriculum-linked pre- and post-course tests, and self-rated confidence using Likert scales.

Findings: Between December 2022 and April 2024 180 nurses, specialty registrars and consultants were trained. Educational effectiveness was evaluated in 60 consecutive participants between December 2022 and April 2023. Pre- and post-course assessments revealed significant improvements in knowledge (mean score 61% vs 83%, P<0.0001). Pre-course, 36% of learners reported feeling confident in HCID PPE donning and doffing, rising to 97% post-course. Participants unanimously rated the learning experience as high- or very-high quality.

Conclusion: This course, incorporating ultraviolet markers for contamination visualization, represents a novel approach outside military settings. The results demonstrate its effectiveness as an educational intervention, improving staff confidence and competence in PPE use.