{
  "abstract": "Introduction Gastroenterology specialist registrars rotating through a tertiary liver transplant centre must manage complex presentations and work effectively within multidisciplinary teams. While previous work showed that simulation-based education improves immediate preparedness for working in a tertiary centre, perceptions of its impact may evolve with real-world clinical exposure. This project evaluates the lasting impact of the ‘RegReady’ simulation programme on registrar confidence after course completion to demonstrate longer-term educational value.Methods The course was delivered across four dates from 2023-2025, and was offered to all registrars prior to rotation through the regional liver transplant centre. High-fidelity simulations covered acute liver failure, acute-on-chronic liver failure, transplant eligibility, post-transplant complications, and emergency TIPSS, alongside tutorials on referral pathways and communication.Participants completed pre- and immediate post-course confidence surveys using a 5-point Likert scale across eight domains of tertiary liver care. A follow-up survey was distributed 6–12 months post-course to assess confidence retention in the 8 domains. Thematic analysis was performed to identify key themes reflecting participants’ experiences and the course’s perceived impact on practice.Results 21 registrars participated (ST4–ST7; 1 trust grade). Immediate post-course surveys (100% completion rate) demonstrated a statistically significant improvement in confidence across all domains (p<0.001), consistent with earlier findings.6-12 month follow-up responses (90.5% completion rate; median 7 months) demonstrated sustained improvements in confidence, particularly in the management of decompensated liver disease and acute liver failure. The lowest retained confidence was reported for Sengstaken tube insertion; however, qualitative feedback indicated this reflected limited clinical exposure rather than deficiencies in the teaching.All participants found the course relevant to their clinical practice (76% strongly agreed; 24% agreed) and that it changed and enhanced their practice (57% strongly agreed; 43% agreed).Analysis of free-text follow-up feedback identified three key themes: (1) timing and access, highlighting the need for delivery closer to rotations and wider availability; (2) realistic simulation, reflecting real-world on-call and referral scenarios; and (3) confidence-building, with structured approaches improving preparedness for managing complex hepatology cases.Conclusions Simulation-based training for registrars entering a liver transplant centre improves confidence for up to 12 months and enhances clinical reasoning, communication, and real-world practice. These findings support the continued integration of simulation-based education to enhance preparedness for complex tertiary care.",
  "authors": [
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Laura Checkett"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Amy Johnson"
    },
    {
      "affiliations": [
        "South Tyneside and Sunderland NHS Foundation Trust"
      ],
      "name": "James Hampton"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Louise MacDougall"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Preya Patel"
    }
  ],
  "title": "O48 Sustained confidence and preparedness to work in a liver transplant centre following registrar simulation-based training",
  "uid": "b584d30c-7fc6-5e6b-a71f-6558c65b41f7"
}