“It’s not just your medical knowledge and procedural skills, but how you interact and communicate that could save someone’s life.”
Professor Tom Gale is an expert in training the medical workforce, and his strength in promoting non-technical ‘people’ skills has been celebrated across the UK.
Grabbing an hour with him is a rare treat, as he splits his time between research, teaching and clinical work as anaesthetist. (His experience in the latter shines through, as he briefly mentions bringing a patient to the emergency theatre with major haemorrhage, only the day before).
And his drive to help people is woven into his teaching, as, in his own words, he is ‘fascinated by the use of simulation in training and how it helps people prepare for real life situations’.
So what do we mean by simulation?
In Tom’s case, it means two things. Firstly, it’s the use of lifelike mannequins that show vital signs and can be programmed to deteriorate right in front of your eyes, and secondly, it’s the replication of real-life team working. “Gaining experience with patients is extremely important in clinical training to prepare students for practice in the NHS,” he said. “But team-based simulations improve participants’ ability to respond to critically ill patients with other members of the healthcare team.
“When dealing with emergencies as an early career graduate, you’ll say ‘thank god’ when you see other professionals walk in. Inter-professional working is so important in practice, so it’s vital that we teach it effectively.”
Tom successfully established the Peninsula Simulation Network for anaesthetists and other specialties, providing training and inter-professional working across the South West. But it was as clinical skills lead at the University of Plymouth that he made one of his simplest, yet most impactful changes.
“Several years ago, we used to have our medical students wearing tabards that said ‘nurse’ when we were practising team-based scenarios. I thought it would be far better to include real student nurses so we could properly simulate inter-professional working; it was so much more authentic and really valuable when everyone was reflecting on the scenario during the team debrief. It’s been great to run it collaboratively with our colleagues in the School of Nursing, ever since.”
This initiative was in fact highlighted as an example of best practice for training in patient safety by the General Medical Council in 2016, and it’s not the only national recognition Tom has received.
Since 2008, he has been a key figure in developing and implementing the national recruitment process for all postgraduate anaesthetic training posts in the UK for the Royal College of Anaesthetists, and more recently for refining methods for workplace based assessment of anaesthetists for the launch of their new curriculum in 2021. As part of this work he pioneered the use of simulation for high stakes assessment, and blueprinted the assessment matrix for national selection based on the non-technical skills of those applying to anaesthetics.
He said: “I remember qualifying and it was such a steep learning curve. So, as I became more involved in teaching, I developed an algorithm for novice anaesthetists to respond to critical emergencies. It was designed to help trainees respond to all types of emergencies that could happen when putting someone to sleep.”
He also has the rare boast of being accredited as an anaesthetist in both the UK and Australia, after travelling to the latter country post-graduation – no mean feat when you consider that qualification takes seven years on top of general medical training in the UK alone.
“I chose anaesthesia as I’d always enjoyed it in training, and I wanted to do something really practical,” he said. “We don’t just put people to sleep, we’re often called to hospital emergencies whenever there’s a crisis or patient who’s deteriorating and they need to be resuscitated. We keep patients alive at the same time as the surgeon is concentrating on what they’re doing.”
It might come as a surprise, therefore, that there is currently a shortage of anaesthetists in the UK. Alongside general practice and psychiatry, it’s one of the specialities that is lacking in the workforce – and it’s something Tom is working to change. He has been conducting research to investigate the personal factors that attract people to apply for certain postgraduate specialties and also the factors that predict success in these specialties. His research in recruitment, workforce planning and preparedness for practice has seen him become Director of Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA) at the University of Plymouth. Alongside other University colleagues, he has six externally funded projects on the go, ranging from analysing the preparedness of new doctors in the health sector, to exploring how fitness to practice is dealt with across regulators.
“One thing I’m really interested in is ensuring that medical graduates are not just competent, but have the capability to function effectively in the increasingly complex world of healthcare,” he said. “Any practical role in healthcare is complex and changing, so a person needs to be able to adapt to unfamiliar circumstances and environments.”
The one thing we know for certain is that his passion for people, learning and communication is something that has stayed with him, and only grows with time.
“Those years at medical school are so important and set you up for your career. But it really is just the start – learning is a lifelong process as a healthcare professional.”
Educating for capability and sustainability of the healthcare workforce – Professor Tom Gale
Inaugural Professorial Lecture | Thursday 22 April | Watch the recording
As the NHS and other healthcare providers face the most challenging era in living memory, the question of how to best maintain a sustainable workforce is arguably more important than ever. Professor of Medical Education, Tom Gale, reflects on his career dedicated to addressing real-world concerns for the healthcare sector by tackling the critical issues around education, recruitment, selection and retention of healthcare professionals.
The Collaboration for the Advancement of Medical Education Research and Assessment (CAMERa) researchers aim to improve the development and sustainability of the healthcare workforce by focusing on three research themes, namely workforce development, continuum of education, and professional regulation.
CAMERa's research programme, carried out by a multi-professional group and employing a mix of qualitative and quantitative methods, impacts directly on national and international literature, educational theory, practice and policy.
Plymouth Institute of Health and Care Research
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