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Does 'On Call' simulation training have a place in medical education programs?

Dr. Anthony LisacekKiosoglous, Dr. Ryan Rees

There is a growing body of evidence newly qualified doctors feel underprepared for working “on-call” shifts. The aim of this paper is to discuss how final year medical students from both medical schools in Cardiff and Swansea University, Wales, United Kingdom benefited from a short 1-2 hour simulation based teaching program for on call / out of hours work. Fortyfour final year medical students completed a 1-2 hour on call simulation session at Bronglais General Hospital, Aberystwyth during their final year clinical placement. Students were treated and expected to perform as day 1 foundation year doctors in the UK. All students completed a questionnaire post workshop with the purpose of measuring subjectively what was gained and if they felt more confident attending their first set of on call shifts. As the feedback from the first few groups was excellent, the remaining students were asked an additional question before the workshop to determine how confident they felt attending an on call shift based on their current training. All students provided outstanding feedback from the simulation training stating they felt more confident with working on call. This was substantiated with 23 students average measure of confidence and safety pre-workshop to be 3/10, which increased to 7/10 post-workshop. All students reported they had not had formal independent training in being on call. The most common learning points for practice included better prioritisation and being clear with patient information and handover to seniors. This study gives testament to the growing body of literature that there may be a place for on call simulation training for undergraduate medical students that mimics the stressors of being on call