‘An hour on call’ – simulated medical education

Aims

To assess whether final-year medical students feel underprepared for their first on call as a foundation year one (FY1) doctor and to design, implement and evaluate a teaching programme to address the anticipated need.

Methods

‘An hour on call’ is a simulated education programme for undergraduate medical students. Since spring 2014, 17 teaching sessions, each 2 hours long and requiring two doctors, have been carried out. 34 final-year students have participated. Students completed a questionnaire before and after the teaching to assess how prepared they felt about their first on call.

Before the simulation, students were briefed. The simulation lasted 1 hour and, during this time the students assumed the role of the on-call FY1. During the hour, they received a handover, carried out outstanding ward tasks, responded to bleeps and assessed an acutely unwell patient, before handing patient care onto colleagues. Following the simulation, there was time for discussion and feedback.

Results

Pre-course questionnaire results showed that of the 34 students, 35% had never shadowed an FY1 on call. When asked how prepared they felt about being on call as an FY1, 71% of students rated their confidence as two or less (one being not at all confident and five being very well prepared). Only one of 34 felt they knew what was expected of them as an FY1 on call.

Post-course questionnaire results showed that 94% of the students felt more confident about being on call following the course. 100% of students recommended that such programmes are formally incorporated into medical school curriculums, 96% rated the teaching as five out of five for enjoyment and over 85% thought that the number and difficulty of the scenarios were at the right level. Students commented that they felt the course was realistic and helped them improve their time management, handover skills, task prioritisation and management of an acutely unwell patient.

Conclusions

Our research has shown that final-year medical students often feel underconfident and underprepared for being on call as an FY1 doctor. ‘An hour on call’ has been found to improve medical students’ confidence in being on call and trains them in prioritisation, time management, handover skills and management of the acutely unwell patient. We suggest that this programme should be made more widely available to medical students. We believe that it enables students to develop the skills required to be on call as an FY1 and aids in the provision of appropriate and effective patient care.