International Journal of Healthcare Simulation

Background:

NHS Trusts must deliver 30 hours of teaching to Foundation Year 1 doctors (FY1s) per year [1]. Our Trust previously delivered weekly hour-long didactic teaching sessions. Feedback was poor, so a new approach was required. Our Trust employs nine FY3 and FY4 junior doctors as Clinical Fellows in Education and Simulation. It was felt that the team, having recently completed FY1 themselves, could develop a useful and enjoyable FY1 teaching program.

Activity:

STR1DE – Simulation, Teaching, and Reflection for FY1 Development and Education – was developed and delivered by the Fellows. STR1DE involves six full teaching days throughout the year. Each day runs four times with a quarter of FY1s attending, to ensure reasonable class sizes. The team felt that simulation would be beneficial in teaching newly-qualified junior doctors. Simulation is an excellent way to help learners put theory into clinical practice [2], and it was felt that using carefully-designed scenarios would ensure FY1s felt the teaching was useful and relevant. Each STR1DE day therefore involves half a day of simulation using the Trusts’ high-fidelity facilities, alongside half a day of teaching including practical skills, small group teaching, and reflective sessions. All scenarios are designed around clinical scenarios which are commonly faced by FY1s in their clinical practice, alongside a variety of human factors. The scenario is observed remotely by other FY1s and the Fellows. The Fellows lead post-scenario debriefings with emphasis on reflection and peer-to-peer discussion and learning.

Findings:

Feedback has been excellent, with 100% of FY1s rating each session as ‘good’ or ‘very good’. The usage of near-peer teachers, the post-simulation debriefings, and the relevance of scenarios to FY1s’ clinical practice have been noted as factors contributing to this success. The benefits of near-peer teaching have been widely discussed in the literature, though often focus on junior doctors teaching medical students [3]. STR1DE demonstrates that teaching (including simulations) developed and delivered by junior doctors for more junior doctors can be relevant, useful, and enjoyable. Full-day teaching sessions seem to be preferable to shorter weekly teaching, allowing FY1s to focus on learning without worrying about work building up back on the wards. This approach also allows the usage of simulation, which would be difficult to deliver in a shorter session.

Conclusion:

Full-day teaching sessions, delivered by near-peers, with heavy usage of simulation, can be a highly effective way to deliver FY1 core teaching.

References

1. UK Foundation Programme. UK Foundation Programme Curriculum. London: UKFPO; 2021.

2. Okuda Y, Bryson E, DeMaria S, Jacobson L, Quinones J, Shen B, Levine AI. The Utility of Simulation in Medical Education: What Is the Evidence?. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine. 2009;76(4):330–343.

3. Rees E, Quinn P, Davies B, Fotheringham V. How does peer teaching compare to faculty teaching? A systematic review and meta-analysis. Medical Teacher. 2015;38(8):829–837.