International Journal of Healthcare Simulation

Background and aim:

Final year medical students are often anxious about commencing foundation training and feel underprepared for the practical responsibilities they are expected to conduct independently [1]. Consequently, a full day programme was created to facilitate immersive simulation of a typical working day of a Foundation Year 1 (FY1) doctor.

Aim: To provide an enriching programme empowering final year medical students to experience the practical aspects of foundation training (including areas of expressed difficulty), whilst creating a safe and realistic learning environment and providing opportunities for interprofessional learning and near-peer teaching.

Methods:

Junior doctors from FY1s to Medical Registrars delivered the programme’s content. In the morning, three interprofessional simulation scenarios were delivered to the medical students and included nursing students for added realism. Each scenario reflected common ward-based and acute-setting situations that had minimal coverage in their undergraduate curricula. Afternoon stations were created to attenuate the medical students’ anxieties about the aspects of foundation training they perceived as difficult. Using a simulated ward, a mock handover was conducted. Students were then expected to complete the tasks of death verification, complex prescribing and female catheterization. The other stations simulated interpreting blood results, discussions with a microbiologist and requesting and discussing radiological imaging. During completion of all stations, the medical students carried and answered a bleep mimicking realistic distractions. Morning and afternoon debriefing occurred in small groups.

Results:

Following programme completion, all the medical students (n = 21) felt more confident in assessing deteriorating patients, escalating to a senior and felt better prepared to commence foundation training. Though not statistically significant (p = 0.2), confidence to commence foundation training and preparedness to perform the clinical and practical responsibilities of an FY1 quadrupled. In addition, over 50% of the medical students felt better able to independently prioritize clinical tasks and undertake complex prescribing on completion of this programme. Qualitative data suggested the medical students found the morning of interprofessional learning (IPL) invaluable and sought future IPL opportunities as they felt this made the programme even more realistic of working life. Furthermore, students felt the programme created a safe learning environment and was relevant in their preparation for foundation training as they felt more confident and better prepared to troubleshoot and apply their knowledge in unknown clinical situations.

Conclusion:

‘FY1 for a day’ is an effective and sustainable educational programme to potently prepare final year medical students for their foundation training whilst safeguarding psychological safety and fortifying multidisciplinary relationships.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.