O13 A longitudinal, mixed methods study investigating the effectiveness of simulation to prepare medical students for professional practice

Introduction Studies have shown that levels of medical students feeling prepared for professional practice have remained static since 20131–3, despite multiple reforms in medical education. Preparedness is vital to ensure patients are getting the best, safest care, and for the well-being of foundation doctors (FY1) to avoid stress and burnout. There has been a rise in use of simulation technology in medical education, with evidence of its efficacy across postgraduate and continuing professional education2, and simulation is now increasingly used in the undergraduate domain. This study seeks to examine whether simulation is an effective methodology to prepare final year medical students for FY1. Methods This mixed methods, two phase study compared a ‘Ward simulation’ where students moved around a simulated ward dealing with scenarios they encountered with a ‘Bleep simulation’ where medical students were given a pager (known as a ‘bleep’) responded to ‘bleeps’ about different aspects of patient care. The simulation was designed to develop key competencies for FY1. Questionnaires and interviews were administered immediately after the simulation (student phase) and 6 months later (doctor phase) to assess changes over time. Results Overall, 72.5% of students felt prepared for practice. Students that undertook the bleep simulation were non-significantly more prepared (OR 1.2, p= 0.638) compared to those that undertook the ward simulation. There were no significant differences between the groups for key competencies including non-technical skills and dealing with acutely unwell patients. Although there were no significant differences between the student and doctor phase, the trend was towards FY1s feeling less prepared than they had thought as students. Qualitative data highlighted the importance of experiential learning through simulation, allowing students to manage situations that they would be unable to in the real clinical environment, with the advantage of repetitive practice to build confidence. The qualitative data also demonstrated FY1s change of behaviours as a result of the simulation. Discussion and conclusions This study suggests that no matter the format, simulation is effective to develop the knowledge and skills required for the transition to professional practice. Furthermore, participants in this study demonstrated a change in behaviours, thereby showing Kirkpatrick level two and three outcomes. Despite this, levels of preparedness echo the wider literature and suggest there is still some room for improvement. This may be achieved with embedding simulation alongside clinical experience in a range of formats, and involving stakeholders, students and FY1s in designing effective simulation teaching. References GMC. General Medical Council - National Training Surveys 2019 [Available from: https://webcache.gmc-uk.org/analyticsrep/saw.dll?Dashboard. Goldacre MJ, Lambert TW, Svirko E. Foundation doctors’ views on whether their medical school prepared them well for work: UK graduates of 2008 and 2009. Postgraduate medical journal 2014;90(1060):63–8. Goldacre MJ, Taylor K, Lambert TW. Views of junior doctors about whether their medical school prepared them well for work: questionnaire surveys. BMC medical education 2010;10:78. Draycott TJ, Crofts JF, Ash JP, Wilson LV, Yard E, Sibanda T, et al. Improving neonatal outcome through practical shoulder dystocia training. Obstetrics and gynecology 2008;112(1):14–20.