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13 Simulated hospital at night: a new simulation to help prepare students for foundation year 1
  1. S Tilson1,
  2. P Ehilawa1,
  3. T McGowan1,
  4. C Sharratt1,
  5. S Khin-Htun2,
  6. R Cullum1,
  7. PT Alsop1
  1. 1Nottingham University Hospitals NHS Trust, UK
  2. 2Trent Simulation and Clinical Skills Centre, UK


Background/context Night shifts are a source of anxiety for newly qualified doctors,1 who report feeling under prepared in a number of areas.2 Sessions designed to teach skills necessary for a night shift have been described, often using clinical simulation practice.

Methodology We devised a “Simulated Hospital at Night” for final year medical students; to recreate common challenges that night shifts present and put the students in the position of the F1. The design group included medicine and emergency medicine higher trainees, teaching and simulation fellows and current F1 doctors. Novel steps to improve fidelity include geographically isolated simulated wards, simulated patients rather than manikins, and mobile phones to give new tasks and alert students to developments. Each session involves 6 students working in teams of 3, with four faculty and four simulated patients. It comprises 15 minutes handover, 75 minutes simulation, and 30 minutes debrief. We have piloted this simulation twice, once as a single session and once with repeat sessions so that 18 students can take part in one day.

Results/outcome All students agreed (82% strongly) that the simulation improved their insight of a night shift’s challenges, and that they felt better prepared for F1 as a result. 88% found the experience stressful, and 94% agreed it should be part of a final year course. Themes from written and focus group feedback included use of phones, knowing who was available to call for advice and appreciation of being put in the role of F1.

Conclusions/recommendation We have found that a simulated night shift is feasible, albeit resource and faculty heavy. It is well suited to teaching prioritisation skills, and helps students feel prepared for a stressful aspect of their F1 year. We will be incorporating it into our local 5th year course, and believe that the principles are reproducible


  1. Illing JC, Morrow GM, Rothwell nee Kergon CR, et al. Perceptions of UK medical graduates' preparedness for practice: A multi-centre qualitative study reflecting the importance of learning on the job. BMC Med Educ 2013;13(1):34.

  2. Tallentire VR, Smith SE, Wylde K, Cameron HS. Are medical graduates ready to face the challenges of Foundation training? Postgrad Med J 2011;87(1031):590–595.

  3. McGlynn MC, Scott HR, Thomson C, et al. How we equip undergraduates with prioritisation skills using simulated teaching scenarios. Med Teach 2012;34(7):526–529.

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