Background Medical school often marginalises team -working skills acquisition. The aim of this study was to observe and improve team-working behaviours of final year medical students in an immersive simulated ward environment.
Methodology A 22 bedded ward was configured in our Simulation Centre incorporating high-fidelity simulators, patient simulators and task trainer, nursing and telephone support.
227 students were split into three clinical teams (of 6 or 7) over 12 sessions. Following consultant led handover, students were asked to manage the ward in their teams. During the simulation additional tasks were requested eg. phone calls from relatives, acting on abnormal results and having to review sick patients. Students were observed by faculty members and a comprehensive debriefing was undertaken.
Faculty and simulator debriefing focus groups were undertaken.
Outcome Faculty debriefing focus groups identified a number of common themes in student behaviours; there was wide variability in the ability to form teams. Students lacked insight into the need to prioritise tasks based on clinical need and frequently overburdened the nursing staff with inappropriate requests. The faculty reflected that the themes emerged were a number of challenges that doctors normally face when they initially start their clinical practice.
The faculty debrief identified the following areas for improvement; smaller group size, modifying ratio of simulators to mannequins and additional aspects to focus on within the initial student briefing to minimise simulation artefact.
Conclusions Mixed modality simulations have the potential to improve the transition into clinical practice as a FY1 doctor and in our experience combining multiple different scenarios in real-time with parallel teams of students produced an informative and highly productive simulation.
Weller Jennifer M. "Simulation In Undergraduate Medical Education: Bridging The Gap Between Theory And Practice". Med Educ 2004;38(1):32–38.
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