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0131 The ontological shift – the influence an interprofessional full patient simulation session can have on a medical students’ learning
  1. Libby Thomas,
  2. Elaine Gill
  1. School of Medical Education, Kings College London, London, UK


Background Undergraduate full patient simulation (FPS) is commonplace. FPS course evaluations show that clinical knowledge and skills are improved. But what do the students really take away from the experience?

Methodology Final year medical, nursing and midwifery students participated in an interprofessional FPS course. A phenomenological approach1 and analysis2 explored ‘meaning’ and transfer of learning into their clinical practice. The ontological shift is one of the resulting themes.

Outcomes The students described a change in the way they observed and participated in their clinical placements post the FPS experience. Student GK explores these issues:

GK Because I had a really good experience and I learnt from it, I went back to the ward, and I was remembering, actually, do you know what? Yes, I can see, that’s why I was looking at the nurses, I was looking at the F1, and the nursing interaction as well. And we had a deteriorating patient, and the other F1s, the other student wasn’t there. And I offered to help, obviously, and I saw how it worked. I saw how the nurses worked, and I thought it was really good. I guess you don’t realise it until you’ve been put into that situation.

Key changes described include:

  • Observing the doctors role differently

  • Observing the interaction between healthcare professionals

  • Using other healthcare professionals as a learning resource

  • Increased confidence to participate in clinical activities

Conclusions An ontological shift can be deemed to have occurred when the subject starts thinking about an ‘entity’ in a new way and categorises it differently. The students describe new ways (for them) of observing practice and behaviours in the clinical arena and re-conceptualise clinical problems, thereby seeing the clinical world in a new light – an ontological shift.


  1. Moustakas C. Phenomenological research methods. London: Sage Publications, 1994

  2. Creswell, JW. Qualitative inquiry and research design; choosing among five approaches. London: Sage Publications, 2007

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