Can a ward simulation exercise achieve the realism that reflects the complexity of everyday practice junior doctors encounter?

Abstract

Recent changes in medical education have resulted in an increased focus on patient safety. It is vital that new doctors can recognize and manage acutely-ill patients, as well as work safely and effectively as a member of a multi-professional team. A ward simulation exercise has been developed to provide a safe, but authentic setting to support junior doctors with further practice and feedback. In developing such an exercise realism is important in recreating the complex climate in which the junior doctor has to function as part of the healthcare team in the hospital ward. This paper shares the design methodology of a ward simulation exercise and the views on its authenticity from both the junior doctors and the observers.

Theorising simulation in higher education: difficulty for learners as an emergent phenomenon†

“…Here, difficulty is described in terms of handling increasing levels of responsibility and high-risk clinical situations with increasing complexity regarding equipment, communications, ethics, and systems-based challenges where only a team can successfully prevent or manage deterioration of the patient (Patterson et al 2013). Ker et al (2006) specifically examine the possibilities and challenges of reflecting this richer complexity in ward simulation exercises, an argument which is developed in terms of new innovations and approaches by Ker and Bradley (2010).Difficulty here is seen less in terms of individual demands or capabilities, but more in terms of parallel sets of relationships between participants, on the one hand, and pieces of equipment on the other. This relational focus leads us to the sociomaterial approach that we propose in this paper.…”

Exploring student perceptions of ward simulation as an exercise to improve decision-making skills in the clinical context

“…This targeted training offers greater long-term benefits to undergraduates than traditional 'on-the-job learning', placing responsibility on the student to make a host of essential clinical decisions (Ker et al, 2006;McGlynn et al, 2012). In addition, students could appreciate that the skills they were developing would better prepare them for life as junior doctors.…”

How we equip undergraduates with prioritisation skills using simulated teaching scenarios

“…The participants were newly qualified doctors, not final year students as detailed here (Ker et al 2006). Previous studies had highlighted the problem of newly qualified doctors' inability to deal with acutely unwell patients (Smith & Poplett 2002).…”

“…One of the issues raised during the evaluation of the Dundee Medical undergraduate model (Ker et al 2006) was the use of Consultants as observers. This may have disadvantages in that these 'figures of authority' may be intimidating to junior doctors/senior students.…”