Pre-clinical Undergraduate Ward Simulations - Too Much Too Soon?

Authors

Dr H M Williams
Dr G T Reid

Theme

Simulators and Simulation

Category

Simulation

INSTITUTION

School of Medicine, University of St Andrews

Background

Ward simulations are becoming an increasingly common feature of undergraduate medical education. Several key benefits of ward simulation have been identified including the development of competence and confidence, an early opportunity to identify professional boundaries and to undertake interprofessional learning as well as identify gaps in knowledge.1

The timing of these experiences is widely debated. Some arguing early exposure is best thereby facilitating the development of professional identity, others however recommend the experience later in the curriculum when the student has a greater understanding of their role.1

 

Summary of Work

Third year students during their final semester undertake a 15 minute ward simulation exercise. The students are exposed to a simulated ward environment and are given tasks to perform as the Foundation Doctors on the ward. Simulated patients and staff are used to make the experience as realistic as possible.

Using a Likert –style questionnaire the students were asked to comment retrospectively upon their experience and whether or not they felt that it occurred at an appropriate stage in their training.

Summary of Results

Conclusion

Our study shows that whilst students find the experience useful and fun, they feel generally unprepared to take part. Most students agree that it is a valuable exercise in teamwork, and this would appear to support the evidence that ward simulations support interprofessional learning.2

Students would appear to recognise the benefits of such experiences and would like to partake in further ward simulations. From the data collected, students feel they have enough knowledge, even at this early stage in their medical training, and do not feel that it is too much too soon.

Take-home Messages
  • Ward simulations are an important part of medical undergraduate education
  • Pre-clinical students find the experience beneficial
  • The timing of these experiences is key in order to maximise the benefits
Acknowledgement

Miss Veronica O'Carroll, Nurse Lecturer (Interprofessional Clinical Skills Education), School of Medicine, University of St Andrews

References

Ker, J.  Mole, L. Bradley, P. Early introduction to interprofessional learning: a simulated ward environment. Medical education 2003;37:248–255

 

2   Freeth, D. Reeves, S. Goreham, C. Parker, P. Haynes, S. Pearson, S. “Real life” clinical learning on an interprofessional training ward Nurse Education Today 2001;21:366-372

Background

Ward simulations are thought to be an essential part of promoting patient safety which is a key part of any medical curriculum. In a controlled environment students can begin to put their learning into practice without the fear that their actions will cause unnecessary suffering. It also allows assessment of skills which were previously difficult to assess such as prioritisation, team-working and decision making. Another key opportunity that ward simulations offer is the opportunity for either group or individual feedback.

Summary of Work

 

Ward Simulation Exercise (WSE) – Too Much, Too Soon?

 

Please answer the following questions about the Ward Simulation Exercise (WSE) you participated in during the 4003 module. Indicate your answer with an ‘X’ according to the following scale –

 

SD – Strongly Disagree

D – Disagree

N – Neutral

A – Agree

SA – Strongly Agree

 

 

SD

D

N

A

SA

     1. I found the WSE useful

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     2. I found the WSE fun

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     3. I found the WSE overwhelming

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     4. I felt well-prepared for the WSE experience

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     5. I felt I had enough knowledge to participate in the WSE

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     6. I enjoyed the experience of acting as an FY1

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     7. I was satisfied with my performance in the WSE

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     8. The WSE is appropriate at my level of training

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     9. The WSE would be more appropriate later in the curriculum

 

 

 

 

 

 

 


SD

D

N

A

SA

     10. I would like to have participated in a WSE earlier in the curriculum

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     11. I have had sufficient clinical experience to participate in a WSE

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     12. The WSE was a valuable exercise in teamwork

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     13. I understood the roles of the medical professionals involved in the WSE

 

 

 

 

 

 

 

 

SD

D

N

A

SA

     14. I would benefit from further WSE experiences

 

 

 

 

 

 

 

Summary of Results
Conclusion

It is not clear whether the students lack key skills required to partake in the scenario, or whether they lack enough information as to what to expect on the day of the scenario, causing them to feel unprepared. However, they seem to feel that they have a sufficient knowledge base and clinical experience, pointing to the likelihood that more information regarding the actual experience would be beneficial. Further evaluation of this will be required.

 

Interestingly, our students feel that they have acquired enough clinical experience to partake in a ward simulation exercise, despite the fact they have only had a limited number of day placements in the community or in hospitals. This would suggest that clinical placements in the first three years of medical training prove to be critical in the development of professional identity and the acquisition of core skills.

 

The majority of students cope well with the ward simulation, suggesting that it occurs at the right time in their training. However, some students appear to be overwhelmed by the experience and further study will be required to investigate the reasons for this.

 

There are recognised limitations of our study. Due to the need for ethical approval, there was a lag time between the ward simulation and the questionnaires being given out. Also, not all of the students in the year responded to the questionnaire. Using a Likert-style questionnaire did not allow us to collect free text comments from the students, which may have been a helpful addition to our data.

 

As well as the points mentioned above, the next phase of our study will include prospective as well as retrospective questioning of the next cohort of students to undertake the ward simulation.

Take-home Messages
Acknowledgement
References
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