P54 Management of acutely unwell patients: simulation training for medical students in emergency medicine

Abstract

Background F1 doctors are expected to be able to manage acutely unwell patients prior to senior support arriving – indeed, one of the GMC’s outcomes for graduates is to ‘provide immediate care in medical emergencies’.1 However, in the transition from medical school to work, it has been found that students often do not feel prepared for this.2 Simulation provides a safe environment for students to practice clinical skills. We designed this programme to give students an opportunity to improve their assessment and initial management of acutely unwell patients. Methodology The sessions lasted three hours, with a maximum ten students per session. Participants were fourth year students undertaking their A and E block at Sheffield Medical School. One facilitator operated the mannequin, with two leading the scenarios and debriefing. A SimMan mannequin was used. Sessions started with initial discussion and demonstration of the ABCDE assessment followed by student familiarisation with the mannequin. Groups of 2 or 3 students were asked to perform an assessment in each scenario. There was a debriefing session along with a handout about each scenario. Evaluation was done using 5-point scale questions, with white space questions. Results Over 5 months we had a total of 81 students take part in the programme. Students gave a rating of 1 to 5 for each question. 81% of the students gave 5/5 for finding the scenarios useful. 86% gave 5/5 for understanding more on the subject. 65% gave 5/5% and 33% gave 4/5 for feeling more confident and 85% gave 5/5 for feeling that the material was relevant to them. Discussion The majority enjoyed the sessions, found it useful, learned more about each of the conditions, gained more confidence in approaching unwell patients and felt that the material was relevant. Self confidence was the poorest ranked area. As these students were at the beginning of their fourth year of training, with more practice, their confidence will grow to the point they are poised to assess acutely unwell patients on the ward. The most common phrases used about the sessions included: ‘useful, interactive, structured, good handouts, approachable, wide range of scenarios, good feedback’. Conclusion Feedback from the students was very positive, they enjoyed the sessions and expressed interest in future opportunities. The plan is for this programme to continue over the next year allowing all students a chance to practice assessing acutely unwell patients in a simulated environment. References General Medical Council. Outcomes for graduates [online]2016. General Medical Council. Available at: https://www.gmc-uk.org/-/media/documents/outcomes-for-graduates-jul-15-1216_pdf-61408029.pdf [Accessed: 20 May 2018]. Illing J, Morrow G, Kergon C, Burgord B, Spencer J, Peile E, et al. How prepared are medical graduates to begin practice? A comparison of three diverse UK medical schools 2008. [Online] General Medical Council/Northern Deanery. Available at: https://www.gmc-uk.org/final_how_prepared_are_medical_graduates_to_begin_practice_september_08.pdf_29697834.pdf [Accessed: 20 May 2018].