Student views of stressful simulated ward rounds.

Abstract

Medical error is common, and frequently results from a failure in non-technical skills. Simulated ward rounds are an innovative new trend in undergraduate medical education. They are increasingly used to recreate the challenges of the real clinical environment to foster appropriate non-technical skills. The objective of this study is to assess whether stressful simulated ward experiences that prepare students for practice are acceptable to undergraduate participants. The simulated ward round experience … helped students to reflect on positive behavioural changes for safe future practice A 30-minute simulated ward round experience with a focus on medical error and distraction was constructed and its pedagogical development described. Twenty-eight final-year medical students volunteered to take part in two simulated ward exercises, with a lag time of 1month between each. Students were asked to complete an anonymised electronic questionnaire to evaluate their experiences. A thematic analysis of qualitative responses was undertaken. The response rate was 96.4percent, with 27 of 28 students completing the evaluation questionnaires. The simulated ward round experience, although acknowledged as being stressful, helped students to reflect on positive behavioural changes for safe future practice, built confidence and was deemed to be of high fidelity. All students felt that mandatory curricular integration was important. With growing evidence on acceptability, coupled with research showing simulated ward rounds to improve undergraduate patient safety behaviours, there is a compelling argument for curricular integration. Improving the cost-effectiveness of simulation is important in realising this aim. Solutions to potentiate feasibility that also address student critique are discussed. Simulated ward rounds offer medical schools an innovative and acceptable approach to meeting the World Health Organisation's Patient Safety Curriculum.