P59 Exploring student perceptions of ward simulation as an exercise to improve decision-making skills in the clinical context. (5th November 2017) - MacMillan, C
Abstract : Background: At the point of graduation from medical school, students are expected to demonstrate competence making a range of decisions in the clinical context (General Medical Council, 2015). However, research continues to highlight that both students and newly graduated junior doctors lack effective methods for dealing with complex decisions, with students emphasising having little, if any, experience of making numerous clinical decisions during their undergraduate training (McGregor et al., 2012). To combat this, an Acute Medical Unit ward simulation exercise (AMUWSE) has recently been implemented into the 4th year curriculum at Dundee Medical School, to offer students the opportunity to develop this aspect of clinical practice. Aims: This study aims to explore how students perceive their clinical decision-making ability is influenced through participation in an AMUWSE, and how it can be improved to make it an effective means of developing these skills. Methodology: An action research approach was adopted to investigate Dundee 4th year medical students' perceptions of how completion of an AMUWSE influences clinical decision-making skills. An initial anonymous online questionnaire was circulated to ascertain the views of students, before four focus group interviews were conducted to provide a deeper exploration. These interviews were recorded and subsequently transcribed, before undergoing thematic analysis to generate key themes. Results: Completed questionnaires demonstrated that the majority of students perceived the AMUWSE to have been of significant benefit in improving a range of clinical decision-making elements. A number of learning points from the exercise were identified, incorporated into six overarching themes: making clinical decisions, prioritising, handing over information, asking for help, dealing with time constraints and preparation for clinical practice. Conclusions: This research study has emphasised the effectiveness of an AMUWSE to improve the clinical decision-making ability of medical students. Introduction of such a teaching intervention also offers invaluable insights for undergraduates into the nature of clinical practice, allowing participants the opportunity to gain awareness of, and preparedness for, the responsibilities of a junior doctor. Despite these findings, areas for improvement have been identified to make this ward simulation exercise a more effective means of improving clinical decision-making. Furthermore, there remains a need for further consideration of how these skills can be developed during the "basic science" years of medical education. References: . General Medical Council (GMC). Outcomes for graduates [Online] 2015. Available at: http://www.gmc-uk.org/education/undergraduate/undergrad_outcomes.asp. [Accessed 10th May 2017]. . McGregor CA, et al. Preparing medical students for clinical decision making: A pilot study exploring how students make decisions and the perceived impact of a clinical decision making teaching intervention. Medical Teacher 2012;34(10):508–517.