LAUSR

It was interesting to see the focus on simulation-based teaching in the recent issue of Medical Teacher. As final year medical students at the University of Bristol, we have experienced a curriculum emphasizing simulation teaching throughout our training. Of particular interest was the article by Eppich et al. (2018) exploring the need for telephone communication training. Typically, our simulation sessions involve immersive manikin-based clinical scenarios which are concluded by simulating telephone communications with a senior colleague. Peer discussion reveals that prior to this, students are often unsure of how to effectively communicate information clearly and concisely. From the results of their analysis, this appears to be common, and we feel fortunate to have received training in how to engage effectively with other clinicians over the telephone. Integrating this into simulation sessions has been of utmost benefit as it allows students to voice their concerns and perceived areas of weakness ahead of time, creating structured learning objectives to be addressed. Allowing students to practice conversations with a facilitator, usually a clinical teaching fellow who is known to the student creates an environment of trust and support, avoiding potential tensions that may arise from a trial-and-error approach associated with learning on the job. Scenarios are followed by a debrief, during which feedback on communication is given with explicit learning points identified and discussed. This allows students to further familiarize themselves with their strengths and weaknesses and allows opportunities to ask questions outside the time-pressured environment of the wards. Any conversational interruptions are addressed which, as mentioned, are often manifestations of “disguised” feedback. Discussion provokes students to recognize this pattern of behavior, enabling recognition of further learning opportunities in future conversations. Having had opportunities to practice these skills in a variety of scenarios we feel more confident in our ability to communicate effectively as junior doctors. It would be interesting for future research to compare experiences across different programs and establish how such training has been implemented, and whether students experience beneficial effects or not.