LAUSR

Introduction The Covid-19 pandemic period necessitated the early graduation of medical students in the UK to join the healthcare workforce as Foundation Interim Year 1 (FiY1) doctors. The aim of this project was to develop and implement a sequential simulation session to improve and assess FiY1 preparedness towards approaching deteriorating patients. Methods A total of 12 FiY1 doctors participated in the session containing three sequential major stations: complex new admission, ward based management, and acute deterioration. Participants were required to interpret investigations, perform examinations, create management plans, and escalate to senior clinicians using a pager. Preparedness to practice was measured quantitatively on six point Likert-type scales and qualitatively using a semi structured interview. Results Following the session there was a significant improvement in preparedness for giving treatment (median(IQR): pre-simulation 3(3–4) vs. post-simulation 4(4–4.75); p=0.04) and paperwork (2(2–3.75) vs. 4(3.25–4.75); p=0.03). Following the FiY1 period participants demonstrated significant improvement in preparedness for giving treatment (median(IQR): pre-simulation 3(3–4) vs. post-FiY1 4.5(4–5); p=0.01), communication and team-working (4(3.25–4.75) vs. 5(5–5.75); p=0.01), and paperwork (2(2–3.75) vs. 5(5–5); p=0.01). Participants felt that the FiY1 programme improved integration within treatment teams and facilitated training, whilst medical school placements did not place students in the role of a decision maker and left them feeling apprehensive and unprepared to practice. Discussion and Conclusion This session provided an engaging method of increasing preparedness towards common challenges new physicians face. This study suggests future senior medical student apprenticeships should give the same investment, opportunities and responsibilities as that of the FiY1 programme