Day as a medical registrar – preparation for the acute medical take

Background and context Contemporary evidence has indicated that 44% of newly appointed Medical Registrars feel unprepared for their responsibilities on the acute medical take1 and that their main concerns were centred on a lack of exposure to clinical decision making. Innovation In response to this Health Education England (East of England) commissioned an experimental and innovative simulation exercise to provide a group of 20 core medical trainees (volunteers) with an educational experience that exposed them to a range of clinical decision problems typical of a medical take, all contained within in single one-day session. Methods Trainees rotated (in pairs) through a series of 10 acute care scenarios designed to run as a continuous carousel. 2 stations utilised simulation manikins, 7 stations employed direct patient assessments (using standardised patients) and 1 station involved breaking bad news to a patient (standardised patient). The manikin-based scenarios were medical emergencies that required ST3 level clinical decision making skills and the standardised patient scenarios were set at a level above PACES Station 5. Each scenario was supervised by an experienced simulation facilitator, with debriefing and feedback (using recognised educational models) being provided to the participants immediately following conclusion of the scenario. Progress to date Evaluations were obtained from trainees, facilitators and also from the standardised patients. Preliminary quantitative analysis indicated a very positive learning experience with more than 97% of (all) participants highly valuing the programme. Next steps and expectations It is anticipated that on-going quantitative and qualitative evaluation and educational audit will enable further improvement in the provision of a meaningful and valuable programme, most importantly it may provide core trainees with an important blended educational experience in their preparation for the role of the medical registrar.