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How we equip undergraduates with prioritisation skills using simulated teaching scenarios

Background: Goldacre et al. [Goldacre MJ, Lambert T, Evans J, Turner G. 2003. PRHO views' on whether their experience at medical school prepared them well for their jobs: National questionnaire survey. BMJ 326 (1):1011–1012.] undertook a study which showed that 40% of undergraduates felt under prepared for work by their undergraduate curriculum. Illing et al. [Illing J et al. 2008. A GMC report: Submitted to GMC.] demonstrated that one of four key areas, for which they felt least prepared, was prioritisation of tasks in the clinical setting. Aim: To equip undergraduates about to become Foundation year 1 with the prioritisation skills along with others highlighted by Illing in a very real yet safe environment. Methods: We devised a simulated teaching session ‘an evening on call'. Each individual student had a 45 min session, held on mock wards where they were given a handover task list, and like a de facto on call would be paged by the wards at varying intervals. Tasks ranged from prescribing night sedation, interpretation of ECG and blood results to dealing with acute gastrointestinal bleeds. At the end of the session each student was given feedback on their prioritisation and patient management by an experienced medic. Results: Feedback from students rate this as one of the best ways to learn as they have responsibility for patients in a very safe yet real environment. They felt better prepared for the job they were about to do. Conclusion: Simulated teaching is a relatively easy yet effective way to teach prioritisation and other skills. We hope that our method is self-explanatory and could be adapted for other teaching groups or material.