An exploration of the effect of simulation on perceptions of medical students’ preparedness for professional practice; a mixed-methods, longitudinal study

Carpenter, Ciara and Brewster, Liz and Vince, Gill and Keegan, Thomas (2020) An exploration of the effect of simulation on perceptions of medical students’ preparedness for professional practice; a mixed-methods, longitudinal study. PhD thesis, Lancaster University.

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Abstract

Studies have shown that some medical students do not feel prepared to practice as a foundation doctor (FY1) once they graduate. Although there have been various reforms in medical education, levels of preparedness have remained static since 2012. Preparedness is vital to ensure patients are getting the best, safest care, and to avoid stress, anxiety and burnout in junior doctors. Technology-enhanced learning has become commonplace in medical education; with this, simulation has been introduced in wide-ranging ways. Although the evidence for simulation improving patient outcomes is clear across postgraduate and continuing professional education, studies have failed to systematically show the same outcomes for undergraduates, despite the widespread use of simulation in undergraduate medical curricula. This mixed-methods, two-phase study was designed to explore the effects of simulation on perceptions of students’ preparedness for professional practice. The study took a longitudinal format, over two academic years, gathering data (with questionnaires and interviews) from two participant groups; fifth-year medical students and key stakeholders. The study compared two diverse simulation formats; ward simulation and bleep simulation, both designed to develop the knowledge and non-technical skills required for the transition to professional practice. The results of this thesis suggest that simulation has a role in preparing students for the knowledge required for professional practice and may result in a change in behaviour longitudinally. However, there is an apparent disconnect between stakeholder and student perceptions of preparedness, and while students may feel prepared, their supervisors and other stakeholders do not agree. Furthermore, despite feeling prepared, students still feel concerned and anxious about the transition to professional practice. The results also highlighted the difficulties in thoroughly preparing students for the complexities of becoming an independent practitioner and emphasises the importance of support and continued learning throughout the foundation years.