Simulated on-call: time well spent

Newly qualified doctors feel unprepared to take responsibility for patients and work independently, lacking confidence in skills essential during on-calls. We designed this study to assess the educational value of simulated on-calls and to explore the characteristics of this approach that contribute to improving students' preparedness.

A total of 38 final-year medical students attended two sessions, each including a simulated on-call followed by a one-to-one debriefing. Students' confidence and perceived preparedness before and after the programme were measured using questionnaires. Students' performance in two on-call skills was also assessed during both sessions. Focus groups explored the challenges of preparing for on-calls and how this approach enabled students to prepare.

Following the programme, students felt significantly more confident in six key skills and significantly more prepared for on-calls (p < 0.001). There was also a significant improvement in students' assessed performance in on-call skills (p < 0.001). All students found it more useful preparation for on-calls than seminars and shadowing on-call doctors. They appreciated the opportunity to work independently and take responsibility in a stressful but safe environment. Having a second session and receiving one-to-one debriefing with personalised feedback enabled students to maximise their learning.

Following the programme, students had better insight into on-call work and felt that the programme should be a mandatory part of training. The opportunity for students to consolidate learning through personalised feedback and a second session maximised the value of the programme, making the significant time commitment from the facilitators worthwhile.

This programme was feasible to run and its educational value supports its wider use.