Exploring student perceptions of ward simulation as an exercise to improve decision-making skills in the clinical...

This article was migrated. The article was marked as recommended. Introduction: At the point of graduation, medical students are expected to demonstrate competence making a range of decisions in the clinical environment. However, research continues to highlight that both students and graduates lack effective methods for dealing with complex decisions, with students emphasising having little, if any, experience of making many clinical decisions during their undergraduate training. To combat this, an Acute Medical Unit ward simulation exercise (AMUWSE) has been recently incorporated into the 4 ^th year curriculum at Dundee Medical School to aid the development of these skills. Methodology: This study aimed to explore how students perceive their decision-making ability is influenced by an AMUWSE and how this teaching exercise could be improved. An action research approach was adopted to investigate medical students' perceptions of how participation in this exercise influences clinical decision-making skills. An initial online questionnaire was circulated before four group interviews were conducted. Results: It was found that the majority of students perceived the AMUWSE to have been of significant benefit in developing clinical decision-making. A number of learning points from the exercise were identified, incorporated into six overarching themes: making clinical decisions, prioritising, handing over information, asking for help, dealing with time constraints and preparation for clinical practice. Within many of these themes, students expressed deficiencies in teaching during the "basic science" years of medical school. Conclusions: This study highlighted the effectiveness of an AMUWSE to improve the clinical decision-making ability of medical students, while offering invaluable insights into the nature of clinical practice. Despite this, areas for improvement have been identified to make this simulation exercise a more effective means of improving clinical decision-making. Furthermore, there remains a need for consideration of how these skills can be developed during the early years of medical school. While a complex process, certain teaching interventions, such as an AMUWSE, have shown potential in aiding this development; helping to create more competent, well-equipped junior doctors.