Preparing for Practice: Evaluating a 3-Week Longitudinal Ward Simulation

Final-year assistantships are a common feature of undergraduate curriculae, both in the United Kingdom and internationally. However, they often fail to adequately prepare students for practice, with task complexity and low confidence as common barriers to engagement. In the face of increasing burnout amongst newly qualified doctors, and recent studies showing lack of preparedness upon qualification, interventions to improve the efficacy and utilisation of assistantships are urgently required.

A 3-week longitudinal narrative simulation, framed within a virtual inpatient ward, was used to prepare final-year medical students for assistantship. The simulation used persistent patient narratives that could be affected by student actions across a range of learning activities. Students had the opportunity to practice autonomously taking greater responsibility for meaningful decisions in handovers, patient admissions and discharges, on-call and routine clinical tasks, emergencies and patient/family discussions.

The module was evaluated with semi-structured interviews and focus groups. Three main themes were identified: acting like a doctor, feelings of safety and feelings of legitimacy. Participants described the virtual ward as a stepping stone to participating on real wards during their assistantships by providing a safe but realistic environment to practice as an FY1, increasing self-efficacy and self-perceived professional identity.

A longitudinal simulation using continuous patient narratives offered students realistic, consequence-driven engagement with doctor-level tasks, bridging the gap between classroom and clinical practice. Despite resource demands, this model may be a valuable tool to enhance assistantships, particularly in preparing students for roles typically inaccessible during training.