Are You PREPAREd? A Structured Approach to Support Safe and Confident Transitions to After-Hours Care

Early after-hours work represents a demanding transition for newly graduated doctors. Preparation is often fragmented, with limited attention to the integrated clinical, organisational, and supervisory demands of after-hours care, contributing to uncertainty that may affect both patient safety and professional development.

PREPARE (PREParing for After-hours caRE) is an eight-week programme designed to support new graduates during their early postgraduate transition by enabling safe and confident participation in after-hours care.

PREPARE was developed through a research-informed, iterative design process. The programme integrates five interconnected components-familiarisation, workplace learning, structured teaching, guided reflection, and entrustment-within a coherent framework that runs parallel to routine clinical work. Rather than functioning as a fixed curriculum, PREPARE provides a flexible structure that aligns educational activities, workplace learning, reflection, and entrustment, while allowing adaptation to local service contexts.

Formative evaluation throughout development and early implementation focused on perceived value, feasibility, and alignment with after-hours responsibilities. New graduates and supervisors reported increased confidence, improved preparedness for managing uncertainty, and enhanced understanding of interprofessional collaboration.

Reflection highlighted how PREPARE engages with real clinical complexity and exposes tensions between educational ambition and organisational feasibility. While the programme demonstrates how after-hours transitions can be more deliberately supported, its sustainability and transferability depend on organisational commitment and protected time for learning.