"Pass the Bleep": Students can do more during clinical assistantships

Oral Presentation 1
Dr Katherine Aiken, Dr Anna Sturgeon, Dr Hannah Gillespie

"Pass the Bleep": Students can do more during clinical assistantships

INTRODUCTION
Graduation marks a crucial transition for medical students: from observers with limited responsibility, to doctors who are expected to care for patients safely and efficiently. Given this abrupt transition, it is unsurprising that new graduates consistently report feeling unprepared (1). Students learn when they are supported to participate in the authentic tasks of clinical care, and clinicians can provide these opportunities. In practice, there is a reluctance to do so, for fears this might make clinical care less safe.

OBJECTIVES
Our objective was to use the best available educational theory to design, implement and evaluate a stepwise programme to develop capable FY1s. We aimed to demonstrate that students can be supported to participate in real patient care without compromising patient safety. Our near peer-programme, “Pass the Bleep”, was developed with guidance from senior academic, medical and nursing colleagues.

METHODS
To guide final year medical students from the classroom to the clinical environment, we used the Experience Based Learning model (2) to develop this programme. The climax was a “supervised on-call shift”, where students were given the hospital on-call bleep. To prepare them for this, we:

1) Shared near-peer experiences of working as junior doctors and allowed students to discuss their concerns;

2) Developed a “bleep-prioritisation workshop”, where students rehearsed clinical prioritisation, categorising jobs as red: go immediately, amber: go soon, and green: can wait. An open discussion followed to discuss the reasoning underpinning these decisions.

3) Organised a “simulated on-call shift” where students responded to common or emergency scenarios faced as an FY1s in the form of high fidelity simulations. Each student actively participated in a simulated scenario, where they responded to a call from a concerned member of staff, attended, assessed, escalated if necessary, and documented their encounter.

OUTCOMES
In its first iteration, twenty-one students participated. All reported it aided their preparation for work. Students were particularly positive about the supported, gradated learning environment which prepared them for the challenge of holding the on-call “bleep”. No related adverse incidents were reported.

CONCLUSIONS
This intervention targets the preparedness “gap”. Research has emphasised the need for medical students to gain experience, not just competence (3). The Experience Based Learning Model gave a framework for the development of this intervention, creating supportive conditions that enabled students to prepare and participate in authentic clinical practice. The programme scaffolded medical students’ learning, harnessing simulation and clinical experience to support progressive independence in practice.