49SIMULATION FOR FOUNDATION YEAR SURVIVAL SKILLS (SIM-FYSS)–USING SIMULATION TO TEACH MEDICAL UNDERGRADUATES TO CARE FOR ELDERLY INPATIENTS BEFORE ENTERING THE UK FOUNDATION PROGRAMME

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Abstract

Background: All medical graduates must undertake the UK Foundation Programme (UKFP), however undergraduate training may not specifically prepare them to care effectively for older people (Bartram et al. Age Ageing (2006) 35(5): 533-535; Gordon et al.; Age Ageing (2010) 39(3): 385-388). Evidence is mounting that simulation-based teaching methods effectively improve students' clinical knowledge, skills and attitudes in many areas of medical practice (Okuda et al; Mt Sinai J Med (2009) 76:330-43; Tullo et al.; J Am Geriatr Soc (2010) 58:1987 93)

Innovation: A questionnaire sent to local Foundation Year 1 doctors established the need for further learning in Geriatric Medicine prior to commencing the UKFP. We designed an educational intervention, using immersive simulation with reflective feedback and small group workshops. This was run for 16 final year students from Glasgow University and evaluated with pre- and post-course questionnaires assessing candidates confidence levels in dealing with common medical problems in elderly inpatients.

Evaluation: Using a two-tailed unpaired t-test to compare pre- and post-course self-rating scores for the question “How well do you feel prepared to assess and manage the following…?”, we demonstrated statistically significant improvement for the following domains: Dementia (p = 0.0023), Parkinson's Disease (p = 0.0093), Falls (p = 0.0470), Poor Mobility (p = 0.0126), Multiple Co-morbidities (p = 0.0141) and End-of-life Care (p = 0.0009). The only domain that was not improved significantly was Confusion (p = 0.1790). 100% of candidates felt the course was beneficial and would recommend it to a colleague.

Conclusions: The new course has evaluated well both in terms of immediate educational benefit and acceptability. We now plan to follow this cohort of students up after they have started their UKFP posts, to assess whether there is any persistence of the measured benefit. In light of our experience so far, we aim to offer the course to a larger cohort of students in 2014 with further evaluative measures planned.

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