“Wardcraft”: Equipping medical students with the procedural knowledge and skills to make them more confident junior doctors Dr Meng Wang (ACF CMT2) and Dr Kate Kiln (CMT2) Background: A recent survey of Cambridge final year medical students regarding their training highlighted that performing the role of an FY1 under the supervision of junior doctors was one of the largest contributors to preparing for the Foundation Programme. However, the major barrier to achieving this on the ward is lack of time in the clinical setting. We wanted to dedicate time to simulate these scenarios in a safe environment, with supervision from junior doctors, to better prepare medical students for the Foundation Programme. Project Aims: 1.Identify clinical topics commonly faced by junior doctors that medical students lack confidence in managing. 2.Recruit junior doctors to design and deliver weekly sessions to final year medical students at Addenbrooke’s Hospital, teaching them the practical knowledge/skills used by junior doctors to tackle the identified clinical topics. 3.Increase the subjective confidence of medical students in managing these clinical problems through our teaching course “Learning To Make a Difference” Fig 1: Students subjective confidence in managing clinical scenario pre- and post- tutorial (10 point Likert scale) * P < 0.05 Method: Questionnaires sent to medical students to identify clinical topics they lacked confidence in managing. Sessions designed based on the identified topics: a short lecture to cover basic knowledge, followed by small group tutorials to teach the ‘wardcraft’ required to manage these clinical scenarios. Sessions incorporated practical skills e.g. simulating phone calls to other health professionals, writing prescription charts, interpreting clinical data. Junior docors recruited to lead small groups of students in these tutorials. Tutorials proofread by junior doctors and, where relevant, cross-referenced with available Local Trust or National guidelines ensuring accuracy and consistency. Putting the plan into practice: We designed 6 sessions based on clinical topics polled from junior doctors and medical students: 1. Prescribing and monitoring antibiotics. 2. Practical prescribing and symptom management. 3. Interpreting common electrolyte derangements and prescribing IV fluids. 4. Interpreting full blood counts and prescribing blood products. 5. Practicalities of inpatient diabetes management and insulin prescription. 6. Practical and organizational skills to survive on-call shifts. We delivered the teaching every Thursday evening from 18:30 – 20:00 in a 6-week block, repeated in 3 cycles throughout the academic year to ensure all the final year medical students with clinical rotations at Addenbrooke’s Hospital had the opportunity to attend. After each cycle, we analyzed the feedback and introduced iterative changes to our teaching style and content to reflect the feedback received from the students (see Figure 2). Results and Lessons Learnt: Medical students’ confidence and exposure to Wardcraft can be increased through structured, interactive tutorials (see Figure 1). Medical students particularly value teaching on practical activities that simulate the role of the junior doctor. Junior doctors are an under-utilized resource in medical student teaching, and are well placed to teach the appropriate skills and knowledge required for a new junior doctor Future Work: We continue to develop the content of sessions based on ongoing feedback from students. We would like to expand the recruitment of junior doctor facilitators and implement formal training to ensure consistent quality of teaching delivered. We will present our work at the AMEE 2015 international conference. We are actively liaising with the Cambridge Clinical School to gain their support and feedback, as well as potentially incorporating our course formally alongside their new curriculum. CYCLE 1CYCLE 2CYCLE 3 Changes: More practical activities e.g. simulated phone calls Inclusion of diabetes management Recruitment of more junior doctors Changes: Reduced duration of lecture Refreshments provided for students Near-peer observation and feedback for junior doctor facilitators Hand-outs provided FEEDBACK Figure 2