How prepared are medical students for their career in practice? New report investigates

Stepping onto a ward for their first day of employment, it’s vital for patient safety that a new doctor is fully prepared for their role.

But, with making complex clinical decisions, and taking on responsibilities for patient care within the wider health and social care team – how can we know that they are really ready?

New research commissioned by the General Medical Council, and led by the University of Plymouth, explored preparedness for practice among doctors across the UK. It found that the current medical education provision is producing doctors that are prepared for many aspects of their career, but further research is also needed to see if the training is fully futureproof.

The GMC were particularly interested in finding out whether medical graduates are prepared to meet future anticipated healthcare needs in the following areas:

  • the changing doctor-patient relationship – characterised by more involvement of patients in decision making and using information to enhance their own health management
  • the doctor in a multi-disciplinary team (MDT) – increased importance of interdisciplinary team working with doctors from all care settings and specialities; and with other health and social care professionals
  • complex clinical decision-making – decisions characterised by incomplete information and a high degree of uncertainty

Taking the form of a literature review, crisis resource management training using simulation and 93 interviews with foundation doctors, health professionals, clinical supervisors and medical educators from across the UK, the report found that students were well prepared for what lay ahead. 
The research showed that the current medical education provision is producing doctors that are prepared for many aspects of practice in these areas, including communication, patient centred care, understanding team hierarchies, knowing when to escalate decisions, understanding their own knowledge, and self-awareness.
But there are areas where foundation doctors were less well prepared, for example, empowering patients to take part in shared decision making processes related to their care and for managing emergency situations out-of-hours. 
The report concluded that any future changes to medical education provision should focus on providing more experiential learning and programmes where medical students get to ‘act up’ to the role of the foundation doctor.
<p>Tom Gale</p>
Lead author Professor Thomas Gale, Director of the Collaboration for the Advancement of Medical Education Research (CAMERa) at the University of Plymouth, said:
“After graduating, doctors complete two foundation years (F1 and F2) before entering more specialist training programmes. It’s not as though they’re sitting in a classroom for the five years of training beforehand – experiential learning in the clinical environment is a hugely important part of their training – but this report has shown just how important the ‘on the job’ skills are, as well as an awareness of the roles of the wider health and social care staff who are intricately involved with patient care."
“This was a really important piece of work as it showed us the areas in which new doctors are fully prepared, and highlighted gaps in research, with possible recommendations for the future. Crucially, the report showed that areas that need some more attention are complex clinical decision-making in acute settings, fostering empowerment, complex communication, dealing with uncertainty, leadership, and prioritising tasks – and these are skills that are learned on the job.
 “While we conducted the research independently, we were pleased that the report showed the importance of learning those experiential skills, as it’s something we pride ourselves on at the University of Plymouth.”

The Collaboration for the Advancement of Medical Education Research and Assessment (CAMERa) researchers aim to improve the development and sustainability of the healthcare workforce by focusing on three research themes, namely workforce development, continuum of education, and professional regulation.

CAMERa's research programme, carried out by a multi-professional group and employing a mix of qualitative and quantitative methods, impacts directly on national and international literature, educational theory, practice and policy.

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