Simulation training for foundation doctors on the management of the acutely ill patient.

Background: A study evaluating subjective trainee responses to simulation training organized by the Malta Foundation Program in particular whether this changed their clinical practice.

Method: Feedback using a standardized questionnaire was obtained from 120 (M=55%) participants. A 0-10 Likert scale was used to evaluate responses.

Results: Participants scored the simulation sessions as "useful" at 7.7 (95% confidence interval [CI] 7.4-8.0), rated "the overall experience" at 7.5 (95% CI 7.2-7.8), and thought it made a change in "daily practice" at 5.83 (95% CI 5.4-6.3). The score for the tutor "creating a satisfactory learning environment" and "quality of simulator equipment" was 7.8 (95% CI 7.6-8.1) and 7.7 (95% CI 7.4-8), respectively. Trainees rated "how close was the simulation to a real-life scenario" as 6.24 (95% CI 5.9-6.6). When asked whether the presence of colleagues hindered or helped, the majority were neutral 50 (41.7%), 36 (30%) said it hindered, while only 21 (28.3%) felt it helped. In contrast, 94 (78.33%) stated it was useful to observe colleagues while only 5 (4.2%) stated it was not. Likelihood for future participation was 7.4 (95% CI 7-7.8). Trainees recommended a median of 3 (interquartile range 2-5) simulations per year.

Conclusion: Trainees rated the sessions as useful and asked for more sessions possibly at an undergraduate level. Rating for equipment and tutors was positive; however, some felt that the effect on daily practice was limited. Most were comfortable observing others and uncomfortable being observed. The value of increasing sessions to 3-4 per year, timing them before clinical attachments and audiovisual prebriefing for candidates naïve to simulation needs to be evaluated in future studies.