Simulated on-call: time well spent.

Background: Newly qualified doctors feel unprepared to take responsibility for patients and work independently, lacking confidence in skills essential during on-calls. We designed this study to assess the educational value of simulated on-calls and to explore the characteristics of this approach that contribute to improving students' preparedness.

Methods: A total of 38 final-year medical students attended two sessions, each including a simulated on-call followed by a one-to-one debriefing. Students' confidence and perceived preparedness before and after the programme were measured using questionnaires. Students' performance in two on-call skills was also assessed during both sessions. Focus groups explored the challenges of preparing for on-calls and how this approach enabled students to prepare.

Results: Following the programme, students felt significantly more confident in six key skills and significantly more prepared for on-calls (p < 0.001). There was also a significant improvement in students' assessed performance in on-call skills (p < 0.001). All students found it more useful preparation for on-calls than seminars and shadowing on-call doctors. They appreciated the opportunity to work independently and take responsibility in a stressful but safe environment. Having a second session and receiving one-to-one debriefing with personalised feedback enabled students to maximise their learning.

Discussion: Following the programme, students had better insight into on-call work and felt that the programme should be a mandatory part of training. The opportunity for students to consolidate learning through personalised feedback and a second session maximised the value of the programme, making the significant time commitment from the facilitators worthwhile.

Conclusions: This programme was feasible to run and its educational value supports its wider use.