# Improving New Doctors’ Confidence of Starting Work Through Simulation-Based Training

## TL;DR

A simulation-based training course significantly boosts new doctors' confidence before they start work, especially for international medical students.

## Contribution

The study demonstrates the effectiveness of a long-term, simulation-based training program in improving FY1 doctors' preparedness.

## Key findings

- The course increased average confidence from 1.99 to 3.68 on a five-point scale.
- International medical students showed increased participation and benefit from the course.
- Transitioning to a simulation-based format in 2021 led to the largest confidence boost.

## Abstract

Introduction

The transition from final year medical student to Foundation Year 1 (FY1) doctor is widely recognised as challenging, with many new FY1s reporting a lack of preparedness. This contributes to increased stress, higher rates of burnout and potential patient safety issues. Although a mandatory shadowing period has been introduced, the structure and content vary greatly and survey data demonstrates FY1s still feel unprepared.

Methods

A free one-day simulation-based teaching course was developed and refined over seven years using an action research model. The course aimed to increase confidence prior to starting FY1. Session content was developed and refined over these years and includes commonly encountered clinical and non-clinical skills. Pre- and post-course surveys measured confidence at starting FY1. Demographic and qualitative feedback was also gathered.

Results

Between 2017 and 2024, a total of 1,406 final year medical students attended the course. There were increasing numbers of international medical students (IMGs) who attended. The pre- and post-course average confidence rating was 1.99 and 3.68, respectively, out of a five-point Likert scale (with 1 being not at all confident and 5 being completely confident). Common themes for improvement from qualitative feedback identified changes in course content and structure. Of these changes, transitioning to a simulation-based course in 2021 led to the largest increase in confidence.

Conclusion

This study highlights the effectiveness of a simulation-based teaching course to improve FY1 preparedness. It can be easily replicated and localised on a wider scale for use in hospital inductions for new doctors.