Working without worry: transition to foundation year 1 simulation training

FY1 doctors are expected to manage patients with acute and chronic conditions, recognise, initiate management and escalate care of deteriorating patients, integrate within a multidisciplinary team, and take appropriate responsibility while working within the limitations of their competence.1 Our goal was to develop a simulation-based training programme to bridge the gap between the self-directed knowledge acquisition and personal time management of medical school, and the multidisciplinary hospital environment, where working as a team towards shared goals under time pressure and high cognitive load requires efficient assessment, communication and teamworking. Participating students had prior exposure to simulation-based training in years 3 and 5 and using the theory of spiral learning we built upon this previous experience in both simulation complexity and debrief.3 Development and delivery Current FY1 doctors were asked for examples of stressful situations for which they felt poorly prepared, and current final year medical students (target participant audience) were asked what their principle concerns of commencing FY1 were. Local feedback focused on specific situations of dealing with deteriorating patients while the national survey reflected more generic human factors and ergonomics including time management, teamworking, communication, handover, resilience and stress management.