In post-graduate medical education, Denmark, in line with several countries, has adapted the CanMed 7 roles. simulation-based training (SBT) as a methodology for learning is growing rapidly in healthcare. The importance of interactive training methods e.g. The educational methods used in medical schools are primarily based on lectures, which do not include the possibility of training and applying these skills. Junior doctors find these aspects difficult. Thereto, typically doctors have responsibility for several patients at a time, which implies being able to prioritize and collaborate in a team of healthcare professionals. One explanation for this might be the focus on the medical expert role and on stable patients in medical schools. Junior doctors experience that finding the right diagnosis and initiating a treatment plan was different from the student perspective, where decisions seemed more clear cut. Accordingly, confidence in history taking, but less confidence in diagnostic skills and decision-making is reported. Junior doctors experience high levels anxiety related to feeling responsible for making decisions about patient care and working alone with less supervision. Especially, being able to identify the deteriorating patient, to make decisions and prepare a plan for the patient is a challenge. The transition from being a medical student, with limited responsibilities and a high level of supervision, to become a newly qualified doctor, with medical responsibility for individual patients and less supervision, is difficult and stressful. However, the application of these skills was more difficult if these skills were unfamiliar to the surrounding clinical staff. The doctors experienced an ability to transfer the use of algorithms and non-technical skills trained in the simulated environment to the clinical environment. Overall, the simulation-based training seemed to facilitate the transition from being a medical student to become a junior doctor. Concern was expressed related to staff willingness and preparedness in using these tools. The usefulness of algorithms and the appreciation of non-technical skills were highlighted and found to be helpful in managing clinical difficulties. The doctors gave several examples of simulation-based training increasing their preparedness for clinical practice and handling the critically ill patient. The following main themes were identified from the interviews: preparedness for clinical practice, organisational readiness, use of algorithms, communication, teamwork, situational awareness and decision making. A content-analysis approach was used to analyse the data. We used a qualitative approach and conducted semi-structured telephone interviews with a sample of twenty first-year doctors six months after a 4-day simulation-based training course in handling critically ill patients. Our aim was to identify first-year doctors’ perceptions, reflections and experiences on transfer of skills to a clinical setting after simulation-based training in handling critically ill patients. However, there are indications of problems when applying learned skills to practice. Simulation-based training on managing emergency situations can have substantial effects on satisfaction and learning. Junior doctors lack confidence and competence in handling the critically ill patient including diagnostic skills, decision-making and team working with other health care professionals.
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