Using a ward round checklist and simulation to teach junior doctors and medical students ward round skills

Background: Newly qualified doctors are often required to facilitate an independent ward round from day one on the job, yet necessary ward round skills are not commonly included in undergraduate education. Methods: A ward round checklist was developed for use on medical wards at the Royal United Hospital (RUH), Bath, UK. This was introduced to fourth-year University of Bristol medical students (N=8) and newly qualified Foundation Year 1 doctors (FY1s, N=34) in small-group simulation sessions. The simulation included three common ward round scenarios using authentic electronic and paper resources, such as drug charts and observation charts. Participants’ confidence in documenting and leading a ward round was assessed before and after the teaching. This was self-rated on a scale of 0-10. Results: The simulation produced a statistically significant increase in self-rated confidence in all groups. FY1s’ confidence documenting increased from 6.8 to 7.6/10 (p=0.007), and their confidence leading increased from 3.9 to 6.6/10 (p<0.001). Medical students’ confidence documenting increased from 5.1 to 7.0/10 (p=0.003), and their confidence leading increased from 2.4 to 5.6/10 (p=0.002). As expected for their level of training, medical students’ confidence in both domains was consistently lower than FY1s. In both groups, confidence documenting was consistently higher than confidence leading ward rounds. In feedback, participants reported the teaching to be ‘useful’ and ‘engaging’, rating it on average 4.9/5 stars. Conclusion: We have shown that using a ward round checklist in tandem with simulation is an effective way of teaching junior doctors and medical students ward round skills. Key words: ward round simulation