International Journal of Healthcare Simulation

Introduction:

The transition from higher specialist training to consultant is challenging. While trainees feel comfortable with the clinical management of patients, they feel unprepared for the consultant role [1]. SimWard Wolverhampton NHS Trust conducted a survey between 2023-24 which revealed that higher specialty trainees felt a lack in confidence, preparedness and understanding of a consultant’s role. They also reported a lack of exposure in managing complaints and a lack of awareness of support available to them as a new consultant.

These challenges were identified and a high-fidelity simulation-based education (SBE) course was piloted in 2023, preparing higher specialty medical trainees for a consultant role. Following its innovative success, this course has now been incorporated within internal medicine regional training programme. After a year of delivery, pre-and post- course feedback were reviewed to assess course impact on trainees’ perception of readiness.

Methods:

High-fidelity SBE was delivered between 2023-2024 to higher specialty trainees transitioning to consultant role within the next year. The course consisted of 4 workshops and 4 simulated scenarios addressing clinical metacognition, debriefing, post-take ward round, complaints management, conflict management and being a consultant. Pre- and post-course feedback were collected to assess perception of the course and areas of improvement.

Results:

Post-course feedback showed there were significant improvement in the number of candidates reporting an understanding of the roles and responsibilities of a consultant and an understanding of the support networks available to them as a new consultant. The candidates also reported an increase in confidence in the following: carrying out a post-take ward round, managing formal complaints, respectfully challenging colleagues, and escalating concerns about a colleague (Table 1-A53). Other relevant topics candidates suggested they would like to see in this course were job planning, preparation for coroner’s court, more conflict resolution, and more scenarios.

Discussion:

Results show that despite seven years of specialty training, higher specialty trainees still feel underprepared for their role as a new consultant. The overwhelming positive post-course feedback shows SBE addresses these concerns and gives higher specialty trainees the toolkit they to prepare them for consultant role. Therefore, a wider implementation of consultant preparation courses in the form of SBE is needed across specialties.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Flavell S, Robinson A, Dacre J. The transition to consultant: Identifying gaps in higher specialist training. Clinical Medicine (London, England). 2020;20(4):406–411.

Table 1-A53.

Pre- and post-course feedback from higher specialty trainees following a high-fidelity SBE course to support transition from higher specialist training to consultant

	Pre-course feedback (%)	Post-course feedback (%)
I understand the roles and responsibilities of a consultant	80.0%	97.6%
I understand the support network available to me as a new consultant	34.3%	90.2%
I feel confident in carrying out a post-take ward round	77.1%	97.6%
I am confident in managing formal complaints	28.0%	90.0%
I feel confident to respectfully challenge colleagues	45.7%	92.7%
I feel confident to escalate concerns about a colleague	57.1%	90.2%