BMC Medical Education (03/03/2023) Vol. 146 Church, Helen R.; Murdoch-Eaton, Deborah; Sandars, John

A scoping review of under- and post-graduate education for managing acutely unwell patients focused on the reason why junior doctors often feel under-prepared when treating acutely unwell individuals. The researchers identified 73 relevant articles and abstracts from journals and conferences. Most educational interventions targeted medical students either exclusively or in collaboration with other healthcare professionals compared with doctors, although doctors more often participated in multidisciplinary team studies. Each intervention involved 6–357 participants. Simulation was a commonly used technique; however, few studies incorporated clinical environment complexities within situations such as multidisciplinary working, distraction-handling and other non-technical skills. The most common educational outcomes were subjective in nature, with more than half assessing confidence or preparedness to manage the acutely unwell patient and about a third focusing on the evaluation of the course as a learning event. Forty percent of the studies assessed observed knowledge improvements, but the researchers noted that only a few studies appeared to highlight practical skills or more direct patient outcomes. They suggest the review should inform future educational programs to increase authenticity in simulation while improving the sharing of educational strategies within the clinical education practice community. "By replicating the 'messy clinical environment' through creating distractions, involving multidisciplinary team members, and embedding non-technical skills, more authentic educational experiences can be created to encourage transfer to real clinical practice," the authors conclude.

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