Simulation-based teaching in using acute ABCDE assessment: improved final year medical student clinical confidence in preparation for foundation years.


  1. Conrad Hayes
  2. Clare Morris
  3. Heather Kitt


10BB Simulation 2


Royal Stoke University Hospital - - Stoke-on-Trent - United Kingdom


​At the time of this project we were a group of Foundation Year 1 doctors at the Royal Stoke University Hospital, a teaching hospital affiliated with Keele School of Medicine.

A group of us from medical schools around the country felt that we had little experience in the management of acutely unwell patients in comparison to the rest of our medical knowledge.

As a result we wanted to create a teaching scheme for final year medical students to address this.

Our aims were:

  1. To give people more experience of a full 'A to E' assessment in a simulated acute situation
  2. To expose people to a range of common emergencies experienced as a junior doctor
  3. By doing the above to increase the confidence of medical students entering their first years of clinical practice​​​


Summary of Results

​Qualitative and quantitative feedback was sought from the students and was unanimously positive. Students enjoyed the sessions and told us they found them useful.















​The quantitative response showed an overall improvement in student confidence in dealing with acutely unwell patients when entering foundation years.

Summary of Work

​The sessions were open to final year medical students only. There were 9 scenarios in total prepared by FY1 doctors and agreed to represent realistic scenarios of what we may see on the wards and what action we would want to take. The scenarios included a brief history and initial observations. Students were then asked to assess the 'patient' and examination findings or investigation results were given once the appropriate assessment had occurred. The patient was represented by a basic plastic mannequin. Free online vital sign software was utilised to enable live altering of the patient's condition.

​The students were expected to perform as a junior doctor would and implement their management as they progressed.

​Pre- and post-session forms were made asking students to rate their confidence on a scale of 1-5 on 10 aspects of the management of acutely unwell patients.

​There was one initial pilot session after which it was decided:

  1. ​There would be 15 minutes dedicated to teaching on shock prior to the simulation.
  2. ​There would be 2 tutors to 4 students. One would run the scenario and the other would observe and focus on feedback.
  3. ​The simulation would last a total of 15 minutes. 10 minutes of activity and 5 minutes of feedback.
  1. Simulation based teaching is a useful tool for improving final year student confidence upon entering their foundation medical practice.
  2. ​High fidelity simulation offers a realistic, good student experience. However low fidelity simulation can still provide an experience that is appreciated by the students and has demonstrated an improvement in self-perceived ability.
Take-home Messages
  1. ​Simulation improves final year medical student confidence upon preparing to enter their careers as doctors
  2. Simulation can be performed cheaply and still provide a good educational experience​
  3. ​Medical schools should consider providing more frequent simulation sessions on the management of acutely unwell patients

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Morgan PJ, Cleave-Hogg D, Desousa S, Lam-McCulloch J. Applying theory to practice in undergraduate education using high fidelity simulation. Med Teach 2006 02;28(1):e10-e15.

Ruesseler M, Weinlich M, Müller M,P., Byhahn C, Marzi I, Walcher F. Simulation training improves ability to manage medical emergencies. Emerg Med J 2010 10;27(10):734-738.

Ten Eyck R,P., Tews M, Ballester JM. Improved medical student satisfaction and test performance with a simulation-based emergency medicine curriculum: a randomized controlled trial. Ann Emerg Med 2009 11;54(5):684-691.


Thank you to the RSUH Clinical Education Centre for allowing us use of their clinical rooms, to Dr Ruth Kinston for her support and advice in this project and to all the Final Year Medical Students for attending and giving us their valuable feedback.

Summary of Results
Summary of Work
Take-home Messages
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