But does it work with real patients? Caution needed in Health Education England’s prioritisation of simulation-based training of new doctors

Kamau-Mitchell, Caroline (2025) But does it work with real patients? Caution needed in Health Education England’s prioritisation of simulation-based training of new doctors. Occupational Psychology Outlook 4 (1), ISSN 2753-426X.

Abstract

The United Kingdom’s Health Education England (HEE) oversees training of new doctors, and it prioritises simulation-based training, but it is unclear whether such training prepares new doctors for clinical procedures involving real patients. To investigate that, this article’s aim was to discuss experiments in the field, noting that a review by HEE missed at least eight studies, and misinterpreted two studies as showing positive outcomes when the results were negative or inconclusive. Occupational psychologists who work in staff development in hospitals should therefore be cautious about the HEE’s review by reading the original studies themselves. This article discusses why the HEE should evaluate the impact of simulation-based training on patient outcomes, and why it should review studies which test causality (e.g., randomised-controlled trials). Looking back at Kirkpatrick’s model about how to evaluate training interventions, occupational psychologists should go beyond the reaction stage (e.g., are doctors enjoying the training?) to the behaviour stage (e.g., does it help them complete clinical procedures with patients?) and the results stage (e.g., does it reduce excess patient deaths in July or August when new doctors start work in hospitals?). Some experiments found that simulation-based training can worsen performance by increasing the duration of clinical procedures, the number of attempts to success and new doctors missing vital steps. Many of the methods are still used today (e.g., in endoscopy, laparoscopy), therefore their efficacy remains questionable. When presented with newer technology such as virtual reality-based training, occupational psychologists should still ask questions about their efficacy and encourage the hospitals to supplement simulation-based training of new doctors with good quality/quantity of clinical supervision and job shadowing.

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