Preparing medical students for clinical decision making: a pilot study exploring how students make decisions and the perceived impact of a clinical decision making teaching intervention.

BACKGROUND: Junior doctors are frequently faced with making difficult clinical decisions and previous studies have shown that they are unprepared for some aspects of clinical decision making. AIM: To explore medical students' feelings and strategies when responsible for making clinical decisions and to obtain students' views of the effectiveness of a clinical decision making teaching intervention.
METHODS: A teaching intervention was developed, consisting of a clinical decision making tool, a tutorial and scenarios within a simulated ward environment. A total of 23 volunteer students participated in individual interviews immediately after their simulator sessions. The qualitative data from the interviews were analysed to identify emerging themes.
RESULTS: Despite extended shadowing programmes, students feel unprepared for clinical decision making as FY1s, and lack effective decision making strategies. Experiencing complex decision making scenarios through individually orientated simulation results in students being subjectively more prepared for work as FY1s.
CONCLUSION: Students continue to feel unprepared for the responsibility of clinical decision making. A teaching intervention, including simulated individual clinical scenarios, later in undergraduate training, appeared to be useful in improving medical students' decision making, specifically in relation to making a diagnosis, prioritising, asking for help and multi-tasking, but further work is required.