Reflecting reality: pager simulations in undergraduate education.

BACKGROUND: Fifth-year medical students build on their experiences of simulation and clinical placement to undertake a period of pager contact, during which they must respond appropriately to a variety of 'bleep' messages, culminating in the team management of a complex scenario. CONTEXT: In anticipation of their graduation to foundation-year doctors, fifth-year students in their final term on clinical placement at Lancashire Teaching Hospitals experience a period of time on call, when they receive a series of pager messages that they must manage whilst on clinical placement. They are expected to manage the variety of random events as if they were doctors on call. INNOVATION: With the agreement of all affected parties, students experience some simulated events of the type that they may experience while on call as foundation-year doctors. They are required to respond appropriately to these and are offered feedback on performance after they gather for a cardiac arrest simulation. DISCUSSION: This has been a very popular and impactful experience for final-term undergraduates as they anticipate the challenges of becoming foundation-year doctors. The need for effective management of clinical and non-technical skills presented in an ill-defined problem space is an appropriate challenge that serves to reassure them about their capacity to manage the unexpected. [The students] are expected to manage the variety of random events as if they were doctors on call.