Experience‐based learning in undergraduate clinical placements: a step too soon?

Abstract

Editor We read with great interest the thoughts and opinions of Coakley et al1 in ‘ ‘Waiting in the wings’; Lived Experience at the Threshold of Clinical Practice’. We found their exploration of the transitional phase from medical student to doctor through the metaphor of an actor ‘Waiting in the wings’ highly compelling, and were particularly drawn to the solutions outlined by the authors to the problems encountered by the participants in the study, in particular the recommendation of a greater emphasis on experiencebased learning in undergraduate clinical training. As a recently appointed F1 doctor and a fourthyear medical student, we are uniquely placed to comment on this issue. Although we appreciate the problems caused by ‘transition shock’, as described, we do not agree with the proposed solution to this issue. As demonstrated in Atherley et al 2019,2 there already appears to be considerable apprehension amongst preclinical medical students regarding the transitional process to clinical training. Furthermore, we would argue that this lack of confidence in the clinical setting continues well into the penultimate and final years of medical school for many students. We believe the proposed solution to ‘transition shock’, by allowing senior medical students to ‘bear some of the burden’ of patient care in an incremental fashion, would only worsen the problems outlined by Atherley et al,2 and potentially lead to medical students feeling responsible in the event of poor patient outcome. Undergraduate clinical training commonly revolves around shadowing highly senior figures and individuals who perform highly specialist roles within the multidisciplinary team. We propose that the problem of ‘transition shock’ be eased by an increased emphasis on shadowing more junior figures within the team, allowing students to gain experience more directly applicable to the role they will be performing as newly appointed Foundation doctors.