An extended assistantship for final-year students.

Background: Many students feel unprepared for clinical practice after completing their medical school training. There is evidence that a brief shadowing period improves student confidence and patient safety, but there is currently little evidence on the impact of a longer shadowing period. A 10-week student assistantship (SA) for final-year students was implemented for Year 5 undergraduates at the University of Bristol in 2011. This study investigated the impact of the SA on student confidence.

Methods: All final-year medical students at the University of Bristol in the academic year 2012-13 (n = 248) were contacted with an online questionnaire at the start of the SA. They were asked about confidence in a range of domains. Further questionnaires were sent at the end of the SA, and again once the students had qualified as foundation doctors. Descriptive statistical analysis was performed. Many students feel unprepared for clinical practice

Results: A total of 37 students responded to the pre-assistantship questionnaire, 62 to the post-assistantship questionnaire, and 13 to the questionnaire sent once students had qualified. Self-assessed confidence improved in all areas when the pre- and post-assistantship scores were compared, in particular prescribing, assessing and managing unwell patients, and aspects of death and dying.

Discussion: Our findings suggest that a prolonged assistantship period improves knowledge and skills in a range of domains relevant to becoming a junior doctor, and could be considered within medical schools as a way to address established areas of poor confidence in new graduates. Larger studies are needed to provide more robust evidence for these initial findings.