A survey evaluating foundation year 2 doctors’ views on medicine reconciliation before and after a simulation-based training intervention

Abstract Introduction Prescribing errors are prevalent amongst Foundation grade doctors, particularly during hospital admissions.[1] Medicines reconciliation therefore is critical in minimising such errors, and yet doctors have reported a lack of preparedness for this task. A training session incorporating simulation-based training (SBT) was designed and delivered to Foundation year 2 (FY2) doctors to support their medicines reconciliation practice.[2] Aim To explore FY2 doctors’ views on medicines reconciliation and to evaluate the SBT. Method A multidisciplinary team developed a new SBT programme that incorporated an admissions scenario with ‘high risk’ medications, error provoking conditions and non-technical challenges. Eighty-six FY2s attended the training over eight sessions. One doctor completed the scenario with others observing via live stream. Each scenario was followed by a debrief and interactive presentation, facilitated by a clinical education pharmacist. FY2 doctors were purposively recruited if they attended the training and were invited to complete a self-administered anonymous survey before and after the session. The pre-survey used a five-point Likert scale (strongly disagree to strongly agree) to assess awareness, views, and confidence in medicines reconciliation. This was repeated post-session, with additional open-ended questions exploring views of the SBT. Survey data were analysed descriptively in Excel using frequencies and percentages for agreement scores. Mann–Whitney U tests were used to compare pre- and post-session agreement scores. A significance level of p < 0.05 was applied. Open ended responses were analysed thematically for common themes. Results There was a 91% response rate (n = 78/86) to the pre-post session survey evaluation. Pre-session, 17% (n = 14/78) of participants agreed that it was the doctor’s role to complete a medicines reconciliation, increasing to 73% (n = 57/78) post-session (p < 0.05). Pre-session, participants reported strong agreement on familiarity with medicines reconciliation (50%, n = 39/78), its value in patient safety (82%, n = 64/78), and awareness of associated risks (38%, n = 30/78). There was a significant improvement post-session for familiarity with medicines reconciliation (86%, n = 67/78, p < 0.05), and awareness of associated risks (81%, n = 63/78, p < 0.05) with non-significant improvement in other areas. Self-rated confidence significantly increased post-session for performing medicines reconciliation (+57%, p < 0.05) and accurate documentation (+29%, p < 0.05). Most participants agreed/strongly agreed that the session was relevant (95%, n = 74/78), applicable (94%, n = 73/78), and beneficial to patient care (94%, n = 73/78). Open-ended responses suggested the SBT was useful, whilst several FY2s suggested the session would have been more impactful in Foundation Year 1. The SBT was valued, with 82% (n = 64/78) agreeing that it was a suitable modality. Open-ended feedback suggested the training was engaging, although some felt the individual SBT participation was limiting for others, and suggested more hands-on tasks for the observers. Conclusion SBT is a realistic environment for medicines reconciliation education, offering practical insights with potential to reduce reconciliation errors. However, its impact on reconciliation quality remains unclear. Many FY2 doctors still view medicines reconciliation as a pharmacist’s role, possibly reflecting traditional professional roles and highlighting the need to shift these perceptions towards a shared responsibility. This single-site study requires further research to broaden understanding of the views across different clinical grades and settings.