“Not the bleep!”; a novel tabletop approach to on-call simulation

Abstract Background On-call simulation has been used as an effective means to address feelings of under-preparedness amongst new doctors transitioning into clinical practice. Traditional “bleep” simulations are delivered in-situ, in the clinical environment using dedicated pager devices. However, these simulations are often limited by a high facilitator burden and resistance from perceived disruption of clinical environments. Tabletop alternatives to in-situ modalities offer solutions to scalability issues, particularly in the context of large cohorts requiring training. Subsequently, we present an evaluation of a tabletop on-call simulation ‘Not the Bleep!’ . Method A learning needs assessment and stakeholder consultation was conducted in September 2023. The results of this informed the design of a tabletop simulation which was delivered at the annual Foundation Year One trust induction. The simulation was evaluated using self-reported metrics, session feedback, facilitator debriefs and a follow-up learning needs assessment in September 2024. Results Eighty-six individuals participated in the tabletop simulation, with 61 candidates completing the evaluative feedback. Self-reported confidence scores improved from 3.9 prior to delivery to 6.4 following delivery of the simulation. Satisfaction with the induction process following implementation of the simulation improved from 3.83 to 6.08. Facilitators remarked on the strength of near-peer debriefing and praised the realism of tasks presented during the simulation which had been derived from the stakeholder consultation. Conclusions ‘Not the Bleep!’ is an effective tabletop alternative or adjunct to in-situ pager-based on-call simulation. It provides the key advantages of real-time near-peer debriefing combined with high throughput and also has comparatively low facilitator to participant ratios. Further research should look at direct comparisons between tabletop and in-situ methodologies as well as expansion into interprofessional education with members of the multidisciplinary team.