Inside the High-Stakes World of A&E... Without Leaving the Classroom

Future doctors experience a chaotic ward in a major simulation event.

The Accident and Emergency department is in chaos. There's been a major road traffic pile-up. Patients are flooding in with life-threatening injuries, alarms are sounding on the monitors, and doctors are forced to make split-second decisions that could mean life or death and some of the patients, sadly, won't make it through the night.

Thankfully, this isn't real.

It's a high-pressure simulation inside a state-of-the-art teaching suite at the University of Worcester's Three Counties Medical School, and for the students taking part, it's as close to reality as training gets.

"The idea was that we just create chaos," said Dan Eccles, Vice Chair of the Emergency Medicine Society and the student behind the event. "In real life, you don't get four doctors to one patient, you get one doctor to four or five, and you have to make decisions under pressure. That's what we wanted to replicate."

The simulation was based on a major road traffic accident, with ten seriously injured patients and a waiting room full of patients with differing degrees of non-urgent injuries.

Students rotated roles, from being doctors, to patients, even receptionists, while the facilitators dialled up the pressure with unexpected complications.

"We wanted that sweet spot," said Daniel. "If it's too easy, we're comfortable, but we didn't want it to be so hard that we break down. We wanted to achieve somewhere in the middle, where you feel the stress and have to think fast because that's what real A&E is like."

The experience was eye opening for some of the students who were first years and had only been on their course for a couple of months. The goal wasn't to test advanced medical knowledge, but to teach them the basics of supporting patients under pressure.

Daniel had suggested the idea to staff at the Three Counties Medical School who supported him in creating a programme which would test the students and develop their skills.

Daniel said: "I told everyone before we started that I wanted them to feel that pressure. When you're in a real emergency department, you can't hide. You have to make decisions quickly and that's what'll make us good doctors."

After each run through, the students would stop and change roles so everyone got the chance to be a doctor. They also spent time reflecting on their performance and speaking about what had happened with their peers and the facilitators.

While the event was fun and immersive, its real value lay in the skills and confidence the students were developing. For many, especially the new first-years, this was their first taste of the unpredictable reality of emergency medicine.

The event was such a success that Daniel is already planning the next one; an even bigger scenario covering more teams and disciplines.

"Doctors can't run the NHS on their own," he said. "Every role matters, from porters to nurses, to paramedics, to doctors, to consultants, everyone is important. For the next one we want to include as many cogs of the NHS as we can to bring together, a huge trauma event where we immerse ourselves in that realistic chaos."

While all medical schools run simulations, including the Three Counties Medical School where they're supported by faculty with joint clinical and Accident and Emergency Roles, they're usually faculty-led.

This scenario was a truly student-led innovation, making it a safer experience for students who didn't feel they were being 'assessed'; they were free to test themselves and support one another.

The event gave Daniel and his peers hands-on experience of leadership and organisational skills. He had an idea for bringing a big scenario to life and was given the opportunity to see it through.

"It was a huge success, and I was over the moon to see my peers getting into their roles; I've had people coming to me already asking when the next one will be!"

Click here for more information on courses at the Three Counties Medical School.