´Night Shift´: A Task Simulation to Improve On-Call Prioritisation, Self-Management, Communication, and Route Planning Skills

75% of the year is outside of the traditional working hours of 9am to 5pm, Monday to Friday. During this "out-of-hours" work, small teams of junior doctors in hospitals face significant challenges yet lack support. There is therefore an increased likelihood of adverse incidents during out-of-hours periods, and doctors report being particularly ill-prepared for non-technical aspects of the role such as task prioritization. We developed a task simulation similar to a serious video game to assist the training of junior doctors in non-technical skills during out-of-hours work. We undertook a small-scale pilot randomised trial of the intervention amongst junior doctors in their first weeks of work at a large teaching hospital in the UK. We obtained excellent data on actual on-call activity from existing task flow systems. Participants in the intervention group completed their non-urgent tasks significantly faster than those in the control group. There was no difference in the time taken to complete urgent tasks between the control and intervention groups. There is a need for training in non-technical skills for junior doctors. Simulations could have a key role to play in this and related training areas. This study shows the potential of newer technologies to record outcomes relating to staff activity and illustrated the large multidisciplinary team required to undertake such an endeavour. Opportunities for further development have been identified around adapting the task simulation into other hospital environments, and increasing the simulation complexity to develop other non-technical and technical skills within users.