Exploring the feasibility and acceptability of using tactical decision games to develop final year medical students’ non-technical skills

ABSTRACT

Introduction: Clinical decision-making, situation awareness, task management, and teamwork are key non-technical skills (NTS) required by junior doctors. Tactical decision games (TDGs) are low-fidelity classroom-based activities designed to develop proficiency in NTS. This study aimed to explore the feasibility and acceptability of using TDGs as a novel teaching method for final year medical students.

Methods: Final year medical students at the University of Edinburgh participated in a single TDG session. Focus groups were then used to explore students’ perceptions of participating in the TDG session and transcribed data from the focus groups was thematically analyzed.

Results: Six key themes emerged from the data: “the value of non-medical games”; “giving and receiving feedback”; “observing and reflecting”; “recognizing and understanding NTS”; “dealing with uncertainty and ambiguity”, and “introducing TDGs into the curriculum”.

Conclusions: TDGs are an easy-to-use, low-fidelity method of teaching medical students about the importance of NTS. Medical students view TDGs as a valuable learning activity that appears to increase awareness and understanding of the importance of NTS.

Glossary

Tactical decision game (TDG): “A simple role-play simulation technique that challenges participants to make decisions and communicate those decisions to others. A tactical decision game is an experiential learning method that has time and information constraints to put participants under some level of stress.” https://definedterm.com/tactical_decision_game

Non-technical skills (NTS): “The cognitive, social and personal resource skills that complement technical skills, and contribute to safe and efficient task performance.” (Flin et al. 2008).

Acknowledgements

The authors wish to thank the students who attended the TDGs and focus group sessions, Dr Catherine Collier for allowing use of the “Decision Making Activity” TDG and June Adamson, Effie Dearden and Vicky Tallentire for helpful comments on earlier drafts of the manuscript.

Disclosure statement

This work was supported by grants from the Clinical Skills Managed Educational Network and the University of Edinburgh Principal’s Teaching Award Scheme. They had no involvement in study design, data collection or analysis, or the preparation of this manuscript.

Notes on contributors

Iain Drummond, MBChB, MRCP (UK) AFHEA, is a fellow in medical education in the Centre for Medical Education, University of Edinburgh and a specialty registrar in nephrology and general internal medicine.

Gauhar Sheikh, is a fourth year medical student at the University of Edinburgh with an interest in medical education.

Janet Skinner, MBChB, FRCS, FCEM, is Director of Clinical Skills at the University of Edinburgh and a consultant in emergency medicine at the Royal Infirmary of Edinburgh.

Morwenna Wood, MA, MBBS, FRCP, is Director of Medical Education, NHS Fife and a consultant in nephrology at Victoria Hospital Kirkcaldy.