Gersten Jonker

108   Chapter 5 in one of the five acute care specialties. This trainee acts as a buddy, provides‘mentoring on demand’, supports the acculturation to the specialty, gives career advice, and helps to validate the student's choice for this direction. We have reported before on early experiences with the program [24] and on experiences with the simulations [25]. The current study aims to evaluate to which degree ACTY’s graduates meet postgraduate expectations of junior doctors to provide acute care, as an indication of enhanced learning and preparation for clinical practice. Design We collected pre-test and post-test data from ACTY students and participants in two comparison groups in a quasi-experimental design. Recruitment All students who commenced the ACTY from September 2015 onwards (small cohorts could start every six weeks) were eligible to participate in the study. We aimed to obtain post-test results from 25 ACTY participants. To value ACTY test results we included two comparison groups. The first group consisted of UMC Utrecht students who did not take part in the ACTY track and composed an individual transitional year program. To match these participants for motivation and affinity with acute care, we invited students who had chosen at least one sub-internship inanesthesia, cardiology, emergencymedicine, intensive caremedicine, or pulmonology for participation in the pre-test and post-test by email. Despite sending reminders, we experienced difficulty in recruiting student controls at the start of the transitional year. We figured that graduating students might be interested to obtain insight in their level of acute care competence and late 2017 we decided to recruit similarly matched non- ACTY medical students around graduation for a single post-test comparison. A second comparison group contained recently graduated, junior doctors currently employed as physicians, not yet in a residency (PNITs). We recruited PNITs with three to nine months of clinical experience in ACTY specialties, by asking regional hospital departments and educationalists to distribute recruitment emails and reminders. Participating PNITs had not graduated from the ACTY. Procedure Participants took part in the comprehensive multimodal assessment of acute care knowledge, clinical reasoning, clinical skills, and performance in high-fidelity simulated situations. Table 1 provides an overview of the assessment modalities (further details