Stepping into the role of a doctor: an instrumental case study to explore the experiences of third-year medical students in a simulated general practice clinic.

Simulation provides an environment in which students can work beyond their competence. Thus even junior medical students can 'step into the role of a doctor'; to explore and gain more insight into their future role. Role-playing as doctor in a simulated environment has shown to be of value for final-year students, but this has not been studied with third-year students, who may struggle to be active participants in the clinical environment. This research used instrumental case study methodology to explore the educational value of third-year students 'stepping into' the doctor-role in a General Practice clinic simulation. Data was gathered via twenty-four interviews with students and tutors, observations and an online student survey. The value of stepping into the role of doctor centered around the experience of responsibility and was associated with feelings of agency; thinking differently with more focus on management and decision-making; insight into, and preparation for, the role of a practitioner, including working with uncertainty. Most students took part in the exercise of adopting the 'doctor' role; student buy-in was dependent upon explicit discussion of the challenge, feelings of authenticity and negotiation of concerns. GP tutors facilitating the clinic played a key role in establishing psychological safety and negotiating student concerns. Stepping into the role of doctor is a valuable exercise for junior medical students as it can provide an authentic experience of clinical responsibility that is not available in the clinical setting; and presents an opportunity to deepen student understanding of the practitioner role.