St Emlyn’s Lesson Plans
Starting your emergency medicine placement
Learn how to contribute safely, seek help early and turn ordinary ED work into supervised learning.
Medical Students · 45-minute session
For learners
Before: Allow about 13 minutes in total. With the reading alternative: about 13 minutes.
When we meet: We will rehearse introducing yourself, calling for help, agreeing supervision and handing over unfinished work at the end of a shift.
For facilitators
Send: the learner preparation link before teaching.
Bring: Local map, emergency-call information and an optional supervised walk round.
Before the session
If you are attending this session, complete the core preparation below before you come. Allow about 13 minutes in total. With the reading alternative: about 13 minutes.
Core preparation
Core listening · 4 min 59 sec
St Emlyn’s Podcast: Ep 96 - Everybody's free - Top Tips for the Class of 2017
Introductions, help-seeking and teamwork on a first emergency department placement.
Search for this episode by title in MedPod Learn if you want to record your listening there.
Prefer to read? Use GMC: carrying out procedures as a student instead of listening. Allow about 5 minutes.
Read the “Carrying out procedures” scenario and its feedback. Focus on identifying yourself as a student, consent, experience and supervision.
https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/student-professionalism-and-ftp/working-on-the-ward
Listen to this 2017 reflection on starting in emergency medicine. Apply its practical advice to the student role, with appropriate training, permission and supervision. Read the separate patient-safety resource too.
https://www.stemlynspodcast.org/e/everybodys-free-top-tips-for-the-class-of-2017/
Read before the session
GMC student placement patient safety · About 5 minutes
Read the patient-safety page, focusing on consent for student involvement, supervision and who retains responsibility for care.
https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/undergraduate-clinical-placements/guidance-on-undergraduate-clinical-placements/patient-safety
Prepare (allow 3 minutes): Write a short introduction that identifies you as a medical student and asks permission to take a history. Add one sentence you could use to ask for supervision with an unfamiliar task.
Think about: Who would you contact, and what would you say, if a patient became less responsive while you were taking a history?
Picture the scene
Tomorrow is your first emergency-department shift as a medical student. You know how to take a history, but not who to ask, where patients go or what to do when someone becomes unwell.
By the end of the session
- Identify the supervisor, emergency-call route and limits of the student role.
- Present a concise assessment that includes the patient’s concern and the help needed.
- Agree a manageable learning plan and follow patients through reassessment.
After the session
- Choose one skill for your first shift and identify who can observe it; at the end, ask what you should try differently next time.
Facilitator guide
Send learners the preparation link several days before teaching. Allow about 13 minutes in total. With the reading alternative: about 13 minutes.
Before learners arrive
- Prepare a simple local map and a named supervision/escalation plan for today.
- Check access to records, student documentation rules, chaperones, procedures, breaks, support and how feedback is arranged.
Equipment: Local map, emergency-call information and an optional supervised walk round.
Setup: Seat the group with a nurse or other team member if feasible. Invite questions about the department before clinical knowledge questions.
If the preparation has not been completed
Use this instead of the first five-minute “Explore” opening. Display a simple local map and the emergency-call information. Spend two minutes collecting practical questions, two identifying the supervisor and urgent-help route, and one rehearsing a student introduction. Then use the scheduled “Establish the essentials” slot to clarify local permissions before case 1.
Suggested session plan
- 0–5 min — Explore. Collect practical uncertainties without asking learners to reveal private anxieties.
- 5–10 min — Establish the essentials. Explain the local roles and emergency call.
- 10–32 min — Discuss & Apply. Spend 12 minutes on role/urgent help and 10 on supervision/handover.
- 32–40 min — Consolidate. Ask learners to introduce themselves to a patient, show how to call for help and hand over an outstanding result.
- 40–45 min — Reflect & Transfer. Help each learner choose one task for their first shift and identify someone who can observe it and give feedback.
Start the discussion
Read the opening scenario together. Give everyone a moment to think, then ask what concerns them and what they need to know next.
Cases and discussion
Use these cases, or invite an anonymised case from the group that addresses the same questions.
Your first patient
The clinician supervising you suggests speaking to a patient with abdominal pain. The patient assumes you are their doctor and asks whether they can eat and go home.
Add this information as the discussion develops:
- The patient consents to you taking a history after you clarify your role.
- While speaking, you notice the patient looks pale and becomes less responsive.
Ask the group:
- How will you introduce yourself and seek permission?
- Which questions can you answer and which need the supervising clinician?
- How do you summon help and remain useful when the patient deteriorates?
Discussion notes
Points to draw out:
- Identify yourself as a medical student, check that the patient is comfortable with your involvement and respect a refusal.
- Agree the task and supervision before starting. Students should not give independent treatment or discharge decisions beyond their role.
- If concerned, stop the routine history, call urgently for help and communicate the change; do not spend several minutes completing a polished differential first.
- Within training and direction, help with observations, obtaining equipment or a concise handover. State clearly what you have and have not done.
Common misconceptions:
- Letting a patient’s mistaken assumption about your role stand.
- Treating a student assessment as a replacement for the responsible clinician’s review.
- Waiting to be certain of the diagnosis before raising concern.
For a more experienced group: Ask how local emergency activation differs between the waiting area, cubicles and resus.
A useful end to a busy shift
You have seen several patients but nobody has given formal feedback. A team member asks you to perform an unfamiliar procedure, and you are nearing the end of your shift.
Add this information as the discussion develops:
- You have practised the procedure in skills teaching but have not done it on a patient.
- A patient you assessed has been referred elsewhere and a test result is still outstanding.
Ask the group:
- How do you ask for the right supervision without apologising for being a learner?
- What needs handing over before you leave?
- How could you obtain one specific piece of feedback?
Discussion notes
Points to draw out:
- State your experience honestly and ask for appropriate supervision; simulation practice alone does not establish independent competence.
- Confirm who is responsible for the patient and outstanding results. Never assume an educational handover transfers clinical responsibility automatically.
- Ask for feedback on one observed task, such as your opening history or handover, and arrange a chance to practise again.
- Take breaks, seek support after distressing encounters and agree how to leave safely; learning benefits from sustainable participation.
Common misconceptions:
- Performing a procedure beyond competence to appear helpful.
- Keeping identifiable patient details in personal learning notes.
- Measuring a successful placement only by the number of patients seen.
For a more experienced group: Discuss how to raise a concern respectfully if a team member’s request appears unsafe.
Important clinical points
- Students must identify their role and work within agreed supervision.
- Obtain permission for student involvement; a patient may decline.
- Oxygen, fluids, analgesia and antibiotics each need an indication; they are not a routine package for every patient.
Closing the session
Use these questions to check what the group will take away. Go back over any clinical points that remain unclear.
- Show how you would call for urgent help in this department.
- Introduce yourself to a patient and explain the proposed task.
- Give a handover that names the responsible clinician and outstanding action.
Key teaching points:
- Explain your student role and obtain permission for your involvement.
- Call for help promptly and describe the change that concerns you.
- Follow the patient’s assessment and response beyond the first history.
- Agree supervision and responsibilities with the team.
Before leaving, ask each person to choose one action from After the session and say when they will try it. They complete that follow-up in practice, with supervision where needed.
Adapting the discussion
Uncertainty and local practice
Student permissions vary by placement and training stage. Clarify the local supervision arrangements during the session.
If the discussion drifts
Who is responsible, what is your agreed task, and what help do you need?
For a more experienced group
For returning students, choose a supervised task with a concrete observation and feedback goal.
A 30-minute version
30 minutes: welcome 5, local orientation 7, cases 10, consolidation 5, reflection 3. Arrange a department walk separately.
Evidence and guidance
- GMC undergraduate placement patient safety — Consent, supervision and responsibility.https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/undergraduate-clinical-placements/guidance-on-undergraduate-clinical-placements/patient-safety
- GMC student scenarios — Practical role and supervision examples.https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/student-professionalism-and-ftp/working-on-the-ward
Suggested curriculum links
GMC Outcomes for graduates / MLA 2026: Professional practice; teamwork, supervision and patient safety
An orientation session supports these behaviours but does not certify them.
Check these links against the learner’s stage and programme. Attendance at a teaching session does not establish competence.
Clinical review: awaiting clinician sign-off
The references have been checked during editing. A named clinician has not yet signed off the revised lesson collection. Use current local guidance when preparing to teach; editorial updates do not constitute clinical approval.
First published 2020-09-22 · Iain Beardsell.