Are You PREPAREd? A Structured Approach to Support Safe and Confident Transitions to After-Hours Care

Background and Need for Innovation: Early after-hours work represents a demanding transition for newly graduated doctors. Preparation is often fragmented, with limited attention to the integrated clinical, organisational, and supervisory demands of after-hours care, contributing to uncertainty that may affect both patient safety and professional development.

Goal of Innovation: PREPARE (PREParing for After-hours caRE) is an eight-week programme designed to support new graduates during their early postgraduate transition by enabling safe and confident participation in after-hours care.

Steps Taken for Development and Implementation: PREPARE was developed through a research-informed, iterative design process. The programme integrates five interconnected components—familiarisation, workplace learning, structured teaching, guided reflection, and entrustment—within a coherent framework that runs parallel to routine clinical work. Rather than functioning as a fixed curriculum, PREPARE provides a flexible structure that aligns educational activities, workplace learning, reflection, and entrustment, while allowing adaptation to local service contexts.

Evaluation of Innovation: Formative evaluation throughout development and early implementation focused on perceived value, feasibility, and alignment with after-hours responsibilities. New graduates and supervisors reported increased confidence, improved preparedness for managing uncertainty, and enhanced understanding of interprofessional collaboration.

Critical Reflection on Our Process and Innovation: Reflection highlighted how PREPARE engages with real clinical complexity and exposes tensions between educational ambition and organisational feasibility. While the programme demonstrates how after-hours transitions can be more deliberately supported, its sustainability and transferability depend on organisational commitment and protected time for learning.