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Medical students are expected to know how to function on hospital wards; i.e. where to find things, other Health Care Professionals’ (HCPs’) roles, and how to use certain items of equipment (GMC, 2018). This ward-based knowledge indicates that a student is ‘ward smart’.1 Whilst being ‘ward smart’ is key for many aspects of medicine, it is particularly important for students learning geriatric medicine: older patients (who make up around 42% of all inpatients)2 are more likely to have communication difficulties and to require assistance. However, formal teaching in this area seems to be somewhat neglected, with students being left to ‘pick up’ this knowledge as they go along.3,4 In our sample of 41 students in their penultimate year (most of whom were undertaking their Healthcare of Older People placement), 98% did not know how to turn on a hearing aid and only 24% knew what a Waterlow score was. Furthermore, 88% did not know how to read an oxygen flowmeter, and only 59% knew where the CPR lever on the bed was situated. This is a significant gap in knowledge: Students may not be as prepared to work in a ward environment as expected. Students felt that their understanding would be improved by teaching sessions, more time on wards, formal ward inductions, and shadowing other HCPs: only 41.5% had had a ward induction or introduction, and less than 20% had shadowed a nurse. We propose specific teaching/practical sessions for students during their Healthcare of Older People placement centred around patient communication and understanding the ward environment. References 1. Walker, Wallace, Mangera, &amp; Gill, The Clinical Teacher, 2017, 14(5), 336–9. 2. NHS Digital, 2018. 3. Prince, Bozhuizen, Van der Vleuten, &amp; Scherpbier, Medical Education 2005; 39(7):704–12. 4. Monrouxe, et al., BMJ Open 2017; 7(1):e013656.

age and ageing

79 Do Medical Students Understand the Ward Environment? A Survey of Penultimate Year Medical Students Exploring How Well Healthcare Of Older People Placements Prepare Them for Working on Hospital Wards