Abstract
BACKGROUND: In the United Kingdom (UK), newly qualified doctors are routinely responsible for out-of-hours (OOH) care, often managing acutely unwell patients with limited supervision. Despite national recommendations encouraging OOH experience during medical school training, there is no formal curriculum for OOH practice. OBJECTIVES: This scoping review aimed to identify the range of educational interventions designed to prepare UK medical students for OOH clinical responsibilities and assess their reported effects on perceived and actual preparedness. METHODS: Following Joanna Briggs Institute methodology, a systematic search of seven databases and grey literature sources was conducted. Eligible studies involved UK-based medical students and reported empirical outcomes on educational interventions focused on OOH preparedness. Data were extracted and synthesised using the Template for Intervention Description and Replication checklist and Kirkpatrick's evaluation hierarchy. RESULTS: Eighteen studies were included, primarily using quasi-experimental designs of simulation-based teaching. Interventions targeted a wide range of competencies, including prioritisation, communication, clinical decision-making, and leadership. Thirteen studies demonstrated improvements in learner confidence or attitudes (Kirkpatrick Level 2a), while only three showed measurable performance improvement (Level 2b), and one demonstrated behavioural change (Level 3). Most lacked long-term follow-up. Grey literature analysis revealed inconsistent institutional expectations for OOH experience. CONCLUSIONS: Educational interventions on OOH are well-received and enhance perceived preparedness. Current interventions often lack objective assessment and long-term evaluation. This review was limited to published sources and may not reflect all current practice. Nationally standardised, longitudinal curricula supported by robust evaluation strategies are needed to improve graduate preparedness for OOH practice.