SP2.2.8Teams, performance, and trust: a perspective from the vanguard

Abstract Aims The aim of this study was to determine surgical trainees’ perspective regarding team environment, function, performance, and trust. Methods A 44-point, anonymous survey was distributed to all doctors working in surgery in a single UK Statutory Education Body with responses received from 116 (n = 17 Foundation Year 1 (FY1), n = 50 Senior House Officer (SHO), n = 49 Specialist Registrar (SpR)). Results Psychological safety was associated with trainee grade; SHO perception of support (60.4%, n = 29), FY1 (88.2%, n = 15), SpR (82.4%, n = 42), p = 0.016; and ability to ask for help: SHO (70.8%, n = 34), FY1 (100.0%, n = 17), SpR (92.2%, n = 47 p = 0.043). Dependability among colleagues was perceived to be poorer by women (69.8%, n = 30) than men (87.5%, n = 63, p = 0.009). Clarity of team structure was associated with grade and perceived to be poor by SHOs (60.4%, n = 29) vs. FY1 (94.1%, n = 16) vs. SpR (78.4%, n = 40), p = 0.014. Meaningfulness and impact of team achievement was associated with grade: SHO (68.8%, n = 33) vs. FY1 (76.5%, n = 13) vs. SpR (94.1%, n = 48), p = 0.005. Inverse correlations were observed between the prevalence of harassment/bullying and markers of psychological safety (rho -0.382, p < 0.001), dependability (rho -0.270, p = 0.003), and clarity of team structure (rho -0.355, p < 0.001). Conclusion Important deficiencies in psychological safety impacted two in five of SHOs adversely. Countermeasures (Enhanced Surgical Resilience Training) are needed to protect morale, patient safety, and clinical outcomes.

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Teams, performance and trust: a perspective from the vanguard

Bulletin of The Royal College of Surgeons of England ◽

10.1308/rcsbull.2021.73 ◽

2021 ◽

Vol 103 (4) ◽

pp. 186-191

Author(s):

OP James ◽

CR Bowman ◽

J Parker ◽

O Luton ◽

DBT Robinson ◽

...

Keyword(s):

Adverse Effect ◽

Patient Safety ◽

Psychological Safety ◽

Stress Resilience ◽

Team Structure ◽

Surgical Trainees ◽

Team Environment ◽

Resilience Training ◽

Perception Of Support

Introduction The aim of this study was to determine surgical trainees’ perspectives on team environment, function, performance and trust. Methods A 44-point anonymous survey was distributed to all doctors working in surgery in a single UK statutory education body. Responses were received from 116 doctors (17 foundation year 1 [F1] doctors, 50 senior house officers [SHOs], 49 specialist registrars [SpRs]). Results Psychological safety was associated with trainee grade, with SHOs showing the lowest results relating to perception of support (F1 88%, SHO 60%, SpR 82%, p=0.016) and ability to ask for help (F1 100%, SHO 71%, SpR 92%, p=0.043). Dependability among colleagues was perceived to be poorer by women than by men (70% vs 88%, p=0.009). Clarity of team structure was associated with grade and perceived to be poor by SHOs (F1 94%, SHO 60%, SpR 78%, p=0.014). Meaningfulness and impact of team achievement was also associated with grade (F1 77%, SHO 69%, SpR 94%, p=0.005). Inverse correlations were observed between the prevalence of harassment/bullying and markers of psychological safety (rs=-0.382, p<0.001), dependability (rs=-0.270, p=0.003) and clarity of team structure (rs=0.355, p<0.001). Conclusions Important deficiencies in psychological safety had an adverse effect on two in five SHOs. Countermeasures (enhanced stress resilience training) are needed to protect morale, patient safety and clinical out

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The changing role of the otolaryngology Senior House Officer

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363506x78992 ◽

2006 ◽

Vol 88 (2) ◽

pp. 66-68 ◽

Cited By ~ 1

Author(s):

AK Arya ◽

KP Gibbin

Keyword(s):

Patient Safety ◽

Junior Doctor ◽

House Officer ◽

European Working Time Directive ◽

Junior Doctors ◽

Senior House Officer ◽

European Working ◽

Working Time Directive ◽

Changing Role

The European Working Time Directive (EWTD) has led to a reduction in the number of hours that a junior doctor is allowed to work. The Hospital at Night project aims to reduce juniors' presence at night through more efficient working. Otolaryngology has been considered to be one of the surgical specialties in which generic junior doctors covering more than one specialty could effectively function. The hope is to reduce junior doctors' hours sufficiently without compromising their training or patient safety.

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Factors that inform the career choice of medical students: implications for otolaryngology

The Journal of Laryngology & Otology ◽

10.1258/00222150260293673 ◽

2002 ◽

Vol 116 (10) ◽

pp. 839-841 ◽

Cited By ~ 15

Author(s):

M. Ranta ◽

S. S. M. Hussain ◽

Q. Gardiner

Keyword(s):

Medical Students ◽

Career Choice ◽

Role Models ◽

House Officer ◽

Career Progression ◽

Senior House Officer ◽

Specialist Registrar ◽

Training Programmes ◽

Medical Specialities

Knowledge of the factors that inform the career choice of medical students may help plan the workforce for medical specialities. To determine which factors inform the career choice of medical students we carried out a survey of medical students at the start of their educational block in Otolaryngology. Of 202 questionnaires handed out 169 were returned (84 per cent). Students were asked to rank factors according to their importance in their career choice. The single most important factor was career progression. Other factors include on-call commitment, teachers as role models, and the interest for a particular subject. At the present time progression from senior house officer grade to specialist registrar grade in Otolaryngology is delayed. If this issue is not addressed the influx of applicants into Otolaryngology training programmes will be reduced, limiting the pool from which candidates can be chosen for a career in Otolaryngology.

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What does it take to become a specialist registrar in clinical radiology? How long will it take to become a specialist registrar after working in the senior house officer grade?

BMJ ◽

10.1136/bmj.331.7527.s226 ◽

2005 ◽

Vol 331 (7527) ◽

pp. s226.1-s226

Author(s):

John Frank

Keyword(s):

House Officer ◽

Senior House Officer ◽

Specialist Registrar ◽

Clinical Radiology

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I have recently been appointed as a first year specialist registrar. I was on the maximum pay scale for senior house officer level. Now my basic pay has been reduced by nearly £8000. Is this fair? My understanding was that my basic pay cannot be reduced as I have put in a number of years of service with the NHS.

BMJ ◽

10.1136/bmj.334.7595.s114 ◽

2007 ◽

Vol 334 (7595) ◽

pp. s114.1-s114

Author(s):

Rachel L Hooke

Keyword(s):

House Officer ◽

First Year ◽

Senior House Officer ◽

Specialist Registrar ◽

Years Of Service

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Psychiatric secrets of success: who wants to be a specialist registrar?

Psychiatric Bulletin ◽

10.1192/pb.28.11.421 ◽

2004 ◽

Vol 28 (11) ◽

pp. 421-424 ◽

Cited By ~ 2

Author(s):

Asim Naeem

Keyword(s):

House Officer ◽

Senior House Officer ◽

Specialist Training ◽

Current Structure ◽

Specialist Registrar ◽

Training Programmes

This paper aims to help trainees successfully negotiate the important ‘step up’ from senior house officer or equivalent grade to specialist registrar. It outlines the current structure of higher specialist training programmes in psychiatry, stresses the importance of early planning during basic specialist training and provides a guide to success in the shortlisting and interview stages.

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How to pass the MRCPsych examination

Psychiatric Bulletin ◽

10.1192/pb.23.3.172 ◽

1999 ◽

Vol 23 (3) ◽

pp. 172-176

Author(s):

I. Cormac ◽

G. Marston

Keyword(s):

Royal College ◽

Professional Training ◽

House Officer ◽

Senior House Officer ◽

Basic Training ◽

Critical Factors ◽

Specialist Registrar ◽

Training Specialist ◽

First Time ◽

Large Investment

Membership of the Royal College of Psychiatrists is the main qualification needed to progress from the basic training grade (senior house officer) to higher professional training (specialist registrar) in psychiatry. The Collegiate Trainees Committee (CTC) recognises that the MRCPsych examinations may generate anxiety in candidates and require a large investment in time and personal resources. The examinations are competitive, with approximately 50% of candidates passing on each attempt. It is worthwhile preparing well the first time, by planning in advance and understanding the critical factors for success. This article aims to help trainees preparing for the MRCPsych examination.

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What is the Role of Senior House Officer or Dental Foundation Year Two Posts in Professional Careers?

Primary Dental Care ◽

10.1308/135576110791654937 ◽

2010 ◽

Vol os17 (3) ◽

pp. 115-122 ◽

Cited By ~ 4

Author(s):

Jennifer E Gallagher ◽

Timothy J Bates ◽

Harpoonam Kalsi ◽

Aneesha Shah ◽

Yon Jon Wang ◽

...

Keyword(s):

Dental Service ◽

House Officer ◽

Senior House Officer ◽

Perceived Benefits ◽

Cross Sectional ◽

Professional Careers ◽

Training Post ◽

Question Difficulty ◽

Motivating Factor

Aims To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts. Method Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents’ entry to their first SHO post. Results There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to ‘learn from experienced clinicians’. The most common perceived benefit reported by those who had completed posts at the time of the survey was ‘an improved understanding of the role of the hospital dental service’ from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. ‘Fulfil approved training post requirements for postgraduate examinations’ reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last ( P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females ( P=0.028). Conclusion The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

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