scholarly journals Understanding the healthcare workplace learning culture through safety and dignity narratives: a UK qualitative study of multiple stakeholders’ perspectives

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025615
Author(s):  
Sarah Sholl ◽  
Grit Scheffler ◽  
Lynn V Monrouxe ◽  
Charlotte Rees
Keyword(s):  
Workplace Learning ◽  
General Medical Council ◽  
Learning Culture ◽  
Medical Council ◽  
Framework Analysis ◽  
Multiple Stakeholders ◽  
Allied Health Professionals ◽  
Healthcare Students ◽  
Qualitative Interview Study ◽  
National Training

ObjectivesWhile studies at the undergraduate level have begun to explore healthcare students’ safety and dignity dilemmas, none have explored such dilemmas with multiple stakeholders at the postgraduate level. The current study therefore explores the patient and staff safety and dignity narratives of multiple stakeholders to better understand the healthcare workplace learning culture.DesignA qualitative interview study using narrative interviewing.SettingTwo sites in the UK ranked near the top and bottom for raising concerns according to the 2013 General Medical Council National Training Survey.ParticipantsUsing maximum variation sampling, 39 participants were recruited representing four different groups (10 public representatives, 10 medical trainees, 8 medical trainers and 11 nurses and allied health professionals) across the two sites.MethodsWe conducted 1 group and 35 individual semistructured interviews. Data collection was completed in 2015. Framework analysis was conducted to identify themes. Theme similarities and differences across the two sites and four groups were established.ResultsWe identified five themes in relation to our three research questions (RQs): (1) understandings of safety and dignity (RQ1); (2) experiences of safety and dignity dilemmas (RQ2); (3) resistance and/or complicity regarding dilemmas encountered (RQ2); (4) factors facilitating safety and/or dignity (RQ3); and (5) factors inhibiting safety and/or dignity (RQ3). The themes were remarkably similar across the two sites and four stakeholder groups.ConclusionsWhile some of our findings are similar to previous research with undergraduate healthcare students, our findings also differ, for example, illustrating higher levels of reported resistance in the postgraduate context. We provide educational implications to uphold safety and dignity at the level of the individual (eg, stakeholder education), interaction (eg, stakeholder communication and teamwork) and organisation (eg, institutional policy).

scholarly journals Medical professionalism among medical students: A multifaceted evaluation

2021 ◽  
Vol 2 (2) ◽  
pp. 237-244
Author(s):  
Joy EwennTan ◽  
Aedin Collins ◽  
Rosalinde Tilley ◽  
Manasvi Upadhyaya
Keyword(s):  
Medical Students ◽  
General Medical Council ◽  
Assessment Method ◽  
Medical Professionalism ◽  
Junior Doctors ◽  
Medical Council ◽  
Allied Health Professionals ◽  
Likert Score ◽  
Significant Difference ◽  
The Moment

Background: Professionalism is one of the five key attributes that the General Medical Council has focused on the guideline of Good Medical Practice. The primary aim of this study is to evaluate how the attributes of professionalism among medical students are perceived by themselves (SG) and patients, parents, carers, junior doctors, nurses, consultants and other allied health professionals (NSG). The secondary aim of this study is to evaluate methods of assessment for professionalism. Methods: This study was carried out for a period of 8 weeks. This was a multifaceted evaluation gathering opinions from SG and NSG. All participants filled-in a questionnaire, using a 5-point Likert score scale satisfaction. Results: In total, we had 185 participants: 88 (SG), and 97 (NSG). The mean score of medical professionalism rated by SG was 3.87 and NSG was 3.95. The top two attributes that scored the highest scores by SG were respectfulness and confidentiality. NSG were confidentiality and appearance. The two attributes that had the lowest score in both groups were attendance and punctuality. One-to-one feedback was the most favorable choice of assessment method among both groups. Conclusion: The level of professionalism among medical students in this study was observed to be positive. There was no significant difference between both groups. Professionalism is a crucial requirement for all medical doctors. It is all educator’s responsibility from all educators to instill medical professionalism from the moment medical school begins.

scholarly journals Enhanced faculty development: using the GMC survey to run a trainer development workshop

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S156-S156
Author(s):  
Martin Schmidt ◽  
Timothy Leung
Keyword(s):  
Online Survey ◽  
Medical Training ◽  
Group Discussion ◽  
Poor Performance ◽  
General Medical Council ◽  
Medical Council ◽  
Supportive Environment ◽  
Annual Survey ◽  
Reporting Tool ◽  
National Training

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to create a trainer development workshop that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Trainer survey, part of the NTS, consists of 47 questions which are grouped into 11 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a workshop to engage trainers in discussion about improving the experiences of trainers and trainees.MethodOur analysis of the NTS used data from the online reporting tool to calculate the scores that were obtained for each question in the 2018 NTS. A question was discussed at the workshop if it performed poorly relative to other questions in the indicator; to provide useful information; or to clarify ambiguity. Indicators where interesting comparisons can be drawn between the views of trainers and trainees were also discussed. The 90-minute workshop was led by the Leadership and Education Fellow and Director of Medical Education. Attendees were subsequently sent an online survey.ResultThe workshop consisted of an introduction to the NTS; group discussion on which indicators were felt to be important, good- or poor-performing; discussion of specific questions; and a review of feedback from trainees.12 questions and 3 indicators (Handover, Supportive environment, Rota design) were discussed. 11 questions were chosen for poor performance, which sought to contextualise the results within the experience of attendees. 8 questions were chosen to provide information, such as resources and current initiatives. 3 were chosen to clarify ambiguity. Many questions met several criteria.17 attendees responded to the online survey. 64.7% agreed or strongly agreed that the NTS asks questions that are important for them. 76.5% agreed or strongly agreed that the NTS can be used to improve the trainer experience.In the subsequent NTS, there was an improvement in 9/11 indicators in the Trainer Survey, with four green flags denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be used to structure a workshop that trainers feel can improve their experience. Our strategy demonstrates the value of analysing the NTS dataset intelligently to engage trainers in improving training.

1012 Surgical Trainee Satisfaction Variations with Seniority and Region: An Evaluation of General Medical Council National Training Survey

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K S Fan ◽  
J McKenna ◽  
J Chan
Keyword(s):  
Clinical Supervision ◽  
Maxillofacial Surgery ◽  
General Medical Council ◽  
Oral And Maxillofacial Surgery ◽  
Medical Council ◽  
Surgical Trainee ◽  
Surgical Trainees ◽  
Training Stage ◽  
Speciality Training ◽  
National Training

Abstract Aim The General Medical Council (GMC) National Training Survey invites all doctors in training and this study evaluates satisfaction in surgical training and variations with speciality, seniority, and training region. Method All survey results were obtained from the GMC website. Responses of trainees, ranging from foundation training to registrar, were collected and categorised by speciality, training stage and location. Results 9465 surgical trainees completed the study in 2019. The highest indicators were Educational Supervision (97.68), Clinical Supervision (87.42) and Clinical Supervision (out of hours) (87.28). The lowest were Workload (44.60), Rota Design (56.00) and Local Teaching (59.31). Highest and lowest ranking specialities were oral and maxillofacial surgery (84.25) and vascular surgery (73.95). Satisfaction varied significantly across training stages, with speciality trainees highest (82.58) overall and foundation year 1 lowest (70.03). London scored highest (77.95) and Northern Ireland, Scotland and Wales collectively scored 77.13. Within England, South England ranked highest in five specialities but only orthopaedics and neurosurgery showed significant national variations. Conclusions Our data show variations in training satisfaction across many training cohorts. Satisfaction increases with surgeon seniority. Trainers and educational boards should target interventions to improve the quality of training for all grades of trainees and ensure appropriate curriculum coverage and address specific concerns.

scholarly journals GMC training survey and missing trainees in psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S155-S155
Author(s):  
Martin Schmidt ◽  
Timothy Leung
Keyword(s):  
Medical Training ◽  
Local Level ◽  
Poor Performance ◽  
General Medical Council ◽  
Medical Council ◽  
North Central ◽  
North West ◽  
Annual Survey ◽  
East Midlands ◽  
National Training

AimsTo investigate the extent of misattributed responses in the General Medical Council (GMC) National Training Surveys (NTS).BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. Benchmarking of trusts’ performance is indicated by red flags denoting outlying poor performance. The validity of this depends on the correct attribution of responses to trusts. We have previously found that responses for Foundation Year One (FY1) trainees undertaking psychiatry placements were misattributed to trainees’ affiliated acute trusts (AT), even though the mental health trusts (MHT) were providing the training placements.MethodData from the online reporting tool were used to calculate the numbers of FY1, Foundation Year Two (FY2), and General Practice Speciality trainees (GPST) on psychiatry placements attributed to ATs and MHTs in 2019. A range is provided for the data, as results for trusts with one or two trainees are not reported. The data were analysed by training level and the 13 Health Education England (HEE) regions to give a proportion of trainees missing from the MHT data (% missing), an indication of response misattribution.Result296-302 FY1s were attributed to MHTs and 114-148 to ATs, giving a % missing of 27.4-33.3%. 261-275 FY2s were attributed to MHTs and 89-125 to ATs, giving a % missing of 24.4-30.0%. 507-511 GPSTs were attributed to MHTs and 49-73 to ATs, giving a % missing of 8.8-12.6%.Across the three training levels, all HEE regions were affected by data misattribution. The regions most affected were South London, Kent Surrey Sussex, and North West London, with missing % of 51.6-54.3%, 33.9-40.7% and 29.9-32.5% respectively. The HEE regions least affected were East Midlands, North Central and East London, and East of England, with missing % of 4.3-6.0%, 5.6-8.1% and 5.5-10.4% respectively.ConclusionResponse misattribution for psychiatry placements in the NTS is rife, with the greatest impact on FY1s. While this issue affects all HEE regions, wide variation exists. Response misattribution means that the calculation of outliers is based on incomplete data, threatening the validity of the results. By liaising with our local HEE office to ensure correct attribution of our trainees, Surrey and Borders Partnership NHS Foundation Trust reduced our % missing from 50.0-56.8% in 2018 to 5.4-10.1% in 2019, thus proving that it is possible to remedy the situation on a local level.

scholarly journals A model for improving postgraduate medical education using the GMC survey

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S155-S156
Author(s):  
Martin Schmidt ◽  
Timothy Leung
Keyword(s):  
Medical Education ◽  
Medical Training ◽  
Postgraduate Medical Education ◽  
General Medical Council ◽  
Medical Council ◽  
Job Descriptions ◽  
Training Experience ◽  
Annual Survey ◽  
National Training ◽  
The Impact

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to develop a plan of action that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Doctors in training survey, part of the NTS, consists of 70 questions which are grouped into 18 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a plan of action to improve the quality of training.MethodWe used data from the online reporting tool to calculate the scores for each question in the 2018 NTS. Taking into account the impact of year-on-year changes in the content of the survey, we examined the score, change from 2017 to 2018, and difference between the score and indicator mean to identify poorly-performing questions. Other questions with clear potential for further improvement were also highlighted. A plan of action was produced by the Leadership and Education Fellow and Director of Medical Education.Result29 actions were identified. The most common were to ensure that information (e.g. job descriptions, professional opportunities) was accessible to trainees (8 actions); liaise with other teams (e.g. Human Resources, Safety team) (6); discuss issues with or provide information to trainers (5); discuss with trainees to contextualise survey results within their experiences (4); and ensure that information was delivered at induction (3).To implement these actions, we conducted a workshop for trainers and held feedback meetings with trainees. 76.5% of trainers (13/17) and 88.5% of trainees (23/26) surveyed following these respective events agreed or strongly agreed that the NTS can be used to improve the training experience. A presentation on making the most of the placement was added to trainee induction and was rated excellent or good by all respondents (28/28). Posters were also produced to disseminate information. In the subsequent NTS, there was an improvement in SABP's performance in 12/18 indicators in the Doctors in training survey, with one green flag denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be analysed to create a plan of action with elements that trainers and trainees feel can improve their experience. Our model demonstrates the potential for using NTS data to plan quality improvement in training.

The Duties of Doctors In Medical Education: A Letter To The Editor (Preprint)

2019 ◽  
Author(s):  
Sneha Barai
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Role Models ◽  
Role Model ◽  
General Medical Council ◽  
Future Generations ◽  
Medical Council ◽  
Positive Role ◽  
The Uk ◽  
And Training

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.

Business of the General Medical Council

BMJ ◽  
1898 ◽  
Vol 1 (1941) ◽  
pp. 729-729 ◽  
Author(s):  
H. Hall
Keyword(s):  
General Medical Council ◽  
Medical Council
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