scholarly journals The validity of the Annual Review of Competence Progression: a qualitative interview study of the perceptions of junior doctors and their trainers

2017 ◽  
Vol 110 (3) ◽  
pp. 110-117 ◽  
Author(s):  
Rowena Viney ◽  
Antonia Rich ◽  
Sarah Needleman ◽  
Ann Griffin ◽  
Katherine Woolf
Keyword(s):  
Assessment Tool ◽  
Medical Training ◽  
Annual Review ◽  
Junior Doctors ◽  
Postgraduate Medical Training ◽  
Medical Graduates ◽  
Qualitative Interview Study ◽  
Negative Perceptions ◽  
Positive Experiences ◽  
Graduate Trainees

Objective To investigate trainee doctors’ and trainers’ perceptions of the validity of the Annual Review of Competence Progression (ARCP) using Messick’s conceptualisation of construct validity. Design Qualitative semi-structured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Kent Surrey and Sussex, Yorkshire and Humber, and Wales in November/December 2015. Part of a larger study about the fairness of postgraduate medical training. Participants Ninety-six trainees and 41 trainers, comprising UK and international medical graduates from Foundation, General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, and Surgery, at all levels of training. Main outcome measures Trainee and trainer perceptions of the validity of the ARCP as an assessment tool. Results Participants recognised the need for assessment, but were generally dissatisfied with ARCPs, especially UK graduate trainees. Participants criticised the perceived tick-box nature of ARCPs as measuring clerical rather than clinical ability, and which they found detrimental to learning. Trainees described being able to populate their e-portfolios with just positive feedback; they also experienced difficulty getting assessments signed off by supervisors. ARCPs were perceived as poor at identifying struggling trainees and/or as discouraging excellence by focussing on minimal competency. Positive experiences of ARCPs arose when trainees could discuss their progress with interested supervisors. Conclusions Trainee and trainer criticisms of ARCPs can be conceptualised as evidence that ARCPs lack validity as an assessment tool. Ongoing reforms to workplace-based assessments could address negative perceptions of the ‘tick-box’ elements, encourage constructive input from seniors and allow trainees to demonstrate excellence as well as minimal competency, while keeping patients safe.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

Feedback and performance scores for direct observation of procedural skills

2014 ◽  
Vol 96 (7) ◽  
pp. e5-e8 ◽  
Author(s):  
H Burnand ◽  
T Fysh ◽  
J Wheeler ◽  
W Allum
Keyword(s):  
Direct Observation ◽  
Medical Training ◽  
Formative Assessments ◽  
Annual Review ◽  
Procedural Skills ◽  
Postgraduate Medical Training ◽  
Surgical Trainees ◽  
And Performance

Direct observation of procedural skills (DOPS) is one of the four main workplace-based assessments (WBAs) in postgraduate medical training. Surgical trainees of all grades and specialties use the Intercollegiate Surgical Curriculum Programme (ISCP) to make an online record of each DOPS. The DOPS are used alongside other WBAs as formative assessments to aid the evaluation of trainee progression at the annual review of competence progression (ARCP).

scholarly journals The association between mentoring and training outcomes in junior doctors in medicine: an observational study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e020721 ◽  
Author(s):  
John Ong ◽  
Carla Swift ◽  
Nicholas Magill ◽  
Sharon Ong ◽  
Anne Day ◽  
...  
Keyword(s):  
Observational Study ◽  
Medical Training ◽  
Positive Association ◽  
Career Progression ◽  
Junior Doctors ◽  
Pass Rates ◽  
Training Outcomes ◽  
Postgraduate Medical Training ◽  
Significant Events ◽  
The Uk

ObjectiveTo determine quantitatively if a positive association exists between the mentoring of junior doctors and better training outcomes in postgraduate medical training within the UK.DesignObservational study.Participants117 trainees from the East of England Deanery (non-mentored group) and the recently established Royal College of Physicians (RCP) Mentoring scheme (mentored group) who were core medical trainees (CMTs) between 2015 and 2017 completed an online survey. Trainees who received mentoring at the start of higher specialty training, incomplete responses and trainees who were a part of both the East of England deanery and RCP Mentoring scheme were excluded leaving 85 trainees in the non-mentored arm and 25 trainees in the mentored arm. Responses from a total of 110 trainees were analysed.Main outcome measuresPass rates of the various components of the Membership of the Royal College of Physicians (MRCP) (UK) examination (MRCP Part 1, MRCP Part 2 Written and MRCP Part 2 PACES), pass rates at the Annual Review of Competency Progression (ARCP), trainee involvement in significant events, clinical incidents or complaints and trainee feedback on career progression and confidence.ResultsMentored trainees reported higher pass rates of the MRCP Part 1 exam versus non-mentored trainees (84.0% vs 42.4%, p<0.01). Mentored international medical graduates (IMGs) reported higher pass rates than non-mentored IMGs in the MRCP Part 2 Written exam (71.4% vs 24.0%, p<0.05). ARCP pass rates in mentored trainees were observed to be higher than non-mentored trainees (95.8% vs 69.9%, p<0.05). Rates of involvement in significant events, clinical incidents and complaints in both groups did not show any statistical difference. Mentored trainees reported higher confidence and career progression.ConclusionsA positive association is observed between the mentoring of CMTs and better training outcomes. Further studies are needed to investigate the causative effects of mentoring in postgraduate medical training within the UK.

scholarly journals Exploration of Academic Postgraduate Medical Training System in the Context of "Internet plus"

2021 ◽  
Vol 271 ◽  
pp. 03073
Author(s):  
Xiaoshan Huang ◽  
Longwu Yin ◽  
Bilan Zhou ◽  
Zhifang Liu ◽  
Meihua Bao
Keyword(s):  
Higher Education ◽  
Evaluation System ◽  
Medical Training ◽  
Training System ◽  
Innovation Capability ◽  
New Era ◽  
Postgraduate Medical Training ◽  
Medical Graduates ◽  
Global Quality ◽  
Higher Education In China

Higher education in China has entered a new era of global quality improvement and innovation. The cultivation of innovative talents is crucial for the development of our higher education. Within the framework of "Internet plus", the culture of university medical graduates must deeply integrate information technology. In the present study, an "Internet plus" academic medical postgraduate training system was discussed. This system includes the establishment of the curriculum system, innovation capability training system and quality evaluation system. By making full use of modern informatics technology, the “Internet plus” system improved the the innovation capability and quality of postgraduates significantly.

scholarly journals Exploring preference for, and uptake of, rural medical internships, a key issue for supporting rural training pathways

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Matthew R. McGrail ◽  
Belinda G. O’Sullivan ◽  
Deborah J. Russell ◽  
Muntasirur Rahman
Keyword(s):  
Medical Training ◽  
Junior Doctors ◽  
Domestic Students ◽  
Rural Location ◽  
Medical Graduates ◽  
Care Access ◽  
Rural Workforce ◽  
Published Evidence ◽  
Career Intent ◽  
International Graduates

Abstract Background Improved medical care access for rural populations continues to be a major concern. There remains little published evidence about postgraduate rural pathways of junior doctors, which may have strong implications for a long-term skilled rural workforce. This exploratory study describes and compares preferences for, and uptake of, rural internships by new domestic and international graduates of Victorian medical schools during a period of rural internship position expansion. Methods We used administrative data of all new Victorian medical graduates’ location preference and accepted location of internship positions for 2013–16. Associations between preferred internship location and accepted internship position were explored including by rurality and year. Moreover, data were stratified between ‘domestic graduates’ (Australian and New Zealand citizens or permanent residents) and ‘international graduates’ (temporary residents who graduated from an Australian university). Results Across 2013–16, there were 4562 applicants who filled 3130 internship positions (46% oversubscribed). Domestic graduates filled most (69.7%, 457/656) rural internship positions, but significantly less than metropolitan positions (92.2%, p < 0.001). Only 20.1% (551/2737) included a rural location in their top five preferences, less than for international graduates (34.4%, p < 0.001). A greater proportion of rural compared with metropolitan interns accepted a position not in their top five preferences (36.1% versus 7.4%, p < 0.001). The proportion nominating a rural location in their preference list increased across 2013–2016. Conclusions The preferences for, and uptake of, rural internship positions by domestic graduates is sub-optimal for growing a rural workforce from local graduates. Current actions that have increased the number of rural positions are unlikely to be sufficient as a stand-alone intervention, thus regional areas must rely on international graduates. Strategies are needed to increase the attractiveness of rural internships for domestic students so that more graduates from rural undergraduate medical training are retained rurally. Further research could explore whether the uptake of rural internships is facilitated by aligning these positions with protected opportunities to continue vocational training in regionally-based or metropolitan fellowships. Increased understanding is needed of the factors impacting work location decisions of junior doctors, particularly those with some rural career intent.

scholarly journals What are junior doctors for? The work of Foundation doctors in the UK: a mixed methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027522 ◽  
Author(s):  
Gillian Vance ◽  
Sharmila Jandial ◽  
Jon Scott ◽  
Bryan Burford
Keyword(s):  
Mixed Methods ◽  
Medical Training ◽  
Mixed Methods Study ◽  
Junior Doctors ◽  
Cross Sectional ◽  
Postgraduate Medical Training ◽  
Foundation Programme ◽  
Independent Practitioner ◽  
Definition Of ◽  
The Uk

ObjectivesTo examine what activities constitute the work of Foundation doctors and understand the factors that determine how that work is constructed.DesignCross-sectional mixed methods study. Questionnaire survey of the frequency with which activities specified in curricular documents are performed. Semistructured interviews and focus groups.SettingPostgraduate medical training in the UK.ParticipantsDoctors in their first 2 years of postgraduate practice (Foundation Programme). Staff who work with Foundation doctors—supervisors, nurses and employers (clinical; non-clinical).ResultsSurvey data from 3697 Foundation doctors identified curricular activities (41/103, 42%) that are carried out routinely (performed at least once or twice per week by >75% of respondents). However, another 30 activities (29%) were carried out rarely (at least once or twice per week by <25% respondents), largely because they are routinely part of nurses’, and not doctors’, work. Junior doctors indicated their work constituted three roles: ‘support’ of ward and team, ‘independent practitioner’ and ‘learner’. The support function dominated work, but conflicted with stereotyped expectations of what ‘being a doctor’ would be. It was, however, valued by the other staff groups. The learner role was felt to be incidental to practice, but was couched in a limited definition of learning that related to new skills, rather than consolidation and practice. Activities and perceived role were shaped by the organisational context, medical hierarchies and through relationships with nurses, which could change unpredictably and cause tension. Training progression did not affect what activities were done, but supported greater autonomy in how they were carried out.ConclusionsNew doctors must be fit for multiple roles. Strategies for transition should manage graduates’ expectations of real-world work, and encourage teams and organisations to better accommodate graduates. These strategies may help ensure that new doctors can adapt to the variable demands of the evolving multiprofessional workforce.

scholarly journals The Level of Confidence, Readiness and its Associated Factors Among Medical Graduates Prior to House Officer (HO) Training

2019 ◽  
pp. 41
Author(s):  
Aneesa Abdul Rashid ◽  
Sazlina Shariff Ghazali ◽  
Iliana Mohamad ◽  
Dalila Roslan ◽  
Husna Musa ◽  
...  
Keyword(s):  
Medical Training ◽  
Clinical Skills ◽  
Junior Doctors ◽  
Cross Sectional ◽  
Medical Graduates ◽  
Adequate Knowledge ◽  
Level Of Confidence ◽  
Preparatory Course ◽  
Training Company ◽  
The Impact

Introduction: House officers are reported to feel less confident in working, especially in the initial part of their training. Among the factors that make them feel unprepared are in terms of adequate knowledge, clinical skills and dealing with workload. The impact of less confident house officers (HO) can lead to detrimental effects.Objectives: This study aims to look into the confidence and readiness levels of medical graduates prior to starting a HO preparatory course and factors associate.Methods: This is a cross sectional questionnaire study done among medical graduates between April – September 2018. This is part of a bigger study looking into the effectiveness of this course, which was initially organised under the Islamic Medical Association of Malaysia (IMAM) and later privatized to Medicorp (a medical training company for junior doctors). 238 participants who fulfilled the inclusion and exclusion criteria, completed the adapted IMU Competency survey pre and post the course. Their level of confidence and readiness to work was scored out of a Likert scale of 1 to 5. The higher the score, the higher the confidence or readiness to work.Results: We found significant association of confidence levels pre-course with ethnic it y (p=0.038). The scores were 2.0 (IQR=2.0), 2.0 (IQR=2.0), 3.0 (IQR=1.0), 2.5 (IQR=1.25) for Malay, Chinese, Indian and others respectively. We report significant associations with level of confidence (p=0.03) and readiness (p=0.08) not only prior, but levels of confidence (p<0.001) and readiness (p<0.001) after the course in association with place of study. Significant association was found for levels of confidence (p=0.048) and readiness (p=0.07) according to gender for scores post-course which were both 3.0 (IQR=1.0) and 4.0 (IQR=1.0) for females and males respectively.Conclusion: Confidence level to start work were higher for the Indian ethnicity before the HOpreparatory- course. Confidence and readiness levels were higher in male after the course, and locally graduated participants pre and post course.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 41

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

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