scholarly journals Assessing the current state of quality improvement training in urology in the UK: Findings from the General Medical Council 2018 trainee survey

2020 ◽  
pp. 205141582092052 ◽  
Author(s):  
Elena Pallari ◽  
Archie Hughes-Hallett ◽  
Silia Vitoratou ◽  
Zarnie Khadjesari ◽  
Phil Cornford ◽  
...  

Objective: The General Medical Council (GMC) of the UK has identified the need to support doctors through education in safety and quality improvement (QI) methods. This study reports findings from the GMC annual survey of 2018 from urology trainees regarding the state of QI training and their training needs. Material and methods: We designed a set of four questions to assess how QI methods are being taught nationally, and inserted them in the 2018 annual GMC trainee survey for urology. This is a cross-sectional study assessing the current state of QI training and mentoring received by trainees, and their self-assessed ability and confidence in completing a QI project as part of training requirements. Data were statistically analysed in Stata 15 stratified by Local Education Training Boards (LETBs)/Deanery and by specialty trainee level (ST3–7). Results: In total, 270 responses were received from urology trainees. Data showed significant variation across the country. Responses from ST3–7 trainees ranged from 5–20% on completing more than three QI projects, while 7–58% replied that they had done none. Across all ST grades, 40% of trainees stated they had not undertaken QI, whereas 0–27% reported they had not received any mentoring on QI to date. There was significant variation across training regions too: 11–74% of trainees answered that they have received training in QI methods, and 58–100% responded that they were confident in undertaking QI projects. Across all LETBs, 1–3% responded that they uploaded projects on national websites for dissemination; finally, a range of 0–18% stated they had completed more than three projects. Conclusion: This is the first national snapshot of QI training for the entire urology specialty in the UK. The study demonstrates wide variation in QI training and activity undertaken by trainees, and shows a lack of systematic implementation of QI education across training regions. Level of evidence: 2c

2018 ◽  
Vol 12 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Tim Terry ◽  
Nancy Redfern ◽  
Gordon French

Trainee and established urologists are familiar with ‘generic mentoring’ as a potpourri of helping aids that include supervision, coaching, buddying, career advice, counselling and patronage to enable mentees to develop professionally. However, most are unfamiliar with ‘developmental mentoring’ as a highly specific learnt technique through which mentors help mentees, by interactive dialogue, to choose their own agendas and arrive at their own solutions to career/professional/personal opportunities or difficulties as distinct from the paternalistic mentor approach typified by the downward flow of information generated by ‘generic mentoring’. This paper is a systematic review of developmental mentoring as pertains to urologists in the UK, and reports outcomes of 1-hour taster sessions between Egan-trained mentors and urologists offered at British Association of Urological Surgeons (BAUS) annual general meetings since 2013. Both the General Medical Council and the Royal College of Surgeons of England imply that ‘mentoring’ is mandatory for both trainees and trained urologists, but fail to clarify what they mean by a ‘mentor’, which potentially creates a void in providing ‘developmental mentoring’ since the later requires specific training and is costly to provide. Currently, most ‘developmental mentoring’ is performed by trained staff in Local Education and Training Boards or National Health Service Trusts. BAUS has an opportunity to offer ‘developmental mentoring’ through a portal on its website to manage opportunities and difficulties experienced by its members. Level of evidence: This paper is a systematic review as pertains to the place of mentoring in current urological practice. By its nature, it has reviewed previous narrative reviews and its highest level of evidence is a contemporary paper from 2016, which was a comparative cross-sectional study; other case series were reviewed. Overall, this amounts to level 4 with a recommendation of C as per the Oxford Centre for Evidence-based Medicine Levels of Evidence.


2021 ◽  
Author(s):  
Sarah Choi ◽  
Setthasorn Ooi ◽  
Eleanor Carpenter

Abstract Aims: Adequate exposure and teaching of Trauma and Orthopaedics (T&O) to medical students is fundamental in order to obtain sufficient knowledge and sustain their interest in T&O as a career. The primary aim is to assess the exposure and delivery of T&O at all medical schools in the UK. The secondary aim is to determine whether there are any associations between attending a particular medical school and having a strong interest in pursuing a career in T&O. Methods: To explore the primary aim, all 33 UK medical schools were investigated in the study, by means of a questionnaire distributed to medical students. This did not include ‘new’ medical schools, defined as those established from 2014 onwards. To investigate the secondary aim of exploring associations between students’ and alumni’s medical schools and their interest in T&O as a career, British Orthopaedic Training Association (BOTA) members were reviewed, using the General Medical Council register to identify the universities from which members had graduated. The authors have made the assumption that membership of BOTA signified an interest in T&O as a career. Results: Results were obtained for all 33 medical schools. The mean total teaching time specifically for T&O throughout medical school was 18 days, ranging from 3 to 60 days in total. 118 BOTA members were reviewed. No member of BOTA in the study had attended medical school in Keele, Liverpool, Plymouth or Lancashire. These universities taught below the national average number of days in T&O. Conclusions: There is a large national variance in the number of compulsory teaching days provided for T&O. The authors advocate medical schools to aim for at least the national average in duration of T&O of 18 days.


2022 ◽  
Vol 9 ◽  
pp. 238212052110727
Author(s):  
Sarah Choi ◽  
Setthasorn Ooi ◽  
Eleanor Carpenter

INTRODUCTION Adequate exposure and teaching of Trauma and Orthopaedics (T&O) to medical students is fundamental in order to obtain sufficient knowledge and sustain their interest in T&O as a career. The primary aim is to assess the exposure and delivery of T&O at all medical schools in the UK. The secondary aim is to determine whether there are any associations between attending a particular medical school and having a strong interest in pursuing a career in T&O. METHODS To explore the primary aim, all 33 UK medical schools were investigated in the study, by means of a questionnaire distributed to medical students. This did not include ‘new’ medical schools, defined as those established from 2014 onwards. To investigate the secondary aim of exploring associations between students’ and alumni's medical schools and their interest in T&O as a career, British Orthopaedic Training Association (BOTA) members were reviewed, using the General Medical Council register to identify the universities from which members had graduated. The authors have made the assumption that membership of BOTA signified an interest in T&O as a career. RESULTS Results were obtained for all 33 medical schools. The mean total teaching time specifically for T&O throughout medical school was 18 days, ranging from 3 to 60 days in total. 118 BOTA members were reviewed. No member of BOTA in the study had attended medical school in Keele, Liverpool, Plymouth or Lancashire. These universities taught below the national average number of days in T&O. DISUCSSION There is a large national variance in the number of compulsory teaching days provided for T&O. The authors advocate medical schools to aim for at least the national average in duration of T&O of 18 days.


2018 ◽  
Vol 182 (8) ◽  
pp. 225-225 ◽  
Author(s):  
Naomi J Booth ◽  
Samuel J Morley ◽  
Richard S Ewers

Radiography is an essential diagnostic tool in small animal practice. A major transition is currently underway from film screen to digital systems. However, there is limited published research detailing the use of radiography in practices in the UK and Republic of Ireland (ROI). The study aimed to describe the uptake of digital radiographic systems, wider aspects of radiographic practice and use of other diagnostic imaging techniques in the UK and ROI. This is a cross-sectional study using paper and online questionnaires. Veterinary surgeons, veterinary nurses and veterinary radiographers working in small animal practice in the UK and ROI were eligible to participate in the survey. Seventy-five per cent of respondents worked in practices using digital radiography systems. Cost appeared to be the largest barrier to digital conversion. Chemical restraint was used on 86 per cent of cases; however, 3 per cent of cases were reported to be restrained by hand. Thirty-one per cent of respondents had not received specific training in radiation safety. Ultrasonography is reportedly now widely utilised on a regular basis. These results provide useful information on the use of radiography and additional diagnostic imaging techniques in the UK. These results should be used to indicate future training requirements, particularly to improve radiation safety.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Ellis ◽  
D Scrimgeour ◽  
J Cleland ◽  
A Lee ◽  
P Brennan

Abstract Aim Fitness to practice (FtP) investigations by the General Medical Council (GMC) can be one of the most stressful experiences in a surgeon’s career. Demographic factors are known to alter the likelihood of GMC investigation. Despite this there are no studies assessing risk factors in surgeons for FtP sanctions. Thus, we used the newly created Intercollegiate Membership of Royal College of Surgeons (MRCS) examination database to identify risk factors for and the prevalence of GMC sanctions in early-career surgeons. Method FtP sanction data contained in the GMC list of registered medical practitioners (LRMP) database was linked at person-level to all UK graduates who had attempted MRCS Part A or Part B between September 2007 and January 2020. Data were anonymised by the Royal College of Surgeons of England prior to analysis. Results f 11,660 candidates who had attempted the MRCS within the study period only 31 (0.3%) candidates had GMC FtP sanctions within the last two years. Of these, 12 had active conditions on their registration, 7 had active undertakings and 14 had warnings. Candidate demographics were similar between cohorts and there were no significant differences between MRCS performance identified. Conclusions In this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ricky Ellis ◽  
Duncan Scrimgeour ◽  
Jennifer Cleland ◽  
Amanda Lee ◽  
Peter Brennan

Abstract Aims Fitness to practice (FtP) investigations by the General Medical Council (GMC) can be one of the most stressful experiences in a surgeon’s career. Demographic factors are known to alter the likelihood of GMC investigation. Despite this there are no studies assessing risk factors in surgeons for FtP sanctions. Thus, we used the newly created Intercollegiate Membership of Royal College of Surgeons (MRCS) examination database to identify risk factors for and the prevalence of GMC sanctions in early-career surgeons. Methods FtP sanction data contained in the GMC list of registered medical practitioners (LRMP) was linked at person-level to all UK graduates who had attempted MRCS Part A or Part B between September 2007 and January 2020. Data were anonymised by the Royal College of Surgeons of England prior to analysis. Results Of 11,660 candidates who had attempted the MRCS within the study period only 31 (0.3%) candidates had GMC FtP sanctions within the last two years. Of these, 12 had active conditions on their registration, 7 had active undertakings and 14 had warnings. Candidate demographics were similar between cohorts and there were no considerable differences between MRCS performance identified. Conclusion In this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.


2015 ◽  
Vol 5 (2) ◽  
pp. 29 ◽  
Author(s):  
Joseph Wan ◽  
Neil H Metcalfe

Background: Portfolios are used in medical practice as a means of instilling “reflective learning” in doctors and accumulating evidence of the doctor’s competence. It is a mandatory requirement by the General Medical Council (GMC), as a form of public accountability, for licensed clinicians to maintain an e-portfolio of daily clinical practice, which is subjected to annual appraisals and ultimately influences their ability to renew their license to practise in the UK. This article reviews the reflective learning process for which the e-portfolio is intended to instil in doctors and the level of evidence required to demonstrate competency and continuing professional development.Methods: A literature review was conducted on Medline and Google Scholar for any available guidance on writing e-portfolio entries and guidelines from the GMC, Royal Colleges and various training boards were reviewed to determine the type of evidence required to be demonstrated.Results: Fifteen articles had met the inclusion criteria on guiding e-portfolio writing. Guidelines reviewed constantly echoed the theme of “reflecting doctors” and “linking evidence to curriculum outcomes”. This article has also proposed a “Do, Reflect, Plan, Act” framework in writing portfolio entries.Conclusions: Creating and maintaining an e-portfolio throughout a lifelong career is no mean feat. We have reviewed the key components that clinicians ought to demonstrate in their e-portfolios, and introduced the “Do, Reflect, Plan, Act” framework, to enhance understanding of the e-portfolio as a learning tool to improve medical practice.


2019 ◽  
Author(s):  
Sneha Barai

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.


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Alice Malpass ◽  
Kate Binnie ◽  
Lauren Robson

Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an “allowed vulnerability.”


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