Abstract

BackgroundThree reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors’ views about their training experience to be heard. In the UK, the General Medical Council (GMC) quality assures medical training programmes and requires postgraduate deaneries to undertake quality management and monitoring of all training posts in their area. The aim of this study was to develop a simple trainee questionnaire for evaluation of postgraduate training posts based on the GMC, UK standards and to look at the reliability and validity including comparison with a well-established and internationally validated tool, the Postgraduate Hospital Educational Environment Measure (PHEEM).MethodsThe Job Evaluation Survey Tool (JEST), a fifteen item job evaluation questionnaire was drawn up in 2006, piloted with Foundation doctors (2007), field tested with specialist paediatric registrars (2008) and used over a three year period (2008–11) by Foundation Doctors. Statistical analyses including descriptives, reliability, correlation and factor analysis were undertaken and JEST compared with PHEEM.ResultsThe JEST had a reliability of 0.91 in the pilot study of 76 Foundation doctors, 0.88 in field testing of 173 Paediatric specialist registrars and 0.91 in three years of general use in foundation training with 3367 doctors completing JEST. Correlation of JEST with PHEEM was 0.80 (p < 0.001). Factor analysis showed two factors, a teaching factor and a social and lifestyle one.ConclusionThe JEST has proved to be a simple, valid and reliable evaluation tool in the monitoring and evaluation of postgraduate hospital training posts.

Highlights

  • Three reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors’ views about their training experience to be heard

  • The Francis report had 290 recommendations for improvement including 21 for education and training [1]. These stated that Postgraduate Deans should ensure an effective programme of monitoring and advised the use of trainee surveys especially as a source of information on patient safety [1]

  • Each country has its own quality assurance (QA) process with some training programmes being accredited by Royal Colleges such as in Canada and others such as USA, Australia and UK by councils (Accreditation Council for Graduate Medical Education, Australian Medical Council and General Medical Council (GMC) respectively)

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Summary

Introduction

Three reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors’ views about their training experience to be heard. The Francis report had 290 recommendations for improvement including 21 for education and training [1] These stated that Postgraduate Deans should ensure an effective programme of monitoring and advised the use of trainee surveys especially as a source of information on patient safety [1]. There have been a number of tools developed to look at educational environment or climate summarised as what is encouraged, rewarded, emphasised and ways of working that are expressed [9] These include the Postgraduate Hospital Educational environment measure (PHEEM) developed in the UK, a 40 item questionnaire [10] and Dutch Residency Educational Climate Test (D-RECT), a 50 item, 11 subscale questionnaire used in graduate medical education in the Netherlands [11]

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