Abstract
There is an increase in mortality when medical graduates replace the previous cohort of foundation doctors. As of 2012, it is now mandatory for new doctors in the UK to participate in induction training in order to ease this transition and reduce the negative impact on patient outcomes. However, there is no guidance on how best to deliver these induction programmes. This review aims to evaluate the effectiveness of several induction programmes to provide insight on this. Medline and Scopus were searched for relevant literature using keywords. Duplicates were removed and inclusion criteria were created to screen the remaining literature. Five studies were included in this review and they were all quality appraised using the Medical Education Research Study Quality Instrument. Different hospital trusts utilised varying induction programmes. The most common method of assessing their effectiveness involved exploring preparedness in junior doctors post-induction through surveys. Patient outcome, anxiety levels and knowledge were also measured. Induction programmes play a vital role in preparing new foundation doctors for practice and thus improving patient outcomes. Although there may be trust-specific variation, some elements of the programme should be standardised to ensure basic requirements are met universally. New doctors should be assessed on aspects of the programme after completion to increase confidence and knowledge. Organisational considerations such as costs and staff availability need to be taken into account. The quality of future research papers could be improved through inclusion of baseline data, control groups, multi-centred studies and outcomes higher on Kirkpatrick’s hierarchy.
Highlights
The national changeover day in August, when the previous cohort of foundation year one doctors (F1s) are replaced by medical graduates, has been coined ‘Black Wednesday’ due to increased mortality rates [1]; it has been reported that there is a 4.3–12% increase in mortality in that month alone [2]
The aim of this review is to evaluate different induction programmes (IPs) and assess their impact on junior doctors’ preparedness
The most prevalent data collection method was a questionnaire (n = 4) [1, 5, 11, 13] measuring confidence or preparedness of F1s starting at a trust, followed by summative assessments testing knowledge (n = 1) [12], self-reported incidents (n = 1) [5] and anxiety assessments (n = 1) [11]
Summary
The national changeover day in August, when the previous cohort of foundation year one doctors (F1s) are replaced by medical graduates, has been coined ‘Black Wednesday’ due to increased mortality rates [1]; it has been reported that there is a 4.3–12% increase in mortality in that month alone [2]. This negative impact on patient outcomes is thought to be due to the new cohort being unfamiliar with the hospital environment and with the tasks they are expected to carry out. This will help to inform future programme design and enable doctors to feel better prepared, improving patient outcomes
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