Are educational or quality improvement interventions delivered at the induction or orientation of junior doctors effective?

Abstract

There has been significant media scrutiny in the UK of the period when doctors change over into new jobs, with a number of reports highlighting increased mortality. Starting work in a new hospital confers a potential patient safety risk and induction programmes are therefore designed to familiarise doctors with local policies. Little is known about using this time as an opportunity to improve patient outcomes or change practice. The aim was to review interventions which may aid hospital trusts during induction and a strategy to direct future educational and implementation research. A review of Medline, Embase, Cochrane, Scopus and ERIC databases with key terms (induction or orientation, junior doctor or intern, intervention or education or implementation, quality improvement or patient safety or outcome) extracted relevant abstracts. Articles of relevance were analysed and coded as to the type of patient or doctor group, intervention and outcome. Only seven studies were found which generally reported perceived benefits rather than objective outcomes. A significant opportunity to improve evidence based practice and patient safety is being missed by not thoroughly evaluating the impact of induction and orientation of health care professionals.