G453(P) Stepping up to middle grade: a peer-led teaching session to improve confidence prior to transition

Abstract

Aim To implement a peer-led study day to improve confidence in transition to middle grade level for paediatric trainees. A secondary aim was to identify areas of anxiety for junior trainees in order to improve future training. Methods In the North-Western Deanery, trainees work at middle grade level from ST3 onwards. Feedback from previous years has suggested that trainees felt unprepared to ‘step up’ to middle grade level. As ST4 registrars, we designed and implemented a near peer-led training session for ST2 and ST3 doctors, aimed at improving their skills and confidence. Prior to the session, we identified that particular areas of low confidence were safeguarding, clinical emergencies and time management. As such, the session focused on these three aspects, with an additional question and answer session to address other concerns. We collated feedback from trainees, focusing on confidence levels in these key domains by asking them to score their confidence before and after delivery of training from 0 (completely unprepared) to 10 (very prepared). Results 23 students attended the session, with feedback response from 17 trainees. 93% of trainees scored higher confidence following delivery of teaching. Average confidence scores increased for all domains with a mean increased score of 3.4, 2.3 and 2.4 in child protection, time management and clinical emergencies respectively. This demonstrated that the teaching session improved trainee’s confidence in preparedness for a range of middle grade responsibilities. All attendees agreed that they would recommend this session to other doctors at their level of training. Additional open questions identified further areas of concern, including fears about contacting consultants and being the most senior paediatrician in hospital overnight. Conclusion This is an example of peer-led teaching helping to prepare junior trainees for middle grade roles. It was found to increase confidence prior to a stressful period of transition for junior trainees. Similar teaching sessions could be expanded upon in the curriculum locally and in other regions, with additional increased focus on peer support, mentorship and resilience training to help combat the high rate of attrition within junior registrars.