The Educational and Clinical Benefits of a “Consultant-Speciality Trainee” ENT Shared Clinic

Abstract

Introduction and Aims. The European Working Time Regulations (EWTR) of 48-hour working week limit have raised concerns regarding the quality of medical training for junior doctors. Our study has looked to improve junior doctors training without impairing patients’ care with the introduction of one-to-one “consultant with specialty trainee” doctor teaching in the outpatient clinic setting. Methodology. In this study, an ENT specialty trainee conducted a 3-month block of solo clinics seeing new patients. After that, the same specialty trainee shared the clinic with an ENT consultant for 3 months and subsequently the same trainee reconducted solo clinics. Outcomes of the specialty trainee performance were measured clinically by completed patient episodes (CPE) (i.e., patient discharged from clinic or placed on surgical operation waiting list) and ongoing patient episodes (OPE) (i.e., patient given follow-up appointment to ENT clinic) and educationally by workplace based assessments (WBA) completed in the trainee’s e-portfolio. Results. 271 patients were recruited in this research: 24% being in the preintervention group, 47% during the intervention, and 29% in the postintervention. The intervention of one-to-one outpatient clinic teaching increased the specialty trainees CPE rate (60% to 67.5%, p>0.1) and reduced their OPE rate (40% to 32.5%, p=0.001). Educationally these trainees completed with the consultant statistically significant WBA (17 assessments) during the one-to-one clinics compared to solo clinics (2.3 on average). Discussion and Conclusion. In this study, a positive trend in the clinical outcomes was obtained in terms of CPE, while a statistically significant reduction of the total OPE was achieved giving an indicator to consider this concept for further research in terms of patient’s clinical outcomes. Nevertheless, it showed a new way of supporting the trainee’s education supported by more WBA being filled.