Views Of Trainees Research Articles

Educational Resources for Trainees in Oral and Maxillofacial Surgery: A Baseline Study

Effective surgical training is under pressure on a number of fronts. There are growing demands from the nHs to increase service commitment and targets. The European Working time regulations (EWTR) and the introduction of modernising medical careers have both decreased surgical training time and surgical exposure. Wade and Henderson looked at the views of trainees with regard to the EWTR and reported that the EWTR have had an impact on trainees' training. These factors may compromise the calibre of surgical education.

Key process issues in Cognitive Behavioral Analysis System of Psychotherapy (CBASP): Translation of an evidence-based model into clinical practice and training.

Our "desired outcome" in writing this article was to present not only key process issues stemming from the Cognitive Behavioral Analysis System of Psychotherapy (CBASP; McCullough, 2000), but to highlight those therapy maneuvers that we, a "seasoned" clinician/supervisor and a clinical trainee, find most useful in delivering treatment and in conducting supervision. We strongly believe that it is only through the translation of evidence-based therapeutic models, such as CBASP, into effective training that a true integration of science and practice can be obtained. Thus, the congruence of trainer's and trainee's views on what constitute top process issues in therapy is important in evaluating the reliability of a therapy model; with this in mind, we focus on three process issues, as follows: (1) problems are anchored to the "here and now" and to specific situational outcomes; (2) patients are encouraged to identify the role they play in affecting their distressing outcomes and to take responsibility for "fixing" them; and (3) the therapist planfully engages in the process of change via disciplined personal involvement. Research and theory supporting these maneuvers are presented, in conjunction with clinical examples.

An evaluation of the effectiveness of online clinical quandaries in increasing trainee clinical psychology knowledge

Game informed learning principles are increasingly being applied to both the wider educational context and specifically to allow the learner to role play a profession in a safe context prior to entering real practice. This questionnaire based study aimed to examine the impact of an online clinical quandary on the knowledge of trainee clinical psychologists in relation to challenging behaviour in people with a learning disability. Trainee knowledge in relation to key concepts required for successful assessment, intervention and evaluation of challenging behaviour was measured before and after using the clinical quandary, prior to any formal clinical psychology training (n=62). Trainee views on the use of the clinical quandary were also gathered. A significant increase in scores was found after using the clinical quandary, for the following factors: dealing with the initial referral; recording and overall total scores. Trainees evaluated the quandary as interesting, challenging, stimulating and helpful as a study aid. The results suggest that online clinical quandaries may offer a useful learning tool for increasing trainee knowledge and allowing them to rehearse skills in an environment where mistakes do not impact on patients.

What do surgical trainees think about patient safety culture, and is this different from their consultants?

Introduction Little is known about the patient safety culture within surgical departments in UK hospitals. What has been done to date is to survey only permanent senior staff opinion of the safety culture in their institution. This study surveyed both consultant and trainee views on perceived patient safety and compared the results between these two groups. Material and methods The previously validated Team Work and Safety Climate Questionnaire was configured in Survey Monkey format and sent to all surgical trainees and consultant surgeons in the South West Strategic Health Authority. Two reminders were sent to achieve as high a return rate as possible. Results Two hundred and ninety-six replies were received. Forty-four percent of trainees and 30% of consultants responded to the survey. Consultants consistently rated a higher safety culture than surgical trainees. Only 2.9% of trainees believe their patient safety concerns would be acted upon by hospital management. There is notable variation in perceived patient safety culture between hospitals. Conclusion This study has suggested that the patient safety culture in hospitals, within a Strategic Health Authority, is variable and sub-optimal when viewed by surgical trainees and their consultants. This study also provides some evidence that the perception of patient safety in an organization varies according to clinical experience. As trainees deliver a great deal of clinical care, surveys of safety culture should include this group. As perceived patient safety culture is correlated to clinical outcomes, validated safety surveys might form part of the assessment of a hospital's performance, along with outcome and patient satisfaction.

Are some subspecialties better with foundation doctors?

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Knowledge, Confidence and Training in Child Protection Issues - A Survery of Trainees Views

Aim: To analyse the confidence, training and knowledge of child protection issues in doctors in training.Methods: An anonymised online survey was sent to all paediatric trainees in the deanery.Results: 218 trainees responded (27%) working across all areas of paediatrics. 45.5% were ST1-3 and 51.9% were ST4-8. Only 70% had received child protection training within the last year and 3.7% had never received any training.No-one rated themselves as ‘very confident’ in managing child protection issues. 66% of ST4-8 and 22.4% of ST1-3. felt ‘confident’. 11.2% of trainees felt ‘not confident’. The most common reason was lack of experience (71%) followed by 'stressful (38%), ‘litigation’ (33%) and ‘lack of training’ (32%)Ability to identify injuries that were not accidental was equal across training grades. Knowledge of Local Child protection procedures was excellent with nearly all trainees scoring 100%.Knowledge of Laming recommendations was heterogenous. The majority (87%) felt that documentation should be completed within 24 hours of admission. More worryingly 70% felt that a child with CP concerns could be discharged without a GP. 25% felt that a nurse could discharge a child with CP concerns. 25% of trainees disagreed with the statement ‘every instance of possible deliberate harm should be considered and treated as a potentially fatal disease’.Conclusion: This has demonstrated trainees recognise physical abuse and are aware of local child protection procedures. However they still lack confidence in this area and are unaware of some of the Laming recommendations which could be addressed by formalised training.

Introducing a Primary Health Care nurse training course at the University of Limpopo: Experiences and views of trainees

BackgroundA new post-basic Primary Health Care (PHC) nurse training was piloted at the University of Limpopo in rural South Africa in order to reinforce PHC services and to address the backlog of trained PHC nurses. The training comprised residential and decentralised training modules based on the principles of problem based learning and community based education, and a patient-centred care approach developed in the field of family medicine was applied for acquiring consultation skills. Clinical reasoning was improved through on-site supervision by individual preceptors.ObjectiveThe aim of the study was to describe the satisfaction, experiences and views of trainees in the first year of implementing the new PHC nurse training programme.MethodThe study had a descriptive, exploratory and cross-sectional design, and used quantitative and qualitative methods for data collection that included a semi-structured survey questionnaire and focus group discussion. A purposive sample of trainees enrolled in the pilot programme (n = 15) was recruited for this study. Results were analysed quantitatively for the survey questionnaire and content analysis was used for qualitative data.ResultsResults revealed trainee satisfaction with the quality of community based visits and classroom lectures and dissatisfaction with on-site supervision and training material. Qualitative findings indicated a need to improve information and communication of supervisors and preceptors, and to provide more training material. Factors related to the work environment were identified as barriers to implement learning, but the use of tools developed in family medicine curricula was perceived as beneficial. Lessons learnt included the need for strong programme coordination and stakeholder commitment, as well as the need to develop a competence framework for PHC nursing.ConclusionThe implementation of a pilot programme for PHC nurse training had the outcomes of trainee satisfaction with the mixed method of teaching, and valuable lessons were learned with regard to programme implementation and organisation. Integration of tools and concepts developed in the field of family medicine proved beneficial, and several recommendations were formulated to inform similar projects.

Career plans and views of trainees in the Academic Clinical Fellowship Programme in England

Background: The Academic Clinical Fellowship (ACF) programme in England was introduced in 2007 to support the training of clinical academics.Aim: To report on career plans and views of ACF trainees.Method: Questionnaire survey of trainees appointed in 2008.Results: Of 102 responders, 63% expected to work eventually wholly in clinical academic posts, 34% in clinical service posts with some teaching and research, and none in clinical service posts with no teaching or research. Of factors that had influenced the choice of an academic career ‘a great deal’, 83% of responders cited having a ‘varied and stimulating career’, 79% the ‘intellectual environment’ of academic departments, 78% the ‘challenge of research’ and 62% the ‘stimulation of teaching’. The most important factors that might dissuade them from eventually pursuing an academic career were ‘difficulty obtaining research grants’ (specified by 42%), followed by ‘competing pressures in the three areas of research, clinical work and teaching’, lack of ‘pay parity with NHS colleagues’, and concerns about adequate availability of academic posts at senior levels.Conclusions: The responders were highly motivated by the challenges of academic work. However, policymakers need to consider what, if anything, might realistically be done about potentially demotivating factors.

BOTA – what do we do for trainees?

The British Orthopaedic Trainees Association (BOTA) has now been established for 23 years. Set up in 1987 by Richard Rawlins, the organisation has grown from the founding 45 members to include over 1,000 trainees. Orthopaedic surgeons make up one of the two largest specialties in the Royal College of Surgeons. As such, we devolved from the Association of Surgeons in Training (ASiT) so that the views of orthopaedic trainees could be represented more specifically. That said, BOTA and ASiT have excellent working ties, joining forces on specific issues such as the European Working Time Regulations.

Gender balance in primary initial teacher education: some current perspectives

The drive to recruit more male primary teachers has been a longstanding aim of many Western countries. Within England the Training and Development Agency for Schools has undertaken a 10‐year marketing campaign to increase the numbers with limited success. Researchers have attempted to analyse the reasons for this failure, considering many areas, for example, the feminisation of the teaching profession, the low status of the primary teacher and concerns about child protection. This paper discusses the findings of a research study undertaken by a group of providers of ITE (initial teacher education) aiming to examine current issues relating to the recruitment and retention of male students in primary ITE. Many similar studies have researched only the male ‘voice’. However, in an attempt to explore any differences in contributory factors, the research reported here examined views of both successful male and female trainees on ITE courses and their course providers. The findings indicated that gender was overwhelmingly seen as irrelevant by trainees themselves. Where there was a significant difference to other studies it was that there was no significant gender difference observed in relation to concerns about child protection. The study also identified successful strategies for retention and completion. Within these there was however a gender divide and the research highlighted that some strategies were seen as particularly supportive for male trainees. Where this is the case it is important that providers/policy makers acknowledge these and continue to address particular groups’ needs.

From autopsy to biopsy: A metacognitive view of lesson planning and teacher trainees in ELT

Lesson planning and implementation of those plans are complex and cognitively demanding for English Language Teacher trainees preparing for the profession. Many find it difficult to develop a lesson holistically and to maintain alignment across aims, procedural steps, and evaluation when planning and implementing a lesson. We attempted to address this problem by establishing a model of trainees’ action that included their deliberate metacognitive structuring of a lesson both in planning and review phases. Data from a first exploration of student thinking elicited by the model indicate positive shifts in trainees’ holistic thinking and a student-centeredness in the critical perspectives they took in both planning and review.

Sources of Occupational Pressure in Intensive Care and Potential Remedial Interventions

This study explores the views of intensive care medicine consultants and trainees concerning sources of occupational pressure, the perceived utility and practicability of organisational changes designed to reduce these, and the relevance of these findings for attempts to promote recruitment into and reduce attrition from the specialty. An anonymised postal self-report questionnaire was used to obtain the views of consultants and trainees, using a combination of specifically designed questions and an existing psychological measure. A wide range of sources of occupational pressure was identified, some generic and some more specific to occupational roles and location. Ratings of potential remedial occupational changes revealed that not all those considered to be most useful were considered to be practicable. Self-report data indicated some differences between consultants and trainees. The complex mixture of occupational pressures warns against simplistic introduction of potential interventions and confirms the need to consider different pressures at different career stages. Responsibility for identifying, implementing and evaluating such remedial occupational changes lies at individual, local, professional and managerial levels. It is suggested that the current methodology could be developed to explore similar questions among other medical specialties or healthcare professions.

Study to assess trainees views of their training in child protection

There have been some tragic deaths and serious injuries to children caused by adults who should have been caring for them. Some children had seen medical professionals shortly before their death. This has led to intense interest in child protection proceedings and questions about how well doctors are trained to recognise children who may be at risk. <h3>Aims</h3> To find out if doctors looking after children have had child protection training, are aware of child protection procedures and know how to identify children at risk. <h3>Method</h3> All trainees from F1 to SpR/ST8 in the specialities of paediatrics, emergency medicine, orthopaedics, ophthalmology, otorhinolaryngology, psychiatry and general practice were selected. These specialities are where doctors are most likely to see children. All 14 postgraduate deaneries in England were offered the opportunity to participate in this study. The deaneries then sent a standard questionnaire to all of their trainees from F1-SpR/ST8 in the selected specialities. Responses were anonymous and returned directly to us via a secure online survey provider. Results 1084 responses from trainees of all grades and specialities working in 10 deaneries. These were analysed as a whole and also by grade, specialty and frequency of consultation with paediatric patients. 59 respondents saw children only as relatives of patients. Most consulted with children either frequently or exclusively. 710 doctors (65.5%) agreed or strongly agreed with the statement “I feel confident that I can recognise the signs of abuse or neglect.” 298 doctors (27.5%) did not know how to find out if a child is subject to a Child Protection Plan. 585 respondents (54%) knew how to make a referral to Children9s Services. 385 (35.5%) said they were aware of the investigations and procedures which follow a child9s referral to children9s services. 105 doctors (9.7%) had “never had any formal child protection training.” A further 163 (15%) of doctors reported poor or very poor child protection training. <h3>Conclusion</h3> Many doctors do feel confident in recognising the signs of abuse and understand the procedures to follow. However, a significant proportion of doctors are undertrained in this area. This must change if we are to offer vulnerable children the protection they need.

Half-day release in vocational GP training: a case study of redesign based on qualitative evaluation

Mindful of the changes to general practice (GP) and GP training over recent years, one vocational training scheme (VTS) decided to thoroughly evaluate its long-running half-day release scheme to decide if it remained fit for purpose, and to plan and implement changes in the light of findings. A literature review was first carried out to ascertain what is known about the contribution that day release and half-day release (HDR) programmes make to GP training. Little has been published on content or evaluation but there is varied experience of incorporating release training into hospital training. This case study reports the views of trainers and trainees on the HDR at Tees Valley Vocational Training Scheme, and the resultant changes made to this HDR programme by the participants. Trainers mostly valued their commitment to HDR small group teaching for their personal development as teachers and for the opportunity to 'keep in touch' with trainees during their hospital posts. Trainees were positive about the HDR programme, but requested more continuity. The plan that evolved is to continue weekly HDR throughout the training programme, keeping trainees in the same small group for three years. In ST1 and ST3 years one programme director per group facilitates each session, maintaining consistency over the year, and liaising with specialists around content. Trainers each teach two sessions in ST2 year. Elective sessions are planned for extended training.

A trainee perspective on the future of clinical psychology in the NHS

In the context of recent cuts in funding for NHS mental health trusts, the Doctorate in Clinical Psychology Programme at the University of Hertfordshire organised a one-day conference entitled ‘The Future of Clinical Psychology in the NHS’ in June 2007. As part of this conference a survey of the views of UH trainees was undertaken which explored trainees’ thoughts and sentiments about clinical psychology and its future within the current climate.

The views of teacher trainees on the classroom applications of lecturers

This study aims to determine the views of teacher trainees on the classroom applications of lecturers.This paper is a descriptive style qualitative research.The study group consists of 19 volunteer teacher trainees studying at Selçuk University Ahmet Keleşoğlu Education Faculty Elementary education teacher Training Department in the first semester in 2008-2009 academic year.Semi-structured and nondirective interview techniques were used to collect data. Interviews were recorded with an audio recorder and analyzed later.“Descriptive analysis” is used to analyze data.As a result, teacher trainees found the classroom applications of most of the lecturers insufficient, and mentioned that those lecturers need self development in this field.

Future of Vascular Surgical Training: The Trainees' Views

In the UK, surgical training includes all aspects of general surgery. Vascular surgery is not an independent specialty. We wished to assess the views of vascular trainees in UK on the future of vascular surgery and training. Trainees were surveyed in 2003, 2004 (after introduction of the European Working Time Directive) and 2005, concentrating on four areas - future practise of vascular surgery, role of endovascular training, vascular specialisation and future training. The majority of trainees want to practise vascular surgery alone. In 2003, 80% thought training should include endovascular techniques. By 2005, all trainees regarded training as mandatory as endovascular techniques would represent a significant part of their future work. Opinion changed on training; from 4 years general then 2 years vascular surgery (qualification in general surgery) to 2 years general and 4 years vascular surgery (specialist qualification in vascular surgery; P < 0.0001). Opinion also changed, that vascular surgery should spilt from general surgery to form its own speciality (P < 0.0007). Trainees now regard training in endovascular techniques and endovascular aneurysm repair as mandatory. The majority wish to specialise from general surgery and achieve a separate qualification in vascular surgery.

An evaluation of the effectiveness of online clinical quandaries in increasing trainee clinical psychology knowledge

Game informed learning principles are increasingly being applied to both the wider educational context and specifically to allow the learner to role play a profession in a safe context prior to entering real practice. This questionnaire based study aimed to examine the impact of an online clinical quandary on the knowledge of trainee clinical psychologists in relation to challenging behaviour in people with a learning disability. Trainee knowledge in relation to key concepts required for successful assessment, intervention and evaluation of challenging behaviour was measured before and after using the clinical quandary, prior to any formal clinical psychology training (n=62). Trainee views on the use of the clinical quandary were also gathered. A significant increase in scores was found after using the clinical quandary, for the following factors: dealing with the initial referral; recording and overall total scores. Trainees evaluated the quandary as interesting, challenging, stimulating and helpful as a study aid. The results suggest that online clinical quandaries may offer a useful learning tool for increasing trainee knowledge and allowing them to rehearse skills in an environment where mistakes do not impact on patients.

Common needs and different agendas: How trainee teachers make progress in their ability to use ICT in subject teaching. Some lessons from the UK

The paper reports on the outcomes of a British Educational Communications and Technology Agency (BECTa) funded study which explored the views of teacher trainees and their mentors in two different school subjects on what strategies, interventions and resources had a positive impact on their ability to use ICT effectively in their subject teaching. The research aimed to explore both commonalities in trainees’ views of which strategies and interventions had a positive influence on their ability to use ICT effectively in subject teaching, and subject discipline dimensions of ICT use, i.e. the ways in which training needs might vary between trainees in different school subjects. The study focused on the views of two successive cohorts of science and history trainees (133 trainees in all), and 21 of their supervising mentors. The outcomes showed that some important determinants of progression in the ability to deploy ICT confidently and effectively in subject teaching were common to both subject groups, but that there were differing views on which ICT applications offered most potential for enhancing teaching and learning in their subject and differences in their preferred priorities for investment in ICT. The study also revealed that trainees felt that many of the experiences and resources which they had encountered in the course of their training had not been helpful. A follow up survey was undertaken of 114 trainees across six subject areas to further explore some of the findings from the initial survey. The concluding section of the paper suggests ways in which trainee teachers might be prepared more effectively for using ICT in their subject teaching.

Technical training in surgery: the trainee's view.

A questionnaire designed to investigate the technical training of general surgical trainees was distributed throughout Scotland. A total of 222 questionnaires were sent out and 179 (81 per cent) were returned. Of the responders, 38 per cent felt that the overall operative workload was too small and the majority thought that there was too little emphasis on supervised operating. Two-thirds of trainees were generally satisfied with the amount of unsupervised operating, although a substantial proportion (21 per cent) sometimes felt out of their depth when performing delegated emergency operations. Few had attended craft workshops or travelled to other centres, but of those who had, most considered both activities to be very useful. Photographic atlases and videos were not generally felt to be of great value by those who had used them. The majority of trainees did not believe that research activity had interfered excessively with their technical training.