Training In UK Research Articles

A comparison of general surgery training programmes across 11 countries: improving understanding of the experience level of international medical graduates in the UK.

Within the past five years there has been a significant increase in the number of international medical graduates (IMGs) joining the United Kingdom's (UK) workforce. Having mentors and supervisors who understand the needs of IMGs and clinical and cultural differences in the workplace can benefit in the transition to working in a new country. Improving knowledge of and understanding differences between general surgical training programmes and grades across different countries could therefore aid in the support of IMGs within the UK. Data on general surgical training programmes of the top ten countries for the primary medical qualifications of IMGs in the UK were collected to provide comparison with the UK training programme. The following countries were included: UK, India, Pakistan, Nigeria, Egypt, Ireland, Sudan, Sri Lanka, Romania, Iraq and South Africa. Training programme lengths ranged from 3 to 10 years. Only some training programmes provide additional training and qualification in sub-specialisation in general surgery. Other differences included a requirement for internship/non specialist training prior to training, differences in lengths of time spent in other surgical specialties and a requirement for research. Understanding the training programmes of other countries may help UK surgeons to understand the prior experience of IMGs and enable them to provide better training and support.

UK Trainee Experience with WALANT - An Audit of 102 Cases.

Background: WALANT has gained much popularity in recent years, especially with COVID-19. However, a recent survey of the American Society for Surgery of the Hand membership (i.e. attendings/consultants) showed that only 17% were exposed to WALANT during residency or fellowship training. There is much interest in WALANT from trainees, but interpretation of the type and volume to be administered is highly varied. Methods: The aims of this study were (1) to survey a group of plastic surgery trainees in the UK about their knowledge of WALANT formulas, and (2) to compare trainee logbook records of WALANT procedures (if available) with published data from the UK. Results: All trainees were familiar with the 'standard' WALANT formula (1% lidocaine, 1:100,000 adrenaline ± 8.4% NaHCO3) described by Lalonde. However, because of local formularies, rather than 1:100,000 adrenaline, all used 1:200,000 adrenaline as it comes premixed in the UK. Other formulas used by UK trainees included 0.5% bupivacaine + 1:200,000 adrenaline, and mixing 1% lidocaine + 1:200,000 adrenaline with 1% lidocaine 1:1. In comparing available trainee WALANT records with published UK data, the average volume of WALANT used was 6.6 mls in the current study versus 12.9 mls for similar procedures (wound debridement and skin closure ± local flap, digital nerve repair, fingertip reconstruction, thenar injuries, phalangeal fracture and single digit extensor repair); specifically, for single digit flexor tendon repairs, this was 10 mls versus 16.3 mls. Conclusions: While the British Society for Surgery of the Hand (BSSH) have developed official guidance for the use of WALANT in the UK, it appears there remains much variation in interpretation and hence, application. Comparison of trainee logbook records of common hand surgery procedures suggests that most can be done with much less WALANT administered than previously reported, with safe and reproducible results. Level of Evidence: Level IV (Therapeutic).

Evaluating the Experiences of Novice Veterinary Clinical Practice Educators: A Qualitative Reflection on a UK Training Program.

Within the evolving landscape of veterinary education in the United Kingdom, an increasing shift toward a distributed model of instruction necessitates that clinicians who assume the role of novice educators, receive training as clinical educators. The University of Surrey has pioneered a training program aimed at promoting understanding and application of educational theory in veterinary educator identitydevelopment. This study investigated the reflections of novice educators upon conclusion of their training to delineate the program's efficacy and identify areas of educator training necessitating further research and enhancement. A convenience sample of 53 reflective narratives was subjected to inductive thematic analysis. Three principal themes emerged. The first encapsulated an enhanced cognizance of student learning needs, underscored by foundational learning theories. Notably, the introduction of "feedforward" and the incorporation of student reflection within the feedback mechanism were identified as innovative concepts. The second theme revolved around the personal growth experienced because of participation in the training program, with 47% of reflections articulating profound introspection. The final theme explored the perceptions of the rewards and challenges associated with balancing the educational program with routine professional responsibilities, highlighting an increase in self-confidence and the obstacles encountered in allocating time for training.

Perspectives on Academic Training in Clinical Oncology in the United Kingdom: A National Cross-Sectional Analysis

AimsThere are longstanding concerns relating to clinical academic training pipelines, with evidence for multiple barriers and enablers to clinical academic career progression. We sought to assess the extent to which these and other factors apply to academic training in clinical oncology in the United Kingdom. Materials and methodsA cross-sectional survey was undertaken using a bespoke, pre-piloted online electronic questionnaire that was distributed to clinical oncology specialty trainees and consultants who had at any point between January 2013–January 2024 commenced an academic post whilst in training. Collated information included demographic data, location and stage of training, research experience and ambitions, research skill confidence and academic career progression. ResultsSeventy eligible responses were included, representing 84% (n = 16/19) of UK training deaneries. Thirty-seven (53%) of the respondents had obtained their certificate of completion of training (CCT) whilst 11% (n = 8/70) and 40% (n = 28/70) were at specialty trainee level and respectively pre- or within-/post-doctoral studies. Of 34 post-CCT respondents, 58% (n = 20) had ongoing research commitments but this reached 30% of their overall activity for just 30% (n = 10). Barriers to academic progression included clinical training requirements, post availability and limited mentorship. Most (60%; n = 35/58) undertook doctoral studies in their final two training years. A majority of respondents lacked confidence in radiation oncology (RO) skills relevant to their career ambitions, with 60%, 40% and 30%, respectively, confident in RO clinical research outcome evaluation, in vitro radiation analyses and using RO animal models. ConclusionThese data provide a granular, long-term analysis of academic clinical oncology training at a national level; identifying poor progression to research independence underlined by limited confidence in RO research skills and multiple barriers to academic career progression. These data provide areas in which policy makers, research funders and training programmes can focus to improve academic training in clinical oncology.

Corrigendum to “A question of credibility: A focus group study examining the experiences of workers attending counter-terrorism training in UK crowded places”

Corrigendum to “A question of credibility: A focus group study examining the experiences of workers attending counter-terrorism training in UK crowded places”

320 Views and Awareness of Egyptian Surgical Trainees on Pursuing Membership of the Royal College of Surgeons (MRCS) in the UK: A Single-Institutional Study

Abstract Aim International surgical trainees view training overseas as an attractive pathway for achieving excellence in surgery. The internationally recognised MRCS examinations provide a benchmark that trainees can use to meet this aspiration while also benefitting from great international mobility. We aimed to look at the awareness and views of Egyptian surgical trainees to training in the UK and pursuing MRCS. The motivations for and the barriers to these aspirations were explored. Method An observational cross-sectional study of interns, residents, and assistant lecturers at Ain Shams University Hospitals was conducted from October to December 2023 using a 26-item paper-based survey. This was designed to assess understanding of UK surgical training and ascertain views on UK surgical training and pursuing the MRCS examinations. Results 194 participants were involved in this study, with 58.76% being male and the mean age being 26.84 ± 2.58 years. 73.4% generally agree that pursuing surgical training in the UK is an attractive career option. 55.85% generally agree that it is a financially viable career option, and 31.38% remain neutral. 66.5% personally know someone who has trained in the UK and/or sat MRCS. 51.59% report it is easy to find information on UK training and the MRCS exams. Conclusions It is evident that surgical training in the UK and pursuing MRCS is an attractive option for Egyptian surgical trainees. However, many barriers and a lack of information make these aspirations hard to achieve. Further work is required to improve support structures and to assess if these sentiments are shared with trainees elsewhere.

1161 Fostering International Surgical Trainee Collaboration: The UK-Iceland Trainee Collaborative

Abstract The Foundation In 2019, the UK Iceland Trainee Collaborative emerged in response to Iceland’s adoption of the Intercollegiate Surgical Curriculum Programme (ISCP), aligning training portfolios with the UK’s practices. A collaboration between core surgical trainees, this new initiative aimed to champion the transition of Icelandic trainees to a new portfolio system, as well as foster a new relationship to encourage combined research and projects between the two nations. The Progression Beyond portfolio alignment, the collaboration expanded into a multifaceted educational platform. Monthly seminars and an annual conference, initially delivered online, provided a forum for knowledge exchange, featuring research showcases, consultant talks, and insights into portfolio optimization and program developments. The Impact The collaborative facilitated seamless integration of ISCP into Icelandic trainees’ competency progression, mirroring UK practices. The annual conference, delivered in person in its 3rd edition in Reykjavik, Iceland, in October 2023, received overwhelmingly positive feedback, with high delegate satisfaction rates, highlighting the leadership skills honed by core surgical trainees leading this initiative. The Future The collaborative now aims to intensify research partnerships between UK and Icelandic trainees, deepening knowledge exchange and advancing collective understanding. The trajectory for 2024 involves strengthening bonds and knowledge sharing among trainees from both nations through collaborative research initiatives. We hope the annual conference will continue to grow and will alternate between the two nations, strengthening the relationship.

P033 Online educational resources in paediatric and adolescent rheumatology- what’s new?

Abstract Background/Aims Paediatric and adolescent rheumatology (PAR) is a small sub-specialty, and due to the rarity of some conditions, UK trainees find it difficult to access relevant educational materials. Furthermore, due to the wide geographical distribution of paediatric rheumatology centres, regional educational opportunities are limited. A 2022 survey of the UK PAR trainee group confirmed that the creation of more PAR specific online educational materials and signposting of current guidelines/ resources was needed. Survey participants were supportive of a range of delivery methods, including webinars, e-learning, case studies and podcasts. Methods A PAR trainee education team was formed in 2022, with the aim of promoting learning opportunities, by developing and collating educational resources. The PAR trainee education team has been working both independently and in conjunction with the British Society of Rheumatology (BSR) education team and Digital Learning Board (DLB) to achieve this aim. Activities have included the following: a) Creation of a BSR hosted Teams channel to store PAR specific educational information; b) PAR trainee inclusion on the BSR DLB, which creates digital education resources including podcasts and the monthly blended learning Spotlight topic series; c) Creation of PAR focused podcasts within the BSR Talking Rheumatology podcast series; d) Organisation of webinars on PAR relevant topics; e) Creation of a PAR podcast playlist on the Spotify platform; f) Production of a resource list and education newsletter to signpost relevant existing/upcoming learning opportunities and events. Results A 2023 follow up survey of the PAR trainee group (n = 16 respondents), showed the most used resources were podcasts (69%), the newsletter (63%) and resource list (43%). Webinars (38%), the Teams channel (38%) and the BSR Spotlight series (31%) had been accessed less. BSR podcast download data illustrated that PAR relevant podcasts from the Talking Rheumatology/ Talking Rheumatology Spotlight series have a UK and international audience. There have been over 2500 downloads from six PAR relevant podcasts covering myositis guidelines, biologics in PAR, HLH, antiphospholipid syndrome and ultrasound in PAR. Feedback from those who have used the various educational resources has been extremely positive, although comments have indicated a barrier in terms of awareness of the materials and how to access them. Conclusion Good progress has been made, however maximising means and opportunities to disseminate available resources within the PAR community is vital. Work to develop, collate and signpost more PAR educational content is ongoing. A project is in progress to create condition-specific lists of classification criteria, guidelines and key studies. The PAR trainee group are very grateful to all of those who have supported this work including the professionals who have shared their knowledge and expertise via podcasts and webinars, members of the BSR DLB and the education team at BSR. Disclosure J. Lemon: Other; Unpaid member of the BSR Digital Learning Board. R. Close: None. G. Dobson: None. K. Maxey: Other; Works for the BSR as Events and Education Officer. J. May: None. D. McLaughlin: None. I. Rajarathinam: None. S. Saadalla: None. L. Yeo: None. P.A. Watson: Other; Works for the BSR in a paid role (2PA per week ) as digital learning editor.

What racialised aspiring clinical psychologists need from a mentoring scheme

PHOTO CREDIT: Christina WocinIt has been long recognised that there is an increased gap between the application and acceptance rates of racialised applicants to clinical psychology training in the UK, relative to White applicants. In 2020, Health Education England released funding for UK training programmes to develop mentoring schemes for aspiring clinical psychologists from racialised groups. This study was undertaken to explore how such mentoring schemes might best support racialised applicants. Three focus groups, comprising a total of 24 racialised aspiring, trainee, and qualified clinical psychologists, were undertaken to gather views regarding how a mentoring scheme could support racialised aspiring clinical psychologists. Data was analysed utilising reflexive thematic analysis. Three themes were developed: ‘Gaining Access to a White Profession – What’s the White thing to say?’ captured participants’ views that mentoring schemes should support mentees to present themselves in ways that fit with what selection assessors will be looking for. ‘A Safe Space to Explore the Impact of Racialisation’ related to the importance of mentoring schemes creating safe opportunities to make sense of the impact of racism within their career. ‘Troubling Whiteness’ spoke to the importance of mentees being empowered to think with other racialised individuals about ways they could actively address Whiteness within the profession and services. The three themes have implications for the delivery and evaluation of mentoring schemes for racialised aspiring clinical psychologists.

Evaluating neurosurgical training: a national survey examining the British trainee experience

Purpose Neurosurgery training in the UK has undergone significant changes over the past few years, including the new competency-based curriculum and a reduction of elective operating due to the pandemic. We conducted a comprehensive survey to assess UK neurosurgical trainees’ experiences and perceptions to develop targeted action plans. Methods An online anonymised survey was developed and distributed amongst the BNTA mailing list. Question types included 10-point Likert scales and free text options. Descriptive statistics, non-parametric testing of Likert scores, and Spearman’s rank correlation were used to analyse responses. Pearson’s chi-squared test was used for subgroup analysis of categorical data. Results A total of 75 trainees with a National Training Number (NTN) responded. Overall trainees feel they are well trained, well supported, and have caught up with training emerging out of COVID. Funding for training varied between deaneries. There is significant concern amongst trainees regarding the workforce crisis. This, as well as financial concerns are leading to more than a quarter of trainees considering quitting. Half of the trainees are considering going OOP. More than one third of the trainees and more than half of the female trainees are considering working Less Than Full Time (LTFT). Most important supportive mechanisms towards completion of training were social support, along with personal satisfaction from work. An independent mentoring scheme is a preferred additional support mechanism. Conclusions Overall training experience for neurosurgery trainees in UK and Ireland was positive. There are significant concerns regarding the workforce crisis and costs of training, with a large proportion of neurosurgery trainees considering resigning. OOP and LTFT are popular means of becoming more competitive for consultant posts and to spend time with their families. Deanery experience, senior and peer support does, and will improve trainee experience and protect against attrition.

Survey of United Kingdom oral and maxillofacial surgery (OMFS) specialists and trainees about the reasons that they retain or drop their registration with the General Dental Council (GDC) including a summary of changes in the numbers registered with the GDC 2014-2023

When dual degree OMFS training was mandated in the UK in 1995, OMFS specialists were required to be registered with both the General Dental Council (GDC) and General Medical Council (GMC). In 2005 this legal requirement for dual registration with both regulators was removed. During 2021 the authors surveyed UK OMFS specialists and trainees asking them why they chose to remain on or leave the Dental Register to give context to the changing numbers of OMFS specialists and trainees holding Dental Registration between 2014 and 2023. In 2014 of 539 OMFS specialists and trainees only 62 (12%) were solely GMC registered, that is, they had let their Dental Registration lapse. In 2023, of 709 OMFS specialists and trainees, 320 (45%) were solely GMC registered. Those whose first qualification was medicine were less likely to be dually registered. Of those who replied to the survey and remained dually registered, most (40%) based this decision on ‘worries about the consequences’ of dropping their dental registration. Some other reasons were not based on fact at that time. Cost was the most common reason (49%) given for dropping their GDC registration by respondents who were only registered with the GMC. On the positive side, the January 2023 GDC position statement about OMFS who are not on the Dental Register removed the GDC’s previous restriction on location of practice and teaching dental students. However the statement does not unambiguously allow OMFS surgeons to practice across the full OMFS curriculum. Will the 2023 GDC position statement alter the trend of OMFS specialists and trainees towards single medical registration?

Regional anaesthesia training in the UK – a national survey

BackgroundAdequate training of anaesthetists in regional anaesthesia is important to ensure optimal patient access to regional anaesthesia. MethodsWe undertook a national survey of UK trainee anaesthetists and Royal College of Anaesthetists (RCoA) tutors to assess experiences of training in regional anaesthesia. We performed descriptive statistics for baseline characteristics, and logistic regression of training indices and tutor confidence that their hospital could provide regional anaesthesia training at all three stages of the RCoA 2021 curriculum. ResultsA total of 492 trainees (19.2%) and 114 tutors (45.2%) completed the survey. Trainees were less likely to have received training in chest/abdominal wall compared with upper/lower limb blocks {erector spinae vs femoral block (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.16–0.39), P<0.001}, or achieved >20 chest/abdominal wall blocks by Stage 3 of training (chest vs lower limb block [OR 0.09, 95% CI 0.05–0.15, P<0.001]. There was a strong association between training received, number of blocks performed (>20 vs 0–5 blocks), and self-reported ability to perform blocks independently, OR 20.9 (95% CI 9.38–53.2). 24/182 (13%) and 10/182 (5.5%) of trainees had performed ≥50 non-obstetric lumbar and thoracic epidurals, respectively, by Stage 3 training. There was a positive association between having a lead clinician for regional anaesthesia, particularly those with paid sessions, and reported confidence to provide regional anaesthesia training at all stages of the curriculum (Stage 3 OR 7.27 [95% CI 2.64–22.0]). ConclusionOur results confirm the importance of clinical experience and access to training in regional anaesthesia, and support the introduction of departmental regional anaesthesia leads to improve equity and quality in training opportunities.

Preliminary Evaluation of a Web-Based International Journal Club for Ketamine in Psychiatric Disorders: Cross-Sectional Survey Study.

The use of novel rapid-acting antidepressants for psychiatric disorders is expanding. The web-based Ketamine and Related Compounds International Journal Club (KIJC) was created during the COVID-19 pandemic by UK academic psychiatrists and trainees for interested global professionals to discuss papers related to the topic of ketamine for the treatment of psychiatric disorders. The KIJC aimed to facilitate bidirectional discussions, sharing of ideas, and networking among participants. The aim of this study is a preliminary evaluation of the journal club's format for satisfaction and impact after the first year of running. A website, email, and word of mouth were used for recruitment. The journal club was held twice per month using videoconferencing software in 3 parts: a 20-minute presentation, a 15-minute chaired question and answer session, and a 25-minute informal discussion with participants' cameras on. The first 2 parts were recorded and uploaded to the website alongside links to the corresponding papers. In total, 24 speakers presented from 8 countries, typically within 2 (SD 2) months of publication. The average attendance was 51 (SD 20) audience members, and there were 63 (SD 50) views of each subsequent recording. Two anonymous web-based cross-sectional surveys were conducted from November 2021 to February 2022, one for speakers and another for audience members, separately. Various survey statements, 14 for speakers and 12 for the audience, were categorized according to satisfaction and impact, alongside obtaining participants' primary career roles and requesting optional written feedback. Responses were compared between both groups and analyzed, including an inductive thematic analysis and a summary of lessons learned. A total of 30 survey responses were obtained, demonstrating overall agreement with the statements. In total, 12 (50%) out of 24 speakers and 18 (35%) out of an average of 51 (SD 20) audience members regarded the journal club's format as satisfying and impactful. The majority (26/30, 87%) of respondents identified as clinicians (9/30, 30%), researchers (9/30, 30%), and clinician-researchers (8/30, 27%). Additionally, 11 (37%) of the 30 respondents also provided optional written feedback: 3 (10%) speakers and 8 (27%) audience members. From the written feedback, 5 main themes were derived: engagement with the journal club, desire for active participation, improving the platform, positive learning experiences, and suggestions for future sessions. The journal club successfully reached its intended audience and developed into a web-based community. The majority of the participants were satisfied with the format and found it impactful. Overall, the journal club appears to be a valuable tool for knowledge sharing and community building in the field of ketamine use for the treatment of psychiatric disorders. A larger sample size and additional testing methods are required to support the generalizability of the journal club's format.

Interventional radiology training in the UK: a view from within-a national survey.

Interventional radiology (IR) training in the UK has evolved since recognition as a subspecialty in 2010 and introduction of a new curriculum in 2021. The changing landscape, increasing workload and COVID-19 have affected training. The purpose of this study was to review trainees' perspectives on training and develop strategies to further improve training. Online survey approved by the British Society of Interventional Radiology Council distributed to British Society of Interventional Radiology Trainee members between 9 March 22 and 25 March 2022. The survey was open to all UK based ST4-6 IR trainees and fellows. Descriptive and thematic analysis was undertaken. 43 responses were received from 17/19 UK training regions. Females represented 10% (4/41) and 5% (2/43) less than full time (LTFT) trainees. 82% (31/38) felt their curriculum was suitable for their training and 28/38 (74%) were satisfied with IR training. Vascular IR, Interventional Oncology, paediatrics and stroke thrombectomy were identified as areas of training desiring improvement. 45% (18/40) stated exposure to IR led clinics and 17.5% (7/40) to IR led ward rounds. Only 6/38 (15.7%) received structured IR teaching at least once a month. Approximately, a third of respondents (13/38) stated training opportunities were significantly compromised secondary to COVID-19. This survey shows overall good satisfaction with IR training. However, improved training opportunities in vascular IR, interventional oncology, paediatric IR and stroke thrombectomy are required. In addition, access to clinics, ward rounds and protected time for research is needed to improve training quality. New national UK IR training survey.

Climate and Health Toolkit for Public Health Registrars

Abstract Background The UK Faculty of Public Health (FPH)'s Climate and Health Strategy vision is for the public health (PH) workforce to “lead on strategies to protect health and wellbeing for current and future generations”, and the UK PH curriculum requires registrars to “demonstrate leadership in environmental sustainability” (ES). However, UK PH training currently provides limited opportunities and support for ES work: a 2022 survey of 18 PH registrars in the East of England found that most (78%) had never or infrequently incorporated ES into past projects, due to uncertainty of appropriate sustainability measures or limitations of supervisory knowledge or support. The majority (89%) felt building ES into their future work was “very important” or “important”, and that a toolkit to support this would be useful (89%). Methods Formulation of this ES toolkit for UK PH registrars is embedded within the FPH's Sustainable Development Special Interest Group (SIG)'s 2023 workplan. The working group comprises current registrars recruited from diverse UK training locations. To inform toolkit contents, previous registrar projects incorporating ES were collected, via national and regional registrar networks, and through interviews with SIG contacts. Usefulness and accessibility will be evaluated following toolkit dissemination to UK registrars. Results The toolkit, structured by placement type, will include: advice on incorporating ES into common placement projects and topics; wider placement activities registrars can undertake to promote greater sustainability; and case studies exploring lessons learned from previous registrar projects that incorporated ES. Conclusions Formulation of a practical toolkit will enable PH registrars to develop knowledge and expertise in ES, equipping the next generation of PH professionals with the leadership skills to champion ES in our climate-changing world. Key messages • It is imperative that public health registrars gain the skills to tackle the health effects of climate change, but additional support for building these skills is required. • This practical toolkit will support UK PH registrars to incorporate ES into their work, thereby building knowledge, expertise and leadership skills around climate and public health.

Is separating obstetrics from gynaecology the way forward? A UK perspective

A recent editorial in this Journal argued that increasing surgical complexity coupled with more limited training calls for separating obstetrics from gynaecology. The speciality suffers manpower challenges and high attrition rates. There is an apparent gulf in approach between researchers focussing on the views of UK graduates or trainees and workforce planners who address the problem through overseas recruitment. Whilst available literature provides scant, if any, indication as to how to address current challenges, it is important that advocates for women’s health assess and mitigate potential drawbacks when exploring the way forward.

Exposure of plastic surgery and urology registrars in the United Kingdom to gender affirming care of transgender patients: A cross-sectional survey of training programme directors

To assess the expected duration of exposure of United Kingdom urology and plastic surgery trainees to the provision of gender affirming healthcare to transgender patients. This observational, cross-sectional survey asked UK training programme directors (TPDs) to report the volume of training in gender affirming care of transgender patients that urology and plastic surgery trainees are expected to receive. A Google Form online questionnaire was distributed to each regional TPD in the UK both for plastic surgery and urology. Eleven of 14 TPDs in plastic surgery and 13 of 19 urology TPDs completed the survey with responses representing 487 trainees. The total estimated exposure of UK trainees to any aspect of gender affirming healthcare was a median of one hour of training per trainee per year (clinical or didactic). Thirteen deaneries reported that trainees received some (didactic or clinical) training in transgender care each year. Only eight of these deaneries reported provision of direct clinical training. The remaining eleven deaneries reported that trainees received no training in gender affirming care. No training was expected to take place for any trainee of either speciality within multi-disciplinary team meetings or in masculinising genital surgery. The above evidence demonstrates the low exposure of plastic surgery and urology registrar trainees to gender affirming care during their training years in the UK.

935 “…And How Are You?” – a Call for Routine Wellbeing Checks in Educational Supervisor Meetings

Abstract Aim The rates of burnout, stress, anxiety, and suicide amongst doctors are increasing. Trainees may not recognise their wellbeing deteriorating or seek support, particularly when they are conditioned to “cope” with extreme experiences. Mental health charities advocate colleagues #starttheconversation to help in destigmatise perceptions of mental health and give those who may not otherwise seek support an opportunity to talk. However, without experience or expertise, this can be daunting. Surgical trainees are mandated to meet their educational supervisor (ES) six times per year. This is an ideal opportunity for trainers to enquire about their trainee’s wellbeing. However, meetings do not mandate any wellbeing discussion and it is unclear how equipped trainers are to have these discussions. This study investigated wellbeing checks within training. Method Two 24-hour cross-sectional polls were conducted via social media asking UK trainees “During your ES meetings, are you routinely asked about your #wellbeing?” and asking trainers “Have you received any formal training in discussing #wellbeing and #mentalhealth with your trainees?”. Results Over 24 hours, 222 trainees voted, with 63.1% not routinely asked about their wellbeing during meetings. 87 trainers voted, with 76.3% without any formal training in discussing wellbeing and mental health with trainees. Conclusions This limited snapshot poll demonstrates that trainee wellbeing is not routinely being checked and that supervisors are variably trained to undertake these discussions. Wellbeing checks should become a standard part of every ES meeting and formal training in discussing well-being should be undertaken to instil confidence. Provisions for checking consultant wellbeing also require investigation.

Evaluating the UK's first national prescribing assessment for GPs in training using an online survey.

GP trainees may not have experienced a systematic and comprehensive education in safe prescribing. Therefore, a self-assessment prescribing review was developed. To determine whether the assessment was feasible, had face validity, and did not disadvantage particular groups of participants. An online survey that evaluates the opinions of GPs in training of a prescribing assessment in the UK. All full-time UK trainees who started their final year of GP training in August 2019 undertook the prescribing assessment along with their trainers, after which they completed an online anonymous feedback questionnaire. The questionnaire completed by trainees sought their opinions of the assessment, and collected ethnicity and disability data. The trainer questionnaire was similar but did not include any demographic information. The questionnaire was completed by 1741 trainees and 1576 trainers. There was no evidence that ethnic group and disability were related to aspects of the review. Most of the trainees (76.4%, n = 1330) and trainers (82.0%, n = 1293) agreed or strongly agreed that the prescribing review was helpful for assessing and learning about the trainee's prescribing. However, most participants (63.2%, n = 1092) took >4 hours to review their prescriptions. A majority of trainees (90.2%, n = 1571) reported that completing the assessment had resulted in a change in their prescribing practice. The majority of trainers and trainees reported that the prescribing assessment was helpful. The study was not able to assess whether there had been an actual change in practice that resulted in an error reduction.

Developing a Serious Game for Rail Services: Improving Passenger Information During Disruption (PIDD)

Managing passenger information during disruption (PIDD) is a significant factor in running effective and quick-to-recover rail operations. Disruptions are unpredictable, and their timely resolution is ultimately dependent on the expert knowledge of experienced frontline staff. The development of frontline employees by their employers usually takes the form of practice reviews and ‘on-the-job’ learning, while academic education majors on theoretical approaches and classroom-based teaching. This paper reports on a novel industry-funded project that has developed a serious game (the ‘Rail Disruption Game’) that combines theory and practice to better manage PIDD for frontline staff in a UK train operating company (TOC). It defines challenges and the development method for the Rail Disruption Game; it also incorporates developer and user feedback. This paper provides insight into how to design, make and deploy a serious game as part of a gamified management process.