This is the sixth in a series of CPD articles aimed at reviewing the recent general medical literature relating to topics that may be of interest to dermatologists. In this issue the new classes of anti-retroviral drugs will be described in the context of the replication cycle of human immunodeficiency virus (HIV). The regimens of drug treatments and the more common side-effects including HIV-lipodystrophy syndrome will be discussed along with the recommendations for testing of people for HIV from new guidelines.
AimTo explore how the South-West Foundation Doctor Quality Improvement programme affected foundation year 1 (F1) doctors’ attitudes and ability to implement change in healthcare.MethodsTwenty-two qualitative interviews were carried out with two cohorts of doctors. The first F1 group before and after their participation in the QI programme; the second group comprised those who had completed the programme between 1 and 5 years earlier. Qualitative data were analysed using thematic analysis techniques.Results Prior to taking part in the QI programme, junior doctors’ attitudes towards QI were mixed. Although there was agreement on the importance of QI in terms of patient safety, not all shared enthusiasm for engaging in QI, while some were sceptical that they could bring about any change. Following participation in the programme, attitudes towards QI and the ability to effect change were significantly transformed. Whether their projects were considered a success or not, all juniors reported that they valued the skills learnt and the overall experience they gained through carrying out QI projects. Participants reported feeling more empowered in their role as junior doctors, with several describing how they felt ‘listened to’ and able to ‘have a voice’, that they were beginning to see things ‘at systems level’ and learning to ‘engage more critically’ in their working environment.Conclusions Junior doctors are ideally placed to engage in QI. Training in QI at the start of their medical careers may enable a new generation of doctors to acquire the skills necessary to improve patient safety and quality of care.
In the current environment of culture change and financial pressure on the National Health Service, quality improvement initiatives are heralded as new vehicles for workplace evolution. Foundation Year One doctors encounter many of the problems impinging on quality, and their enthusiasm and number make them an indispensable resource and critical mass for improvement.In response to the increasing importance of quality improvement training, and as part of an ongoing project to embed quality improvement education in the Severn Deanery region, this paper describes the evolution of a questionnaire tool to assess the attitudes and beliefs of a cohort of new Foundation Year One doctors.An electronic survey was developed and validated to address each aim of quality care. The survey was sent by email to every Foundation Year One doctor in the Severn Deanery.New Foundation Year One doctors' attitudes are overwhelmingly positive towards quality improvement and patient safety; however, universally, they do not feel valued and listened to. In addition, they do not feel that their previous medical education has fully equipped them to improve the quality and safety of the care they deliver to their patients. Foundation Year One doctors represent a large, intelligent and enthusiastic workforce and in an environment where quality is now accepted as paramount, harnessing their potential through better quality improvement training could prove advantageous to all National Health Service stakeholders.
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