A cultural change is needed for trainees to feel that WBAs are not just a tick box exercise, but a useful educational tool for learning. Ongoing work on implementation needs to include additional training, especially on the value of WBAs for formative assessment and consultants having protected time in their job plans for training.

Background: Workplace based assessments (WBAs) have been part of UK training for the last 3 years. Carrying out procedures efficiently and safely is of paramount importance in anaesthesia. Aims: To explore opinions and experiences of Direct Observation of Procedural Skills (DOPS) assessments in a regional anaesthetic training programme. Methods: 19 and 20-item questionnaires were distributed to trainees and consultants respectively. Results: Questionnaire response rate was 76% (90/119) for trainees and 65% (129/199) for consultants. 43% of consultants and 33% of trainees were not trained in DOPS use. Assessments were usually not planned. 50% were ad hoc and the remainder mainly retrospective. Time spent on assessment was short with DOPS and feedback achieved in 15 minutes in the majority of cases with lack of suggestions for further improvement. Both trainees and consultants felt that DOPS was not a helpful learning tool ( p ¼ 0.001) or a reflection of trainee competency. Conclusions: DOPS assessments are currently not valued as an educational tool. Training is essential in use of this WBA tool which needs to be planned and sufficient time allocated so as to address current negative attitudes.

Despite increasing numbers of UK medical students, the number of trainees selecting paediatrics as their specialty choice has decreased. Previous studies show that most students will choose their ultimate career during undergraduate training. We therefore explored the views of students in the final year at Birmingham University about a career in paediatrics. Students completed a 27-item questionnaire during the penultimate week of their paediatric clerkship (PC) and 97% responded (127/131). Prior to the PC, 29% (37/127) of students had considered a career in paediatrics, rising to 50% (63/127) after the PC (p < 0.001). Students felt that paediatricians were enthusiastic and keen on teaching, and the ward working atmosphere was good. However, students perceived paediatrics as a difficult specialty with high competition for training posts. Students felt their paediatric experience was too limited and advice was needed on paediatric careers early in undergraduate training. This study confirmed that focusing on improving the PC is not sufficient if we are to inspire medical students to consider a career in paediatrics. Exposure to the specialty is needed from year 1 of undergraduate training along with career advice to dispel current myths about specialty training. Students would then be able to make more informed career decisions.

Background Leading a ward round is an essential skill for hospital consultants and senior trainees but is rarely assessed during training. Objectives To investigate the key attributes for ward round leadership and to use these results to develop a multisource feedback (MSF) tool to assess the ward round leadership skills of senior specialist trainees. Methods A panel of experts comprising four senior paediatric consultants and two nurse managers were interviewed from May to August 2009. From analysis of the interview transcripts, 10 key themes emerged. A structured questionnaire based on the key themes was designed and sent electronically to paediatric consultants, nurses and trainees at a large university hospital (June–October 2010). Results 81 consultants, nurses and trainees responded to the survey. The internal consistency of this tool was high (Cronbach's α 0.95). Factor analysis showed that five factors accounted for 72% of variance. The five key areas for ward round leadership were communication skills, preparation and organisation, teaching and enthusiasm, team working and punctuality; communication was the most important key theme. A MSF tool for ward round leadership skills was developed with these areas as five domains. Conclusions We believe that this tool will add to the current assessment tools available by providing feedback about ward round leadership skills.

An 11-field structured template for reflective practice was not completed well. We suggest four fields as a maximum so as to enable trainees to reflect and note their personal key learning points. There needs to be an emphasis on quality rather than quantity of ePortfolio reflective logs, both in number and length of log aiming for 1-2 well completed reflections per post.

Background A five-domain multisource feedback (MSF) tool was previously developed in 2009-2010 by the authors to assess senior paediatric trainees' ward round leadership skills. Objectives To determine whether this MSF tool is practicable and reliable, whether individuals' feedback varies over time and trainees' views of the tool. Methods The MSF tool was piloted (April-July 2011) and field tested (September 2011-February 2013) with senior paediatric trainees. A focus group held at the end of field testing obtained trainees' views of the tool. Results In field testing, 96/115 (84%) trainees returned 633 individual assessments from three different ward rounds over 18 months. The MSF tool had high reliability (Cronbach's α 0.84, G coefficient 0.8 for three raters). In all five domains, data were shifted to the right with scores of 3 (good) and 4 (excellent). Consultants gave significantly lower scores ( p<0.001), as did trainees for self-assessment ( p<0.001). There was no significant change in MSF scores over 18 months but comments showed that trainees' performance improved. Trainees valued these comments and the MSF tool but had concerns about time taken for feedback and confusion about tool use and the paediatric assessment strategy. Conclusions A five-domain MSF tool was found to be reliable on pilot and field testing, practicable to use and liked by trainees. Comments on performance were more helpful than scores in giving trainees feedback.

Although three-quarters of paediatric trainees found having an ARCP helpful, they did not feel prepared for the ARCP. Educating both trainees and trainers about ARCPs and the required portfolio evidence is continuing; however, we believe trainees will only truly feel prepared for their ARCPs after successfully addressing the more challenging issues of good IT infrastructure in each trust, with consultants readily undertaking workplace-based assessments (WBAs) and with educational supervision being of a consistently high standard.

SummaryObjectivesTo look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one.DesignA 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes.SettingWest Midlands Deanery, UKParticipantsTwenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training.Main outcome measuresReasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year.ResultsKey influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work–life balance and a growing feeling that family came first.ConclusionsSenior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.