Formal education programmes for senior house officers: comparison of experience in three hospital specialties

Abstract

This study was designed to compare the attendance rate of senior house oYcers (SHOs) in three specialties at formal educational events, examine experiences of protected time, use of educational objectives, and perceived barriers to attendance and evaluate diVerences found in the context of variations in training practice within each specialty. A quantitative questionnaire survey was completed by Trent region SHOs in obstetrics and gynaecology, general medicine, and accident and emergency posts. An independent researcher visited a selection of educational programme events over a two month span, recorded attendances, and administered the questionnaire. Attendance rates ranged from 40.8% of those in obstetrics and gynaecology jobs to 55.4% of those in accident and emergency jobs. The questionnaire findings found that service commitments were a major obstacle to attendance for the majority of those in obstetrics and gynaecology and general medicine jobs, while relatively few of the accident and emergency SHOs specified any barriers. SHOs in accident and emergency jobs had significantly more protected time for education and found educational objectives to be more widely used by senior staV. The findings suggest that the planned integration of formal education programmes with appropriate working pattern systems-in this case full shifts within accident and emergency departments-will result in SHOs receiving a better deal in terms of provision and structure of education. (Postgrad Med J 2001;77:650-653)

Paediatric registrars’ perceptions of education and training opportunities

“…The second most common reason SpRs gave for not attending teaching was clinical duties on the ward, in A&E or in outpatient clinics, implying that scheduled teaching was not truly protected and ‘bleep‐free’. This has previously been noted to affect junior doctors in general medicine, and obstetrics and gynaecology, but not those in A&E, where formal educational activities had been integrated successfully into a shift pattern of working 7 …”

“…This has previously been noted to affect junior doctors in general medicine, and obstetrics and gynaecology, but not those in A&E, where formal educational activities had been integrated successfully into a shift pattern of working. 7 Comments from SpRs suggest that there is discordance between what consultants and SpRs consider to be teaching or learning. Formal structured teaching activities such as grand rounds (formal presentation of selected cases, including discussion points and literature search), departmental meetings and case presentations may be timetabled as teaching but are not considered as such by SpRs if these events are not focused on SpR learning objectives, or are not bleep-free.…”

The modernisation of the surgical house officer

“…Previous studies looking at junior doctors' working patterns have used similar numbers of house officers, 2,3 but no study has carried out a direct comparison between two time periods as far apart as 4 years. Studies have suggested that it is possible to implement the shift system successfully with improved quality of life for doctors, 4 better education, 5 and more opportunities for flexible training. The detrimental effect on training is, however, well documented [6][7][8] with some of the studies reporting increased job dissatisfaction 8 and a reduction in quality of life.…”

Education of senior house officers: current challenges

“…15 Similarly, Flett et al reported that in general medicine service commitments were a major obstacle to attendance at formal educational sessions in the Trent region. 16 Hopefully, some of these issues will be addressed by initiatives such as the ''Changing Workforce'' programme, 17 which is currently reviewing the roles of staff groups within the NHS.…”

“…21 22 To improve access to the linear curriculum a model of integrating formal educational programmes within the shift pattern has been shown to be workable 16 in an accident and emergency setting. A different model may be to structure a programme of educational modules repeated on several occasions to accommodate individual shift patterns.…”