The association between trainee demographic factors and self-reported experience: Analysis of General Medical Council National Training Survey 2014 and 2015 data

Gill, Dipender

doi:10.1177/2054270416632705

Cited by 10 publications

(4 citation statements)

References 18 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…33 The perception that bias can affect learning is reflected by national surveys reporting that newly qualified BME UKGs were less likely to agree ‘the NHS is a good equal opportunities employer for doctors from ethnic minorities’34 and were less satisfied with their training35 although IMGs were more satisfied than UKGs 35. It may be that IMGs have different expectations—one IMG in our study expected to be discriminated against, feeling it was natural to prefer one's own (black IMG ST1–3 medicine).…”

Section: Discussionmentioning

confidence: 99%

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

et al. 2016

View full text Add to dashboard Cite

ObjectivesExplore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification.DesignQualitative semistructured focus group and interview study.SettingPostgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales.Participants137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad.ResultsMost trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising.ConclusionsBME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee–trainer relationships at work and organisational changes to improve trainees’ ability to seek social support outside work.

show abstract

Section: Discussionmentioning

confidence: 99%

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…A meta-analysis of 22 studies found moderate ( d = 0.42) effects whereby ethnically non-white UK graduates underperformed relative to white UK graduates in assessments at both undergraduate and postgraduate levels. Nor is it merely an assessment issue – questionnaires evaluating the postgraduate working experience find ethnically non-white trainees experience lower levels of satisfaction [ 5 ]. In relation to sex, there is evidence that men and women prefer different types of assessment and in at least one case – true/false MCQs (Multiple Choice Questions) where candidates are penalised for incorrect answers – the format of the assessment can produce significant sex differences [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Using differential item functioning to evaluate potential bias in a high stakes postgraduate knowledge based assessment

et al. 2018

View full text Add to dashboard Cite

BackgroundFairness is a critical component of defensible assessment. Candidates should perform according to ability without influence from background characteristics such as ethnicity or sex. However, performance differs by candidate background in many assessment environments. Many potential causes of such differences exist, and examinations must be routinely analysed to ensure they do not present inappropriate progression barriers for any candidate group. By analysing the individual questions of an examination through techniques such as Differential Item Functioning (DIF), we can test whether a subset of unfair questions explains group-level differences. Such items can then be revised or removed.MethodsWe used DIF to investigate fairness for 13,694 candidates sitting a major international summative postgraduate examination in internal medicine. We compared (a) ethnically white UK graduates against ethnically non-white UK graduates and (b) male UK graduates against female UK graduates. DIF was used to test 2773 questions across 14 sittings.ResultsAcross 2773 questions eight (0.29%) showed notable DIF after correcting for multiple comparisons: seven medium effects and one large effect. Blinded analysis of these questions by a panel of clinician assessors identified no plausible explanations for the differences. These questions were removed from the question bank and we present them here to share knowledge of questions with DIF. These questions did not significantly impact the overall performance of the cohort. Group-level differences in performance between the groups we studied in this examination cannot be explained by a subset of unfair questions.ConclusionsDIF helps explore fairness in assessment at the question level. This is especially important in high-stakes assessment where a small number of unfair questions may adversely impact the passing rates of some groups. However, very few questions exhibited notable DIF so differences in passing rates for the groups we studied cannot be explained by unfairness at the question level.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1143-0) contains supplementary material, which is available to authorized users.

show abstract

“…There is an assertion that the number of cases undertaken by trainees has fallen over time. This has been attributed to (among other reasons) organisational and political changes such as the European Working Time Directive . England reported that trainees undertook around 1000 cases per year in 1990, but by 1999, this figure had dropped to 500 with this downward trend persisting .…”

Section: Discussionmentioning

confidence: 99%

“…Minimum competencies are specified in the training curriculum that is maintained by the RCoA . However, experience accrued during the course of postgraduate specialty training is thought to vary across geographical regions . In recent years, training in anaesthesia has undergone significant change.…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of case‐load and supervision from a large anaesthetic logbook database

et al. 2019

View full text Add to dashboard Cite

The recent development of electronic logbooks with secure off-device data storage provides a rich resource for research. We present the largest analysis of anaesthetic logbooks to date, with data from 494,235 cases logged by 964 anaesthetists over a 4-year period. Our analysis describes and compares the annual case-load and supervision levels of different grades of anaesthetists across the UK and Republic of Ireland. We calculated the number of cases undertaken per year by grade (median (IQR [range]) core trainees = 388 (252-512 [52-1204]); specialist trainees = 344 (228-480 [52-1144]); and consultants = 328 (204-500 [52-1316]). Overall, the proportion of cases undertaken with direct consultant supervision was 56.7% and 41.6% for core trainees and specialist trainees, respectively. The proportion of supervised cases reduced out-of-hours, for both core trainees (day 93.5%, evening 86.3%, night 78.6%) and specialist trainees (day 81.0%, evening 67.7%, night 56.4%).

show abstract

The association between trainee demographic factors and self-reported experience: Analysis of General Medical Council National Training Survey 2014 and 2015 data

Cited by 10 publications

References 18 publications

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

Using differential item functioning to evaluate potential bias in a high stakes postgraduate knowledge based assessment

A retrospective analysis of case‐load and supervision from a large anaesthetic logbook database

Contact Info

Product

Resources

About