The training/service continuum: exploring the training/service balance of senior house officer activities

Abstract

It is no longer appropriate to assume that all junior doctor activities represent either training or service individually: activities are perceived differently along the training/service continuum depending on their execution and their relation to the SHOs' learning curves. Within the reduced hours framework, it is necessary to match this balance to experience, in order for both training and service requirements to be satisfied.

Night emergency cover for ENT in England: a national survey

“…Implementation of the European Working Time Directive and the ‘Modernising Medical Careers’ initiative will mean that junior surgeons must be trained in fewer hours over a shorter period; for this reason, surgical training opportunities must be optimised 9 . The continued reduction in UK junior doctors’ hours has made it no longer appropriate to assume that all activities represent either training or service individually in relation to a trainee's learning curves 10 . In a pilot project in Ireland, it was observed that a tightly defined shift system caused a deterioration in training; 81 per cent of the trainee in this project also felt that patient care had suffered as a result 11 …”

The power of one: Looking beyond the teacher in clinical instruction

“…Because students learned in situ, their textbook knowledge became contextual knowledge as they 'learned how to practice medicine, not about the practice of medicine' (p. 453). These findings are reinforced by Derrick et al (2006) who examined the service/ training continuum among senior trainees and highlighted the contextual factors contributing to learning. Both studies examined residents rather than students.…”

“…It is not surprising that good teachers create good learning environments. Perhaps as revealing is the work on impediments to teaching and learning (Seabrook 2003;Derrick et al 2006) which clearly identifies the social and structural issues related to learning in the clinical environment and fails to mention the individual teacher. What is it that good teachers do to create this environment?…”

The co-construction of medical disposals in emergency medicine consultations

“…As a result junior doctors are under pressure to gain appropriate and sufficient experience in fewer hours than was the case when their senior colleagues were themselves junior doctors. This has inevitably led to disquiet about the impact on the balance between training and service (Derrick et al 2006). It has also led to junior doctors' decision-making abilities being called into question (Bull at al 2013).…”