Charlotte Kergon

User perceptions of multi-source feedback tools for junior doctors

Medical Education 2010: 44 : 165–176

Are specialist registrars fully prepared for the role of consultant

The step-up from specialist registrar (SpR) to consultant has been acknowledged by doctors as being large. It can involve relatively sudden change, and can be both stressful and demanding.1,2 There is increasing pressure on available time for training, with shortened training programmes and fewer hours spent at work as a result of the European Working Time Directive.2,3 Medical education research has not fully addressed this transition or explored ways of improving it for the benefit of patients and doctors. Newly appointed consultants are more prepared for some aspects of their work than others. The quality of training in clinical skills is rated most positively, although even this has room for improvement.2,4 New consultants feel less well prepared for their management responsibilities than they do for clinical work,2,4,5 including self-management.6 Training and experience in handling complaints, dealing with difficult professional relationships, recruitment and disciplinary proceedings have also been identified as weaker areas of specialty training.5,6 Feeling inadequately trained in communication and management skills can impact on stress, burnout and the mental health of consultants.4,7 It is notable that two-thirds of cases referred to the National Clinical Assessment Service (NCAS) involved behavioural issues (including difficulties with colleagues), either on their own or in conjunction with other concerns.8 In the light of these issues, a research project was developed to determine the extent to which specialty training provides doctors with the skills they require when they become consultants.

Asking the right questions and getting meaningful responses: 12 tips on developing and administering a questionnaire survey for healthcare professionals

Questionnaires provide a useful and versatile tool for new and occasional researchers, and can be applied to a wide range of topics. This paper provides simple guidance on some of the potential pitfalls in developing and running a questionnaire study, and how to avoid them. Each tip is illustrated with a real-life example from the development of a UK-wide questionnaire survey of trainee doctors and their educational supervisors.

Educational dimensions of life as a sessional GP: a 20-year journey.

Sessional GPs, once perceived as an under-class, are growing in numbers and therefore importance. They have been receiving particular attention due to the need for a ‘one size fits all’ model for revalidation which is objective, fair, and equitable without being overly onerous. A number of changes have had significant influence on the creation of sessional (non-principal) GP working options and expansion of their numbers: PMS (Personal Medical Services), the new GMS (General Medical Services) contract, the Flexible Career Scheme, retainer scheme, Career Start type schemes and returner (now termed ‘refresher’) schemes. There is evidence that at least half of sessional GPs work in this way out of a positive choice and not, as often described in the 1990s, because of lack of skills, confidence or ambition. Some may see this as a transitional phase but many do not. Whilst sessional GPs today grapple with many issues identified in a systematic way as far back as 1998, namely isolation, lack of access to education and information and low status, there can be no doubt that their status has improved dramatically since that time as understanding of this group of doctors has grown. They are not only less invisible as a group, having grown in number and been incorporated into local practitioner lists (subsequently supplementary lists and then performers’ lists), but the amount written about them as a result of research has increased as well. The GPC (General Practitioners Committee) model salaried contract introduced a weekly session of protected continuing professional development (CPD) in 2004, and the increased availability of e-learning has benefited sessional GPs as, unlike much traditional education, it is not restricted to practice-based GPs. In the 1990s a number of deaneries carried out surveys into the educational issues affecting non-principals. The largest and most well known, covering 598 non-principals, with a response rate of 80%, was published by the Standing Committee on Postgraduate Medical Education (SCOPME). The survey revealed a variety of problems: isolation, low status, poor peer support, financial insecurity and a ‘triple whammy’ of disincentives limiting access to education: loss of income, childcare costs and course fees. As well as difficulties accessing education, these GPs also had problems accessing professional peer support (mentoring, careers advice, opportunities for career development). There was also confusion among non-principals regarding eligibility for, and availability of, funding for education. The SCOPME survey was repeated in 2000 and its findings showed encouraging improvements in a number of areas. More respondents had contracts of employment, isolation had reduced, and this tied in with greater contact with local tutors and postgraduate centres and non-principal groups. Access to education remained a problem, attributable to loss of income as before, but many more sessional GPs had personal development plans (PDPs) (Walls D, personal communication, May 2010). Important developments were clearly beginning to have an impact, namely the advent of non-principal groups which were increasing in number thanks to the steer of the National Association of Sessional GPs (NASGP), and the increasing number of deanery-led initiatives supporting non-principals. These included return to practice initiatives, Career Start and other supported salaried schemes, and the creation of dedicated educationalists supporting non-principals. A series of conferences brought together educators working with sesEducation for Primary Care (2010) 21: 347–51 # 2010 Radcliffe Publishing Limited