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Publication Watching the watchmen: an evaluation of educational supervision in a busy district general hospital(Oxford University Press, 2020-08-20) Heining, Christopher; Wheeler, Marie; Fletcher, Peter; Heining, Christopher; Wheeler, Marie; Fletcher, Peter; Medical and DentalIntroduction: Educational supervisors (ESs) play a critical role in the training of Foundation doctors. Many hospital trusts do not currently offer formal mechanisms to ensure the quality of supervision is at a high standard. Our Trust wanted to empower trainees to offer objective feedback on the quality of the supervisors. Methods: We introduced a feedback form sent to all Foundation doctors at our Trust. The questionnaire was designed to identify whether ESs were meeting their responsibilities as defined by the Health Education England South West's Severn Deanery. We collected data throughout the academic year 2017-2018 (Year 1) as a pilot, before rolling out the definitive questionnaire with minor modifications from 2018 to 2019 (Year 2). Results: All respondents met with their supervisor within the first month of the placement and 90.7% of the trainees found it easy to meet with their supervisor. The Trust received generally very good feedback for all of its supervisors. Low numbers (4/120 trainees) reported supervisors not engaging with the exception reporting process. Conclusion: Our Trust provides ESs of a high standard. The authors believe collecting feedback for ESs will achieve three things: 1) Drive up standards through increasing accountability of ESs receiving objective feedback. This will be of critical importance in the context of the severe acute respiratory syndrome coronavirus 2 pandemic and the changes to our work it has necessitated. 2) Empower trainees to make informed decisions about where they wish to train and under which supervisors. 3) Facilitate revalidation and appraisal for supervisors by collecting data from trainees on the quality of their supervision.Publication ‘Is there a doctor on board?’ – Preparing students for life as a doctor beyond the clinical environment, a pilot study(Elsevier, 2021-01-12) Powell, Laura; Davies, Phillip; Samuels, Abigail; Powell, Laura; Davies, Phillip; Samuels, Abigail; Medical and DentalNo abstract availablePublication Knowledge is power: Redeployment lessons to build resilience(BMJ Publishing Group, 2021-10) Jefferson, Lucy; Fenton-Jones, Mary; Wynn-Lawrence, Laura; Croft, Harriet; Hambridge, James; Tsakmakis, Maria; Mannix, Paul; Hambridge, James; Medical and DentalFeeling unprepared in an unfamiliar environment contributes significantly to the stress felt by trainees starting a new rotation. This feeling was magnified in 2020 for paediatric trainees redeployed to a new specialty, often at short notice, to respond to the rapidly changing demands of the SARS-CoV 2 pandemic. As a group of neonatal intensive care doctors we were redeployed, with limited preparation time, to a variety of adult departments. Despite the unfamiliarity of the pathologies, the diverse needs of particular patient cohorts and alarmingly high doses of lorazepam, our neonatal skills and knowledge were often transferrable to adult medicine (including the case of an encephalopathic patient who required regular stimulation to remember to breathe). However, whilst a clinically necessary move, we felt the communication and information provided could have been enhanced to improve our readiness for redeployment. Objectives To improve well-being and readiness for redeployment by creating a trainee led induction framework. Methods As a neonatal cohort, together with our College Tutor and following our experience of redeployment, we identified the following specific training needs and challenges faced by paediatric trainees in our trust: New environment – Building, wards, logistics Different IT systems Training eg. ALS Unfamiliar escalation processes Adult medicine: ceiling of treatment, guidelines, medications and conditions Different resilience requirements – breaking bad news, death rate, drugs and alcohol. HR processes eg leave, rotas. Results We produced an electronic package to address these areas which outlined information and signposted to resources and training. This was the first collection of all relevant information drawing on multiple trust sources, discussions with adult colleagues, independent research and our own experience. This was registered as a QI project and presented to hospital management for use in future inductions. We received excellent feedback and the areas we highlighted were used as a basis to frame induction requirements in subsequent redeployments. Conclusions Paediatric trainees have much to gain from the redeployment experience. As a trainee group we have sufficient medical training to revert to adult medicine and have the procedural, situational awareness and communication skills to thrive in unfamiliar settings. However, uncertainty can adversely impact well-being whilst preparedness allows trainees to both better cope and to excel in new environments. From our experience of redeployment we identified key areas of uncertainty and addressed them in a framework that can be translated to other trusts and for other specialities. We believe that providing structured information to trainees moving out of their comfort zone helps them to best support their adult colleagues, to take advantage of development opportunities and builds resilience.Publication 7890 Establishing an inter-deanery paediatric clinical exam revision programme (PACER): a success story of near-peer education(BMJ Publishing Group, 2025-05-30) Quek, Lee Ann; McMahon, Susannah; Wooding, Eva; Harty, Megan; Richardson, Giles; Tsakimakis, Maria; Quek, Lee Ann; Medical and DentalNo abstract availablePublication Greater tolerance of uncertainty facilitates thriving in doctors entering postgraduate training(BioMed Central, 2025-07-16) Peek, Russell; Arnold, Rachel; Moore, Lee; Peek, Russell; Medical and DentalBackground: Medical curricula increasingly emphasise the need to prepare graduates to manage uncertainty. Uncertainty is an inevitable consequence of the complex nature of human health and illness but may be stressful for clinicians less able to tolerate it. Although work-related stress is prevalent in healthcare services, not all clinicians struggle under the pressures they face. Indeed, some thrive, experiencing success and development, observed through the joint experience of high levels of wellbeing and perceived performance. Therefore, this study aimed to explore relationships between tolerance of uncertainty, perceived stress, and performance and wellbeing (i.e., human thriving) in doctors entering UK foundation training. Methods: Sixty-six doctors entering UK foundation training completed validated self-report measures to assess tolerance of uncertainty, perceived stress, wellbeing and performance. Multiple linear regression analyses were used to investigate relationships between tolerance of uncertainty, perceived stress, and human thriving. Mediation analysis was then undertaken to explore whether the observed relationship between tolerance of uncertainty and thriving was mediated by perceived stress. Results: Tolerance of uncertainty and perceived stress predicted a significant proportion of variance in thriving, independently of sex, lifetime stress, and adverse childhood experiences (model adjusted R2 = 0.51). Additionally, tolerance of uncertainty accounted for a significant proportion of variance in perceived stress after controlling for covariates (model adjusted R2 = 0.43). Furthermore, the effect of tolerance of uncertainty on thriving was partially mediated by perceived stress. Conclusions: Tolerance of uncertainty may represent a novel enabler of thriving and act, at least in part, by reducing perceived stress. Medical educators should consider how best to equip doctors in training to face uncertainty in clinical practice. Further research is required to examine whether interventions can optimise tolerance of uncertainty, or reduce perceived stress in uncertain situations, to facilitate thriving in early career doctors.Publication Survey on the implementation of the European training requirements in anaesthesiology(Lippincott, Williams & Wilkins, 2024-01-23) Langenecker, Sibylle; Bielka, Kateryna; Rees, Ted; Oremus, Kresimir; Rees, Ted; Medical and DentalNo abstract availablePublication EP096 A qualitative study of DCTs’ preparedness for OMFS posts after simulation-based education(Elsevier, 2024-12-12) Cameron, Alice; Holden, Adam; Cameron, Alice; Holden, Adam; Medical and DentalThe evidence demonstrates that many Dental Core Trainees (DCT) feel unprepared to manage the unwell patients and emergent situations encountered during Oral and Maxillofacial Surgery (OMFS) posts. Simulation-based education (SBE) can facilitate learning without compromising patient safety. This original study aimed to explore how a one-day, high-fidelity SBE course could enhance DCTs preparedness for their OMFS jobs.Publication Differential attainment in assessment of postgraduate surgical trainees: a scoping review(BioMed Central, 2024-05-30) Jones, Rebecca; Prusmetikul, Suwimol; Whitehorn, Sarah; Jones, Rebecca; Medical and DentalIntroduction: Solving disparities in assessments is crucial to a successful surgical training programme. The first step in levelling these inequalities is recognising in what contexts they occur, and what protected characteristics are potentially implicated. Methods: This scoping review was based on Arksey & O'Malley's guiding principles. OVID and Embase were used to identify articles, which were then screened by three reviewers. Results: From an initial 358 articles, 53 reported on the presence of differential attainment in postgraduate surgical assessments. The majority were quantitative studies (77.4%), using retrospective designs. 11.3% were qualitative. Differential attainment affects a varied range of protected characteristics. The characteristics most likely to be investigated were gender (85%), ethnicity (37%) and socioeconomic background (7.5%). Evidence of inequalities are present in many types of assessment, including: academic achievements, assessments of progression in training, workplace-based assessments, logs of surgical experience and tests of technical skills. Conclusion: Attainment gaps have been demonstrated in many types of assessment, including supposedly "objective" written assessments and at revalidation. Further research is necessary to delineate the most effective methods to eliminate bias in higher surgical training. Surgical curriculum providers should be informed by the available literature on inequalities in surgical training, as well as other neighbouring specialties such as medicine or general practice, when designing assessments and considering how to mitigate for potential causes of differential attainment.Publication Clinical endoscopist up-skilling using an existing training programme for general practitioners in Gastroenterology – Experiences from the South West(BMJ Publishing Group, 2024-07-01) Pohl, Keith; Howden, Adam; Feeney, Mark; Taylor, Charlotte; Dunckley, Paul; Howden, Adam; Dunckley, Paul; Medical and DentalAbstract Introduction Despite making up only 12% of the endoscopist workforce, Clinical Endoscopists (CEs) undertake almost a quarter of endoscopies nationwide. April 2023 saw the end of the Health Education England (HEE) nationally co-ordinated clinical endoscopist training programme, with funding diverted to individual training academies. The South West Endoscopy Training Academy (SWETA) supports CEs in acute trusts across the South West of England in both their training and continued professional development. SWETA also funds a regional training programme for General Practitioners (GPs) with Extended Roles (GPwER), which is currently training 5 GPs. Alongside their clinical training, the GPs complete a comprehensive online educational programme. To enhance their knowledge base and clinical decision making, this online educational programme has been offered to qualified CEs. We present their feedback and knowledge attainment from the programme. Methods Clinical endoscopists from across the SW were invited to join the GPwER Upper and Lower GI online modules. Each module consists of a pre-module assessment to gauge knowledge, live online lectures, interactive case-studies, written assignments and an end-of-module assessment. Data collected from delegates includes pre- and post- module assessment scores, module completion rates, and subjective feedback from delegates on the online platform, course organisation and the impact of the training on knowledge and confidence. Wilcoxon rank test is used to identify significant differences in assessment scores from before and after each module. Feedback data is presented narratively. Results 10 CEs joined the Upper GI module, and 12 joined the Lower GI module. 80% (n=8) completed the Upper GI, and 83% (n=10) completed the Lower GI module. The mean pre-module assessment score among the CEs was 52.38% in the Upper GI module and 45.20% in the lower GI module. The online training led to significantly improved mean scores of 74.13% (p=0.014) and 70.80% (p=0.009) respectively. Both modules received unanimously positive feedback, with all elements rated at least 4.5 out of 5. In particular, candidates felt that the modules had increased their knowledge of common presentations and conditions, and that the knowledge gained would directly enhance their daily clinical practice. The online platform and course organisation was also unanimously praised. Conclusions Clinical endoscopists provide an essential service, performing high-quality endoscopy across the UK. We describe a novel way of enhancing their clinical knowledge and decision-making by utilising an existing training programme for GPwERs. By allowing CEs to complete elements of this programme we have demonstrated objective and subjective improvements in their clinical knowledge without any additional cost or time outlay. Furthermore our online platform is highlighted as an accessible and easy way of accessing training.