Evaluation of feedback given to trainees in medical specialties.

The aim of this study was to evaluate the quality of feedback provided to specialty trainees (ST3 or higher) in medical specialties during their workplace-based assessments (WBAs). The feedback given in WBAs was examined in detail in a group of 50 ST3 or higher trainees randomly selected from those taking part in a pilot study of changes to the WBA system conducted by the Joint Royal Colleges of Physicians Training Board. They were based in Health Education Northeast (Northern Deanery) and Health Education East of England (Eastern Deanery). Thematic analysis was used to identify commonly occurring themes. Feedback was mainly positive but there were differences in quality between specialties. Problems with feedback included insufficient detail, such that it was not possible to map the progression of the trainee, insufficient action plans made and the timing of feedback not being contemporaneous (feedback not being given at the time of assessment). Recommendations included feedback should be more specific; there need to be more options in the feedback forms for the supervisor to compare the trainee's performance to what is expected and action plans need to be made.

Improving core medical training--innovative and feasible ideas to better training.

A recent survey of UK core medical training (CMT) training conducted jointly by the Royal College of Physicians (RCP) and Joint Royal College of Physicians Training Board (JRCPTB) identified that trainees perceived major problems with their training. Service work dominated and compromised training opportunities, and of great concern, almost half the respondents felt that they had not been adequately prepared to take on the role of medical registrar. Importantly, the survey not only gathered CMT trainees' views of their current training, it also asked them for their 'innovative and feasible ways to improve CMT'. This article draws together some of these excellent ideas on how the quality of training and the experience of trainees could be improved. It presents a vision for how CMT trainees, consultant supervisors, training programme directors, clinical directors and managers can work together to implement relevant, feasible and affordable ways to improve training for doctors and deliver the best possible care for patients.

Survey of core medical trainees in the United Kingdom 2013 - inconsistencies in training experience and competing with service demands.

There is currently considerable concern about the attractiveness of hospital medicine as a career and experiences in core medical training (CMT) are a key determinant of whether trainees continue in the medical specialties. Little is understood about the quality and impact of the current CMT programme and this survey was designed to assess this. Three key themes emerged. Firstly, the demands of providing service have led to considerable loss of training opportunities, particularly in outpatients and formal teaching sessions. Trainees spend a lot of this service time doing menial tasks and over 90% report that service takes up 80-100% of their time. Secondly, clinical and educational supervision is variable, with trainees sometimes getting little consultant feedback on their clinical performance. Finally, 44% of trainees report that CMT has not prepared them to be a medical registrar and many trainees are put off acute medical specialties by their experiences in CMT.

New machine-marked tests for selection into core medical training: evidence from two validation studies.

This study examined whether two machine-marked tests (MMTs; a clinical problem-solving test and situational judgement test), previously validated for selection into U.K. general practice (GP) training, could provide a valid methodology for shortlisting into core medical training (CMT). A longitudinal design was used to examine the MMTs' psychometric properties in CMT samples, and correlations between MMT scores and CMT interview outcomes. Independent samples from two years were used: in 2008, a retrospective analysis was conducted (n=1711), while in 2009, CMT applicants completed the MMTs for evaluation purposes (n=2265). Both MMTs showed good reliability in CMT samples, similar to GP samples. Both MMTs were good predictors of CMT interview performance (r = 0.56, p < 0.001 in 2008; r = 0.61, p < 0.001 in 2009) and offered incremental validity over the current shortlisting process. The GP MMTs offer an appropriate measurement methodology for selection into CMT, representing a significant innovation for selection methodology.

The employment, attitudes and aspirations of non-training grade doctors.

Acute care in the NHS is increasingly delivered by junior doctors who receive little educational supervision. There is a continuing dramatic increase in the numbers of trust doctors. Staff grades are also increasing in number and face many frustrations.