We believe that CTFs could be a useful asset in all medical schools by delivering high-quality, reliable, standardised teaching for students, as an adjunct to consultant teaching, with additional managerial roles and trainee benefits. CTFs can benefit non-CTF trainees by facilitating and encouraging them to teach. CTFs can organise sessions and advise on curriculum topics, allowing trainees to deliver more targeted teaching. Teaching students may improve trainees' communication, management and leadership skills, which are useful for clinical practice.

Simulating cases and using real drug charts is an effective method for improving students' prescribing ability and confidence in common medical emergencies. Tutorials like these, whether tutor-led or self-directed, could be incorporated into medical curricula. This could help prevent drug errors in practice, thereby improving patient care and safety.

High-quality training environments may increase job satisfaction, reduce attrition and promote excellence in education and training. Data on training are collected through the General Medical Council Survey, Training Evaluation Form and Workforce Survey. Attrition rates in obstetrics and gynaecology are high (30%)among the highest across all specialtiesand reasons for this include morale and undermining, training processes and paperwork, support and supervision, work-life balance, National Health Service environment and job satisfaction. High attrition rates affect the remaining workforce and can have a negative impact on the working environment.Learning from excellence may be more helpful than focusing on negative aspects of poor training. Learning objectivesTo understand the fundamental features of highly performing units. To identify contributors to poor training performance. To implement a simple structure for analysing training performance. To learn simple interventions that can improve training.