BackgroundThe fundamental importance of good end of life care has been well documented however recent national publications have high-lighted inadequacies in training in this area. For many patients dying in the UK today care is provided in hospital and the number of inpatient deaths is forecast to climb significantly in future. The demands of providing medical care for these patients by junior doctors will continue to rise. However, there is currently only limited research on training for doctors in this setting.MethodsA qualitative study using semi-structured interviews of trainees working in general medicine analysed utilising a grounded theory approach.ResultsEleven medical trainees from nine different medical schools participated. They had worked in fifteen different UK hospitals in the course of their careers. All of the doctors interviewed felt generally confident in managing a dying patient. This had developed at postgraduate level and increased when working in certain key specialties. Emerging themes fell into five main categories: perceived ability in clinical management, different learning opportunities experienced, the impact of variations in approach to end of life care, the role of the specialist palliative care team and suggestions for improvements to training. All participants felt further teaching would be beneficial.ConclusionsThis study identified key areas where training could be improved. This included small changes in everyday practice to shift the emphasis for trainees to education. There also needs to be focus on end of life care in the curriculum, formal teaching programmes and assessment of junior doctors. The specialist palliative care team played a vital role in training as well as service provision. For those working in this specialty, every clinical encounter provides an opportunity for education. Specifically targeting junior doctors will not only improve patient care today but empower the consultants of the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-015-0039-6) contains supplementary material, which is available to authorized users.

Receiving a diagnosis of AS was viewed as a double-edged sword, allowing the development of insight into lifelong difficulties, but also creating the potential for prejudice. Understanding AS traits provided an explanation for challenges in the workplace and therefore opportunities to find solutions. Understanding AS traits provided an explanation for challenges in the workplace DISCUSSION: This study explores the benefits and disadvantages of defining and labelling a specific professional support need for a group of trainees. It also reveals the need for improved awareness of AS amongst all clinical educators.

The team played an important role in both education and well-being for trainees, and several factors were identified that could engender a more supportive team. With an ageing population and with increasing demands on limited resources, the requirement for shift work is likely to increase, and there is a fundamental need to maintain support for the next generation of doctors. There is little literature on the extent to which trainees actually feel part of a team.

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<p>This thesis addresses the research question “How could a mobile game be designed to facilitate education and improve healthcare engagement around skin sores in children?”. Health behaviour issues such as lack of education and low adherence to treatment regimes impact the success rates of treatments in children for common ailments such as skin sores. Skin sores are a particular health issue in New Zealand where the rates of admission to hospital for serious skin infections in 2006 were double that of USA and Australia (Craig et al., 2007, p. 278-282). Hospitalisation can be prevented by ensuring treatment regimes for skin sores are correctly completed after early diagnosis (Gray et al., 2013, p. 2). Literature states that game design is a viable solution to healthcare issues, as it can be used alongside persuasive strategies to engage and educate children around their treatments. However, there is a gap in the literature and existing precedents for health games addressing treatment of common ailments. This thesis addresses the research question through developing design criteria for a health game by identifying suitable theories to encourage positive health behaviors and educate children. These include: simulation, personalisation, reward and flow theory, as well as the information, motivation, strategy model to increase engagement with treatment. These criteria are used alongside user personas and journey maps methods to create the design output of a mobile health game to educate and engage New Zealand children around the treatment of skin sores. The game was tested for education, engagement and usability during the design process. Methods for user testing included observation, an adaption of the System Usability Scale and semi-structured interview questions. Thematic analysis of the testing results showed that most participants were engaged with the game and gained education around treatment steps. Insights on user testing with children for education, engagement, and usability are reported. The final output was refined and accessed against the design criteria. Findings from this thesis discuss how game design techniques including simulation, flow theory and reward can be used to educate and engage children with treatments of common ailments.</p>