The value of the post-take ward round: are new working patterns compromising junior doctor education?

Chaponda, Mas; Borra, M; Beeching, Nicholas J.; Almond, D S; Williams, Peter S.; Hammond, M.; Price, Victoria; Tarry, Laura; Taegtmeyer, Miriam

doi:10.7861/clinmedicine.9-4-323

Cited by 16 publications

(25 citation statements)

References 15 publications

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“…Limited senior reviews were captured but this may reflect a bigger problem with team structures. 18 Workload distribution and staffing might have a serious impact on clinical outcomes. Increased consultant presence has been shown to be associated with reduced case-adjusted mortality rates in at least one publication.…”

Section: Discussionmentioning

confidence: 99%

‘The time it takes…’ How doctors spend their time admitting a patient during the acute medical take

et al. 2016

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Patient safety depends on adequate staffi ng but the number of doctors required for safe staffi ng for medical emergencies is not known. We measured the duration of the admission process for patients seen by medical teams in emergency departments (EDs) and acute medical units. History taking and examination by a core medical trainee took 22 minutes for a patient referred from the ED and 21 minutes for a patient referred from primary care. A complete admission clerking with prescription and ordering of investigations ranged from a mean of 15 minutes for a consultant in acute medicine to a mean of 55 minutes for a foundation year 1 trainee. The duration of post-take ward rounds also showed signifi cant variability. Our data can be used to model staffi ng patterns if combined with information about admission numbers and local set up.

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Section: Discussionmentioning

confidence: 99%

‘The time it takes…’ How doctors spend their time admitting a patient during the acute medical take

et al. 2016

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“…A study by Dewhurst promotes the idea that the PTWR provides a range of learning opportunities, but concluded that time constraints and a lack of consultants’ appreciation of the possibilities limits the incorporation into practice . This is supported by a large published audit, showing that target‐driven changes to working practice negatively impacted on training opportunities during the PTWR . These primarily focused on medical education, but ‘teaching time’ could easily be translated to a discussion of the process of leading a ward round.…”

Section: Discussionmentioning

confidence: 99%

Leadership training for registrars on ward rounds

Levett

Caldwell

2014

Clin Teach

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“…5,9,10 In the Annual RCPL Registrar Survey 2011, 96% of medical registrars felt that reviewing new admissions that they had assessed on 'the take' with a consultant was important for their training. 11 importance of using learning opportunities in every clinical situation.…”

Section: Discussionmentioning

confidence: 99%

Training in general medicine – are juniors getting enough experience?

et al. 2013

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-There is a widespread perception that trainees in medicine in the UK are 'not as good as they used to be' and reduction in hours of training is often cited as one cause. However, there are no data on the current experience of medical trainees in general medicine. The experience of foundation year doctors (FY1/2) and core medical trainees (CTs) in the management of 10 common medical conditions, eight common medical procedures and other aspects of medical training were collected by national survey in 2011. Trainees reported finding out-ofhours care the best setting for acute general medical experience and that the medical registrar was a key part of training. There was a significant lack of experience in both the management of medical conditions and the use of common procedures. These results highlight the challenges in general medical training and show that there is substantial room for improvement. KEY WORDS: Training, clinical skills, after-hours care BackgroundThere are concerns that the quality of junior doctors' training has deteriorated since the introduction of the European Working Time Directive (EWTD). [1][2][3][4][5][6] Training structure and delivery has also been influenced by the introduction of Modernising Medical Careers (MMC), the Foundation Programme and development of new curricula by the Joint Royal Colleges of Physicians Training Board (JRCPTB). It is recognised that the traditional experiential model of training in England might no longer meet the training needs of junior doctors, given the significant reduction in working hours. 6 Continuing to achieve a balance between service demands and the training needs of junior doctors is a challenge. 7 Delivery of training has to adapt to current working patterns to continue to deliver high-quality training to junior doctors in England.Anecdotal evidence suggests that core medical trainees (CTs) feel increasingly under prepared to become medical registrars by the end of CT2. Medical registrars also feel that their supervisory role is increasing owing to junior doctors being less experienced. There are potential safety concerns if medical registrars themselves are less experienced, lack confidence or do not have the time to supervise and train adequately their junior doctors as their workload increases. 4,5,8 Despite the recent changes to training, there has been limited work done at a national level assessing the perspectives of medical trainees on their current training experiences. In this article, we report the results of national surveys exploring junior doctors' views and experiences of training in general medicine. MethodsSurveys were developed following discussion forums with Royal College of Physicians of London (RCPL) New Consultants Committee, RCPL Regional Advisors Committee, RCPL Trainees Committee, heads of schools for medicine in England, RCPL Patient Carer Network, medical registrars from the Severn deanery and representatives from RCP Edinburgh.Three electronic surveys were distributed, using Vovici software, via email t...

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The value of the post-take ward round: are new working patterns compromising junior doctor education?

Cited by 16 publications

References 15 publications

‘The time it takes…’ How doctors spend their time admitting a patient during the acute medical take

‘The time it takes…’ How doctors spend their time admitting a patient during the acute medical take

Leadership training for registrars on ward rounds

Training in general medicine – are juniors getting enough experience?

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