Managing the Quality of Ward Based Training in Surgery in UK- A Critical Review.

Abstract

Junior doctors alerted the Director of Medical Education (D.M.E.) to a lack of training by senior colleagues on ward rounds in surgery. At the same time surgical training was rated poorly on the General Medical Council (G.M.C.) Trainees Survey. The West Midlands Deanery threatened to withdraw posts recommending that at least 40% of trainee time be dedicated to training. Trainers reported a lack of time to train and poor engagement by trainees. This review examines the merits of different quality improvement initiatives to patient care through programmed ward round training. Poor feedback from trainees within the trust at the ‘Junior Doctors Forum (J.D.F.)’ had suggested a lack of ward based training opportunities due to unstructured ward rounds poorly led by the senior doctors within surgery. The Medical Director (M.D.) tasked the Royal College of Surgeons Tutor for the trust with changing the learning environment on ward rounds to improve care and training. To identify factors within the educational and management literature that would enable training within the workplace. To consider the values, mind-sets and barriers to managing changes to training within varied clinical environments. To consider the quality improvement strategy that would enable doctors to develop and maintain robust reproducible training on the surgical ward round.