1. Learning and Working in Clinical Environments
Anél Wiese
Dr. Caroline Kilty
Dr. Deirdre Bennett

2. In the media

3. Your Training Counts 2014 National Score Ireland 170
Very wide variation
Lower scores for more junior trainees
Areas of weakness – feedback, educational supervision

4. Quality Data
Published data : Limited to surveys of satisfaction amongst trainees, variable quality and response rates
Year
Trainee Group
Outcome
2004
Interns
63% agree training abroad better
2005
2 cohorts 6 &11 years post grad
Better facilities, further training and better career prospects abroad
2011
65% rate internship excellent or good
2012
GP Trainees
>80% satisfied with training post
All NCHDs
50% dissatisfied with training in current post
2013
Surgical BST
49% would NOT undertake BST in Ireland again
Add the GMC data here as a benchmark

5. Why do this research? Learning & Working in Clinical Environment
Interested in looking at activities that trainees undertake in the clinical environment. Activities include service delivery, pt care, learning, etc.
Many competing activities, of which learning is just one
How do the competing activities, interact with each other, and impact on learning.
Clinical learning environments are complex systems to analyse

6. Methodology
“What is the relationship between PGMET and the competing activities happening in clinical learning environments?”
Qualitative methodology to find out what activities trainees undertake in day-to-day job. And when or how does learning happen during the course of the activities that they undertake daily.
Data collection: interviews, audio-diaries and observation of staff (trainee, consultants, nurses, allied health, management) within a department across 4 different hospitals.
Departments: infectious diseases, geriatrics, paediatrics and surgery
Include alternative departments?
Up to date: n= 50 interviews completed and transcribed
Data analysis has not yet commenced

7. Service vs Learning
Trainees learn through service - on the job learning main driver for junior doctor training
Increased busyness and demanding service delivery create a problem for learning
Difficult to find balance of optimal clinical exposure for learning

8. Relationship with Senior Doctors
Trainees value relationships and interactions with senior doctors
Relationships shaped and influenced by competing activities within the CLE - i.e. motivation (consultants’ and trainees’), demands of providing patient care
EWTD clinical exposure, lack of patient continuity – contradictive to learning

9. Perception of learning
Junior trainees – view learning with undergraduate mind set
Perceive learning to happen away from CLE – lectures, courses, tutorials
Lack of protected time for learning due to constraints within CLE – issue worthy of addressing
Further consideration of trainee expectation and awareness?

10. Level of Training
Difference between learning opportunities and the grades of doctor. Miss learning opportunities, doing other jobs at the same time.

12. Funded by HRB, Medical Council and HDTP
The Team
Principal Investigator : Dr. Deirdre Bennett Co-Investigator : Dr. Caroline Kilty
Collaborators:
Prof. Martina Kelly, Dept. of Family Medicine, University of Calgary.
Dr. Michelle Reardon, Mercy University Hospital
Prof. Mary Horgan, Dean, School of Medicine, UCC.
Prof. Agnes Higgins, School of Nursing, TCD.
Prof. Colm Bergin, Dean of Postgraduate Training, Royal College of Physicians of Ireland.
Dr. Mike O’Connor, Clinical Director, Cork University Hospital
Prof. Patrick Flood, Professor of Organisational Psychology, DCU.
Dr. Bridget Maher, Senior Lecturer, Medical Education Unit, UCC
Dr. Siun O’Flynn, Head of Medical Education, UCC.
Mrs. Margaret Murphy, Patient Advocate
Dr. Dubhfeasa Slattery, Consultant Paediatrician, Children’s University Hospital, Temple St.
Dr. Na Fu, Business School, Dublin City University
Royal College of Physicians of Ireland
Dr. Sinead Murphy, Consultant, Children’s University Hospital, Temple St.
Funded by HRB, Medical Council and HDTP