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Abstract
Objectives Both general and subspecialty paediatric trainees undertake attachments in highly specialised tertiary hospitals. Trainee feedback suggests that mismatches in expectations between trainees and supervisors and a perceived lack of educational opportunities may lead to trainee dissatisfaction in such settings. With the ‘Shape of Training’ review (reshaping postgraduate training in the UK to focus on more general themes), this issue is likely to become more apparent. We wished to explore the factors that contribute to a positive educational environment and training experience and identify how this may be improved in highly specialised settings.
Methods General paediatric trainees working at all levels in subspecialty teams at a tertiary hospital were recruited (n=12). Semistructured interviews were undertaken to explore the strengths and weaknesses of training in such a setting and how this could be optimised. Appreciative inquiry methodology was used to identify areas of perceived best practice and consider how these could be promoted and disseminated.
Results Twelve best practice themes were identified: (1) managing expectations by acknowledging the challenges; (2) educational contracting to identify learning needs and opportunities; (3) creative educational supervision; (4) centralised teaching events; (5) signposting learning opportunities; (6) curriculum-mapped pan-hospital teaching programmes; (7) local faculty groups with trainee representation; (8) interprofessional learning; (9) pastoral support systems; (10) crossover weeks to increase clinical exposure; (11) adequate clinical supervision; and (12) rota design to include teaching and clinic time.
Conclusions Tertiary settings have strengths, as well as challenges, for general paediatric training. Twelve trainee-generated tips have been identified to capitalise on the educational potential within these settings. Trainee feedback is essential to diagnose and improve educational environments and appreciative inquiry is a useful tool for this purpose.
- health services research
- medical education
- qualitative research
- paediatric practice
- multidisciplinary team-care
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Footnotes
Contributors AA and AL designed the work. AA conducted the literature review and the semistructured interviews. AA and AL were both involved in analysing the results of the data. AA drafted the first version of the manuscript, and AL revised and approved the final version. JM contributed to project conceptualisation and design, advised on data collection methods and was involved in critical revision of the article and approval of the final version to be submitted. SS contributed to project conceptualisation including defining the research question and was involved in critical revision of the article and approval of the final version to be submitted.
Competing interests None declared.
Ethics approval Ethical approval was obtained both from UCL and from the study hospital.
Provenance and peer review Not commissioned; externally peer reviewed.