G201(P) Understanding the experience of transition from senior house officer to registrar for paediatric speciality trainees in Wales, discovering the learning needs and what is perceived to ease the experience. (25th October 2020)

• Record Type: Journal Article
• Authors: Alam, SMA; Allery, L
• Is Part Of: Archives of disease in childhood. Volume 105(2020)Supplement 1
• Page Start: A72
• Page End: A72
• Publication Date: 2020-10-25
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2020-rcpch.170
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: The transition from senior house officer to the registrar grade has limited study in existing literature, providing narrow insight into the learning needs of paediatric trainees at this junction, or the educational practices that may optimise the experience of transition. This qualitative study examined the perceptions of such paediatric trainees in order to: 1) understand trainee perception about their positive and negative experiences of transition to the registrar grade; 2) identify their learning needs; 3) derive educational interventions to ease the experience of transition. Methods: University Ethics approval and informed consent was gained. Six Wales Deanery paediatric ST3 and ST4 trainees were questioned via semi-structured interview using critical incident technique. Transcribed responses were thematically analysed until data-sufficiency was achieved. Results: Fourteen learning needs were identified, dichotomised to clinical skills or leadership and management skills. Clinical skills included child protection assessment, difficult communication scenarios, emergencies, a dying child, difficult procedures, tertiary neonates, family anxiety and expectations, dealing with uncertainty and running clinics. Leadership and management skills included clinical decision making, leading ward rounds, managing workload, leading a team and supervising juniors. Six educational interventions were derived: acting-up, feedback, senior support, staff support, familiarising with the initial ST4 placement and maximising SHO learning opportunities. Conclusion: The following recommendations for practice change to improve the experience of transition for paediatric trainees target five key stakeholders. Trainees could focus PDPs toward identified learning needs and volunteer for acting-up opportunities. Seniors should routinely offer trainees to lead ward rounds and clinics, provide feedback constructively avoiding criticism, and directly touch base with transitioning trainees prior to and during out-of-hour shifts, stressing their availability to address concerns. Support is also important from senior registrars offering mentorship, or from nursing staff offering leeway and avoiding potentially undermining behaviour. Educators should target step-up courses and study/simulation days to address aforementioned learning needs, in particular leadership and management skills. Educators should ensure the first ST4 placement is at a centre familiar to the trainee, whilst rota coordinators should introduce out-of-hour shifts in a stepwise manner from evenings to nights, whilst ensuring an appropriate skill mix of supporting staff.