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Making medical education great again: analysing trainee feedback to identify key drivers of trainee satisfaction and improve experience
  1. Katheryn Ferin1,
  2. Tony Hufflett2,
  3. Thomas Rance1,
  4. Jonathan Round1
  1. 1 NHS England, London, UK
  2. 2 DataSyrup/Fat Planet, London, UK
  1. Correspondence to Dr Katheryn Ferin; katheryn.ferin{at}nhs.net

Abstract

Objectives The London School of Paediatrics (LSP) surveys trainees annually regarding their training placements. There is a wide variation in satisfaction. We explored the last 5 years of data to identify trends and determine predictors of overall trainee satisfaction.

Methods The survey is distributed annually to all London paediatric trainees with response rates of 86–90%. It explores overall placement satisfaction, followed by key questions covering staffing, supervision, teaching, facilities and other facets. The survey blends both quantitative and qualitative feedback.

Satisfaction levels were analysed using time series trend analysis. Overall levels were compared using t-tests. Associations between satisfaction and components of the survey were identified using a convergence of multiple regression and other multivariate analyses.

Results Overall trainee satisfaction increased steadily until 2020. There was a considerable variation across sites, some having consistently higher or lower scores than the median, while others showed an upward or downward trend, or very variable pattern.

By training levels, ST3 trainees consistently rated their placement below average and ST7 trainees above average. There was also a considerable variation in responses by training level with regard to perceived staffing levels and teaching.

To understand the influences on overall satisfaction, regression coefficients were derived between specific metrics and overall satisfaction using multiple regression and then normalised to 100%. The explanatory power of this list to explain satisfaction overall is high at 82% R2.

Trainee satisfaction was most strongly correlated with workplace atmosphere and consultant support. Staffing, educational supervision, facilities and wider MDT (Multidisciplinary Team) support are associated with overall satisfaction, but to a lesser degree.

Conclusions Trainee satisfaction is crucial, affecting patient safety, retention and trainee mental health. Our analysis identified significant associations with satisfaction including modifiable elements such as consultant engagement and team morale. Staffing levels were less related to satisfaction than expected.

Experimental data exploring the components of clinical training in real-world situations are lacking. These data use the natural experiment of placing trainees in different training locations to explore the factors that relate to their overall experience.

  • Paediatrics
  • Qualitative research
  • Statistics
  • Child Health Services

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Footnotes

  • X @DrTomRance, @jround999

  • Contributors This project was devised by KF and TR. TH carried out data analysis. KF, TR and JR co-authored the paper. KF is the guarantor for this work.

  • Funding Data analysis by a third party company (DataSyrup) was funded by Health Education England (now NHS-E) as part of annual funding offered to the London School of Paediatrics for trainee activities.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.