Table 2

Themes generated from trainees’ most positive and negative training experiences

Themes from trainees’ positive experiences
Changed practice
 Adopting innovation‘Removal of bureaucratic and motivational barriers to instituting change- it is possible and also possible quickly’.
 Remote working‘Increased use of virtual meetings meaning it is possible to join meetings from other sites or home’.
 Virtual learning‘Change of teaching to zoom to provide teaching across the deanery… was really useful, especially as these were recorded and could be accessed at a later date’.
New skill
 Acting up‘More opportunities to step up to a senior level due to staff shortage’.
 Leadership and management‘Able to understand the structure of the response and how authority varies between different levels of the organisation’.
 Managing complex patents‘We don't usually see the ward round and detective work around complicated cases. I have had a chance to see a child… and see them through to a conclusion’.
 Novel clinical experiences‘Thinking more about global health, public health and health promotion/prevention of disease’.
 Virtual consultation‘A lot of time spent doing telephone outpatient clinics, I had much more experience in outpatients than I ever would on a normal rota’.
Extra time
 Admin‘More time to spend on updating eportfolio and finishing projects such as guidelines’.
 Projects‘Less clinical work [so] more time to spend on QI project - my most successful project yet’.
 Reflection‘I have read around interesting cases, searched for relevant journal articles and because they are interesting to me I’ve gained a lot from this’.
 Self-directed learning‘Now we have more time to learn and teach and feels like actual training rather than just service provision’.
 SLEs‘More time for consultants to teach and complete wba(work-based assessments)’.
 Facilitating learning’Have been better staffed and quieter than usual so I have had good opportunities to do informal teaching for others’.
 Work–life balance‘Felt better work/life balance and hence actually enjoying work more’.
 Senior support’Regular pragmatic engagement with consultant body about managing workload and training opportunities’.
 Team morale’The pandemic has improved our team cohesion and interpersonal relationships’.
Themes from trainees’ negative experiences
 Progression‘The worries regarding progress through training have not been addressed at the department level, where some of the changes need to be made to enable trainees to meet the new ARCP criteria’.
 Cancelled event‘Cancelled study leave which I had already paid for and have therefore lost out financially – hotels, train tickets etc’.
 Reduced opportunities‘There is less consultant presence on the wards to allow social distancing so clinical workload has seemed to increase for junior medical team but without increased opportunities for consultant led WBPAs and training’.
 Teaching‘Unable to attend deanery teaching sessions, reduced departmental teaching’.
 Fatigue‘Working endless Nights and Long days takes its toll. We are all doing it because we have a sense of duty - but we are 8 weeks in and are feeling fatigued. This is manageable for short periods but not for months on end’.
 Inadequate PPE‘I was told I was “self interested” and “a doom monger” by some consultants for requesting PPE at the start of the pandemic for my colleagues and myself’.
 Inadequate supervision‘Being redeployed - no induction, no clinicians responsible / expecting us / acting as supervisors’.
 Inadequate staffing‘There was minimal staffing in the paediatric department which meant that the paediatric team were often short and therefore a higher workload was passed on to the junior doctor (x1) that was left on the ward’.
 Communication breakdown‘Different staff groups receiving different information regarding how the hospital should be running. E.g. who gets swabbed, what ppe to wear, where patients are to be admitted’.
Clinical experience
 Redeployment‘Moving to several different departments in 3 months and being changed to 4 different rotas in short notice’.
 Shielding‘Shielding at home was difficult personally, but it also massively reduced my training opportunities. It took a while for me to find something to do at home’.
 Extra workload‘Felt we were covering vast amount of GP work, trying to help ED as much as possible whilst still doing our day-to-day job’.
 Reduced exposure’Less patients attending acutely and patients being physically seen in clinic’.
 Rota‘I have also had significantly more on calls which has affected my energy and mental health to a degree and I feel has increased my risk of burnout’.
 Suboptimal patient experience‘Dealing with bereaved parents after an unsuccessful neonatal resuscitation where the parents were unable to have the support of family and friends around them and would be unable to have a proper funeral’.
 Childcare‘Also changing child care has been difficult to juggle with changing rotas. This has made things more stressful generally’.
 Inadequately informed or consulted‘Appreciation of the stress it caused trainees. Better info of who and how to contact people. More communication even if just explanation of decisions or uncertainty’.
 Morale‘It felt that we had completely lost our sense of team, having not yet developed a strong sense of teamwork to begin with. This increased team anxieties, and affected emotions and work ethic’.
  • Themes from trainees’ positive experiences in blue background. Themes from trainees’ negative experiences in green background.

  • ARCP, Annual Review of Competency Progression; ED, emergency department; GP, general practice; PPE, personal protective equipment; QI, quality improvement; SLEs, supervised learning events.