Can the transition process from foundation doctor to neurosurgical specialty trainee be improved through "learner-centered induction programs"?

Abstract

The transition period from foundation program doctor to specialty trainee can be difficult for junior doctors. This difficult period often acts as a major obstacle for learning in the workplace. Existing induction programs are commonly seen as inadequate at easing this transition, and therefore, a pilot study intervention was undertaken to assess if the initiation of "learner-centered induction programs" could help improve the confidence, knowledge acquisition, and satisfaction of junior doctors as they begin specialty training in neurosurgery. Ethnographic and anecdotal evidences were collated from junior doctors, specialty trainees, and consultants in order to investigate if further work on this subject would be beneficial. All participants were working in the Department of Neurosurgery at University Hospital Coventry and Warwickshire, Coventry, UK, over a 4-week period in March/April 2015. A review of the relevant literature was also undertaken. This report found that despite the reservations around the increased organizational demands of induction programs of this nature, as well as concerns around a single junior doctor covering the ward alone during the induction period, feedback following the intervention was largely positive. Junior doctors appreciated being taught about their roles and responsibilities from their predecessors as well as deciding among themselves what topics they wanted covering. As a result, the induction sessions tended to focus on clinical skills rather than theoretical knowledge, which most of the junior doctors believed they could cover adequately in their own time. The junior doctors felt that they benefited from learning/refreshing their relevant practical skills in a safe environment under senior supervision, prior to starting on the wards. Finally, as the induction program was of a greater duration than the traditional half day, they felt they had sufficient time to ask questions and address concerns while "on the job". Overall, "learner-centered induction programs" did appear to show promise in this pilot study with regards to increasing the confidence of junior doctors starting a neurosurgical placement and helped ease the transition process from foundation doctor to specialty trainee in neurosurgery. We believe further work to formalize and quantify these findings using questionnaires and a larger sample group as well as across successive is indicated and may help junior doctor learning and transition processes in future practice.

Keywords: foundation training; induction programs; junior doctor transitions; transition processes.