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. 2024 Aug 6;16(8):e66313.
doi: 10.7759/cureus.66313. eCollection 2024 Aug.

Introducing an Emergency Department Electronic Handbook to Junior Doctors New to Emergency Medicine

Udara Wickramanayake  1 , Ahmed Arrayeh  1 , Venoth Arulvasan  2 , Bhaskar Sarvesh  1 , Charles Nwankpa  1 , Ravindu Hewagamage  3 , Ayesha Malik  1 , Angelo Giubileo  1
Affiliations

Introducing an Emergency Department Electronic Handbook to Junior Doctors New to Emergency Medicine

Udara Wickramanayake et al. Cureus. .

Abstract

Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs.

Keywords: confidence; ed e-handbook; ed induction; handbook; induction handbook; induction satisfaction; junior doctor induction; king's lynn; knowledge and confidence; queen elizabeth hospital.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Queen Elizabeth Hospital King's Lynn NHS Foundation Trust Audit and QIP Department issued approval Unique QIP number 202. This research does not have an IRB number as our research department does not use IRB numbers. This was conveyed to us by the Research Governance Coordinator at Queen Elizabeth Hospital. It was ethically approved by the Audit and Quality Improvement Project (QIP) Department and registered internally in the hospital. We received a unique QIP number to confirm this. This research project used human participants to provide us with surveys. However, they were not subjected to any harm or potential medical therapies. The participants were exposed to already approved (and within date) national and local emergency medicine guidelines for educational purposes. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. The pie charts show ED junior doctors perceived confidence before the handbook’s introduction (Survey 1), after the handbook’s introduction on day one (Survey 3), and after one month of handbook use (Survey 4).
This relates to the primary objective. Candidates were asked, “How confident are you to proceed into your new role after the induction?”
Figure 2
Figure 2. The pie charts show how useful the ED Handbook was in increasing the confidence of new junior doctors in ED on day one of the initial induction (Survey 3) vs after one month of handbook use (Survey 4).
This relates to the primary objective. Candidates were asked, “How useful do you think the ED Handbook has been to increase your confidence as a new doctor in ED?”
Figure 3
Figure 3. The pie charts show how useful the ED Handbook was in increasing the perceived knowledge of new junior doctors in ED on day one of the induction (Survey 3) vs after one month of handbook use (Survey 4).
This relates to the primary objective. Candidates were asked, “How useful do you think the ED Handbook has been to increase your knowledge as a new doctor in ED?”
Figure 4
Figure 4. The pie charts show ED junior doctors’ satisfaction rating of the induction program before (Survey 1) vs after the introduction of the ED Handbook (Survey 3).
This relates to the secondary objective. Candidates were asked, “How satisfied were you with the content of the ED Junior Doctor Induction Programme?”
See this image and copyright information in PMC

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