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. 2024 Sep 23;16(9):e70061.
doi: 10.7759/cureus.70061. eCollection 2024 Sep.

Enhancing Junior Doctors' Preparedness and Satisfaction in Trauma and Orthopaedics: A Quality Improvement Project With the Development of a Comprehensive Guidebook

Ghulam Dastagir Faisal Mohammed  1 , Zubair Younis  2 , Jebran Amin  3 , Zaina Mansoor  4 , Leonie Lingnau  5 , Edwin P Jesudason  1
Affiliations

Enhancing Junior Doctors' Preparedness and Satisfaction in Trauma and Orthopaedics: A Quality Improvement Project With the Development of a Comprehensive Guidebook

Ghulam Dastagir Faisal Mohammed et al. Cureus. .

Abstract

Background: Junior doctors often feel underprepared for their trauma and orthopaedics (T&O) rotation due to limited exposure during medical school and inadequate support. This project aimed to enhance junior doctors' preparedness and satisfaction during their T&O rotation by developing a comprehensive guidebook that addresses key orthopaedic knowledge and logistical challenges.

Methods: A quality improvement project (QIP) was conducted at Ysbyty Gwynedd Hospital. Initial surveys identified factors contributing to poor experiences during the trauma and orthopaedics rotation, including limited knowledge of orthopaedic emergencies and a lack of useful reference resources. A guidebook was developed and refined through multiple plan-do-study-act (PDSA) cycles. The guidebook covered topics such as orthopaedic emergencies, common injuries, referral pathways, and hospital logistics, presented in an accessible flowchart format.

Results: The primary objective of achieving 75% satisfaction among junior doctors was successfully met, with satisfaction increasing from four (40%) to eight (80%) doctors in the most recent survey. Secondary outcomes included a marked improvement in the understanding of quality improvement projects, rising from three (30%) to eight (80%) doctors. Orthopaedic knowledge also saw a significant enhancement, increasing from four (40%) to nine (90%) doctors. Confidence in handling night on-call duties improved dramatically, with all 10 doctors (100%) reporting increased confidence, compared to four (40%) doctors initially. Additionally, seven doctors (70%) expressed a greater interest in pursuing a career in orthopaedic surgery.

Conclusion: The comprehensive guidebook significantly improved junior doctors' preparedness and satisfaction during their T&O rotation. While the guidebook is a valuable resource, ongoing mentorship and hands-on experience remain essential for long-term success. Replication of this project across other departments and hospitals is recommended to assess its broader applicability and impact.

Keywords: guidebook development; medical induction; night shift confidence; quality improvement project (qip); resident satisfaction.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Ysbyty Gwynedd Hospital issued approval Ysbyty Gwynedd Hospital. Since this study was a retrospective study from a rolling quality improvement project where verbal consent has been obtained from all the participants before proceeding ahead. 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. Driver diagram created during the initial quality improvement project (QIP) to determine the best strategies for enhancing the T&O experience for junior doctors, identifying the root causes of low satisfaction
Image credits: First author
Figure 2
Figure 2. Overview of the diagnosis and management for cauda equina syndrome
Image credits: First author
Figure 3
Figure 3. Graph depicting satisfaction during T&O rotation
Image credits: Second author
Figure 4
Figure 4. Graph depicting knowledge among junior doctors about the quality improvement process
Image credits: Second author
Figure 5
Figure 5. Graph depicting orthopaedic knowledge
Image credits: Second author
Figure 6
Figure 6. Graph depicting confidence on first night shifts
Image credits: Second author
Figure 7
Figure 7. Graph depicting interest in orthopaedic surgery as a career among junior doctors
Image credits: Second author
See this image and copyright information in PMC

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