Increasing Internal Medicine Trainees' Satisfaction With Their Formal Teaching Program: A Quality Improvement Project During the NHS Workforce Crisis

Abstract

The goal of this quality improvement project was to improve internal medicine trainees' satisfaction with their formal teaching program. Initially, qualitative and quantitative data were collected from trainees, which demonstrated an overall negative attitude towards their teaching. Based on the feedback collected, changes were made to the teaching program, including switching to face-to-face teaching, using study leave in trainees' rosters to allow for higher attendance rates and planning subject-specific "teaching afternoons". After these interventions, trainees' satisfaction with their teaching improved substantially in areas of teaching quality, relevance and reliability. This quality improvement project demonstrates that low-cost interventions based on trainee feedback can improve satisfaction with teaching, which has the potential to alleviate workforce challenges in the UK healthcare system.

Keywords: internal medicine training; junior doctor training; medical education research; quality improvement project; teaching and training residents and medical students.

Figure 1. Teaching satisfaction as assessed in 11 questions using Likert scale responses across both cycles

Eleven questions (Q1-Q11) were spread across the three domains of Relevance (Q1-4), Quality (Q5-8), and Reliability (Q9-11). See Table 2 for these questions. An overall calculated "agreement score" (X-axis) is shown in response to each of the 11 positive statements put to trainees (Y-axis). Scoring is outlined in the Materials & Methods section. A score greater than 0 indicates overall agreement with the statement, and a score less than 0 indicates disagreement. Cycle 1 (purple) is compared to Cycle 2 (light blue).

Figure 2. Overall satisfaction with quality and quantity of teaching across both cycles

Five-point Likert scales were used for both questions, with the neutral option being assigned a value of 0, the two negative options values of -1 and -2, and the two positive options assigned values of +1 and +2. Values on the X-axis reflect summed total scores across trainees; hence, values greater than 0 reflect overall satisfaction and values below 0 overall dissatisfaction.