National Framework for Induction & Introduction to Histopathology (England/Wales)

Strand A: An audit of the induction period, ST1 trainees' perspectiveDr Anna Green1, Mrs Sue Cossins2, Dr Elizabeth Byrne2

Royal Free Hospital, London 1, The Leeds Teaching Hospitals2INTRODUCTION

Many ST1s starting histopathology training have limited previous exposure to histopathology. Those experienced in the specialty are likely to have moved to a new department and some new trainees may have never worked in the NHS before. The induction is fundamental to ensuring effective transition for specialist trainees into a new role/department.

The aims and objective for this audit were:•To identify the standards for induction as set out by GMC/PMETB1 and the MMC2.

•To establish, from the trainees’ perspectives, whether the current histopathology ST1 induction meets these standards and is satisfactory to the trainees. (Strand A)

•To correlate the results with Strand B (an audit of the ST1 induction period from the trainers’ perspectives).

•Where necessary, to make recommendations to bring ST1 induction in histopathology in line with these standards.

METHODS AND TECHNOLOGY

A questionnaire was created using ‘Survey Monkey’ . This covered all the standards set by PMETB and MMC for induction. Some questions relating to specific standards were modified to reflect unique information required by histopathology trainees. For each standard trainees were asked whether it was included in their induction and to rate their satisfaction (excellent/adequate/poor) with that aspect of the induction.

The questionnaire was distributed to all current ST1 trainees in England and Wales and the data was analysed and current practice compared to the PMETB and MMC standards.

RESULTS

The response rate was 40.6% (28/69)- 92.9% completed all the questions looking at what topics

were covered by their induction - 85.7% completed questions relating to their satisfaction with

each aspect of induction. - The results of the questionnaire are given in Figures 1 – 6.

LIMITATIONS

There was a poor response rate , which may reflect the timing of the questionnaire . The audit was carried out >5 months after the start of ST1 . Due to slight differences in training between regions, it was not possible to identify whether experiences related to the departmental and/or regional induction.

REFERENCES1 Postgraduate Medical Education and Training Board. Generic

standards for training. July 2008 and September 2009.2 Modernising Medical Careers. A Reference Guide for Postgraduate

Specialist Training in the UK. The Gold Guide Third Edition June 2009.

 

QUESTIONNAIREDuring your induction period were you:•Provided with a physical orientation to your workplace•Told where to find key policies/protocols relating to your role? •Provided with information on how you fitted into the team and who the key members are? •Informed of who you should report to? •Made aware of support systems available to you? •Provided with health & safety information eg. Fire & lab safety? •Given training on IT systems / communication arrangements? •Informed of your duties within the job? •Provided with information on the service you were working within, incl. equality and diversity within your workplace? •Provided with information on how training would be delivered, in line with national standard/an explanation of curriculum. •Reminded of your requirement to register with the RCPath?•Informed about requirement to complete an on-line portfolio? •Reminded of the stages of training to CCT? •Made aware of the minimum datasets? Were you told when the RCPath events were, eg. MSF, HY1A, ARCPs, WBAs?

During your induction period did :•You and your educational supervisor set out aims and objectives you would be expected to achieve during the post? •You meet with your educational supervisor at the start of ST1?

DISCUSSIONFor the majority of the standards audited, >80% of trainees were given information at induction to meet this standard. The two standards in which <80% of trainees received induction were:

- ‘provision of information about the service the trainee is working within;

- ‘provision of information about when RCPath events were’, eg MSF, HY1A, ARCPs, WBAs.

For the majority of the standards audited, >85% of trainees felt the information provided relating to that standard was adequate or excellent. The areas where ≥15% trainees felt induction was poor were:

- information about support systems available (15% of trainees felt this was poor);

- information about the service they were working within (16% of trainees);

- information telling them that they were required to complete an on-line portfolio (20% of trainees)

- 29% of trainees felt the induction was poor in terms of informing them about RCPath events .

RECOMMENDATIONSThis audit indicates parts of the induction period that could be improved to bring it in line with national standards. Introduction of a national framework for induction in histopathology would provide consistent induction across the ST1 training schools, incorporating the PMETB and MMC standards and focussing on the specific needs of new ST1s in histopathology.

0

10

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Yes No

Had you previously been employed as a histopathologist prior to your training as an ST1? Did you have a departmental and/or regional induction period?

96%

4%

Yes

No

Figure 1.

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Figure 5.Figure 6.

RESULTS (Cont:/…)

Some specific comments added by ST1s in the free-text section of the survey included:

-‘Regional introduction should be as early as possible - within the first 2 weeks of taking up post, so that this can influence induction and rotation within own department’

-‘Very well organised in xxxx, generally very impressed. A folder was provided with all information including eg of macro reports, datasets, etc’

- ‘My Educational Supervisor was away for the first 3 weeks of starting the job, it was left to another trainee’

Figure 3.

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