An evaluation of foundation doctor training: a mixed-methods study of the impact on workforce well-being and patient care [the Evaluating the Impact of Doctors in Training (EDiT) study]

Patient and public involvement in emergency care research

Patients participate in emergency care research and are the intended beneficiaries of research findings. The public provide substantial funding for research through taxation and charitable donations. If we do research to benefit patients and the public are funding the research, then patients and the public should be involved in the planning, prioritisation, design, conduct and oversight of research, yet patient and public involvement (or more simply, public involvement, since patients are also members of the public) has only recently developed in emergency care research. In this article, we describe what public involvement is and how it can help emergency care research. We use the development of a pioneering public involvement group in emergency care, the Sheffield Emergency Care Forum, to provide insights into the potential and challenges of public involvement in emergency care research.

A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements

Objectives

To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes.

Design

A longitudinal study using an online survey administered at four time points (2010–2011).

Setting

28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England.

Participants

Junior doctors who had a placement in an ED as part of their second postgraduate training year.

Main outcome measures

Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2).

Results

217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties.

Conclusions

While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties.