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Senior House Officers (senior + house_officer)
Selected AbstractsSenior house officers' experience of a six month post in a hospiceMEDICAL EDUCATION, Issue 1 2002M Lloyd Williams Background Hospices provide care for patients with a terminal prognosis , a very small number of hospices employ Senior House Officers. Method A survey was carried out to determine the experiences of SHOs working in hospices and their perceptions of the learning opportunities available. Perceived stress was measured by a Visual Analogue scale and psychological distress by the GHQ 12. Results Of the 38 posts identified 23 SHOs (60%) responded and the majority had qualified during the last five years. Formal teaching was limited, but experiential teaching was very positively described. Many SHOs described their posts as stressful and cited staff conflict and caring for young patients as particularly stressful. Median stress scores as measured on the VAS was 55 mm (range 0,98 mm). Five respondents 22% scored for identifiable psychological distress on the GHQ 12. Conclusion Conclusions include the need to acknowledge the important learning opportunities provided within hospices but also the need for consultant staff to be aware of the sources of stress for SHOs and their need for support. [source] Using job analysis to identify core and specific competencies: implications for selection and recruitmentMEDICAL EDUCATION, Issue 12 2008Fiona Patterson Objective, Modern postgraduate medical training requires both accurate and reliable selection procedures. An essential first step is to conduct detailed job analysis studies. This paper reports data on a series of job analyses to develop a competency model for three secondary care specialties (anaesthesia, obstetrics and gynaecology, and paediatrics). Methods, Three independent job analysis studies were conducted. The content validity of the resulting competency domains was tested using a questionnaire-based study with specialty trainees (specialist registrars [SpRs]) and consultants drawn from the three specialties. Job analysis was carried out in the Yorkshire and the Humber region in the UK. The validation study was administered with additional participants from the West Midlands and Trent regions in the UK. This was an exploratory study. The outcome is a set of competency domains with data on their importance at senior house officer, SpR and consultant grade in each specialty. Results, The study produced a model comprising 14 general competency domains that were common to all the three specialties. However, there were significant between-specialty differences in both definitions of domains and the ratings of importance attached to them. Conclusions, The results indicate that a wide range of attributes beyond clinical knowledge and academic achievement need to be considered in order to ensure doctors train and work within a specialty for which they have a particular aptitude. This has significant implications for developing selection criteria for specialty training. Future research should explore the content validity of these competency domains in other secondary care specialties. [source] Multiple mini-interviews: opinions of candidates and interviewersMEDICAL EDUCATION, Issue 2 2008Sarah Humphrey Objectives, To assess candidates' and interviewers' perceptions of the use of a multiple mini-interview (MMI) for selection of senior house officers (SHOs) to a UK regional paediatric training programme. Methods, Both candidates and interviewers completed anonymous questionnaires (comprising 16 and 25 questions, respectively). Demographic data were recorded for both groups. Data were analysed by frequencies; using Mann,Whitney and Kruskall,Wallis tests for comparisons; and Cronbach's alpha for internal consistency within the data. Results, Both candidates and interviewers were positive about the fairness of the MMI (mean scores of 4.0 and 4.4, respectively). The majority of candidates (83%) had not been to this type of interview before. Gender, age and previous experience of MMIs did not account for differences in candidate responses (P > 0.05). A total of 86% of candidates were international medical graduates who preferred the format more than UK graduates did (P = 0.01). Interviewers were mainly experienced consultants who agreed that the multi-station format was better than the traditional interview (mean score 4.8) and represented a reliable process (mean score 4.4). Interviewers were concerned about the range of competencies covered and the subsequent performance of candidates in post (mean scores 3.6 and 3.2, respectively). Conclusions, Both candidates and interviewers agreed that the MMI format was reliable, fair and asked appropriate, easy-to-understand questions. In high-stakes interviews such as for specialty training in Modernising Medical Careers programmes, it is vital that all concerned have confidence in the selection process. [source] Sci45: the development of a specialty choice inventoryMEDICAL EDUCATION, Issue 7 2002Rodney Gale Objective, To devise a valid career selection instrument to help doctors in training choose from a range of specialties that match their attributes and aspirations and to help selection interviewers focus on the key issues pertaining to the suitability of candidates for particular training opportunities. Design, A psychometric instrument of 130 4-response choice items was developed to match individual personal and professional preferences to possible career specialty choices. The development process involved semi-structured interviews with consultants in 35 specialties, a national postal survey of consultants in 45 specialties, factor analysis of the results, design of the pilot instruments, testing on 450 senior house officers (doctors in basic specialist training within 2,5 years of leaving medical school), and further item analysis to derive the final instrument. A scoring system and software were developed to indicate the best and worst fit specialties for the respondent. Participants, The participants were hospital consultants, general practitioners and senior house officers (SHOs) in basic specialist training. Outcome measure, The successful construction of a valid and accessible career choice instrument (Specialty Choice Inventory/Sci45). Conclusions This project has yielded a psychometrically valid computer- or paper-based instrument that can be used by doctors at any stage of training to assist in career choice. It can be used as part of the selection process, for careers guidance, for analysis of career problems, for research or to validate a particular range of career options. [source] Surgical skills training: simulation and multimedia combinedMEDICAL EDUCATION, Issue 9 2001Roger Kneebone Context Basic surgical skills are needed throughout the medical profession, but current training is haphazard and unpredictable. There is increasing pressure to provide transparency about training and performance standards. There is a clear need for inexperienced learners to build a framework of basic skills before carrying out surgical procedures on patients. Effective learning of a skill requires sustained deliberate practice within a cognitive framework, and simulation offers an opportunity for safe preparation. Objectives This paper presents a new approach to basic surgical skills training, where tuition using a specially designed computer program is combined with structured practice using simulated tissue models. This approach to teaching has evolved from practical experience with surgical skills training in workshops. Methods Pilot studies with 72 first-year medical students highlighted the need for separate programs for teaching and for self-directed learning. The authors developed a training approach in the light of this experience. Subsequent in-depth observational and interview studies examined (a) individual teaching sessions between surgical teachers and learners (five consultant surgeons and five senior house officers) and (b) group teaching sessions with general practitioners (14 participants in three group interviews). Further work has resulted in a self-directed learning program. Conclusions Qualitative analysis of observational and interview data provides strong preliminary support for the effectiveness of this approach. The response of teachers and learners was extremely positive. The combination of information (presented by computer) and practice of psychomotor skill (using simulated tissue models) could be extended to other surgical and practical skills. [source] Defining the content for the objective structured clinical examination component of the Professional and Linguistic Assessments Board examination: development of a blueprintMEDICAL EDUCATION, Issue 7 2000Philip Tombleson Introduction We describe the steps taken to develop an appropriate list of ,clinical problems' used to define the content of the objective structured clinical examination (OSCE) component of the Professional and Linguistic Assessments Board (PLAB) examination. Method A blueprint and list of 255 clinical problems was compiled by reviewing PLAB questions, published curricula of the UK Royal Colleges and other sources such as the General Medical Council's own guidelines. This list was sent to a random sample of 251 successful PLAB candidates who were asked to rate the clinical problems using a scale of ,seen frequently/seldom/never' and to 120 members of the accident and emergency (A&E) specialists' association who were asked to identify ,important' tasks. The list was further validated using activity data obtained for consecutive A&E attendances (934) and admissions (6130) at three hospitals. Results After two mailings, 131/251 (52%) former PLAB candidates and 89/120 (74%) A&E specialists replied. All of the 255 clinical problems were seen by some former candidates and were felt to be important by some A&E specialists. Of the 255 problems, 40 were neither rated as important nor as seen frequently/seldom by over 50% of respondents. The 255 clinical problems covered a mean 94% consecutive A&E attendances and 97·6% reasons for hospital admission. The correlation between clinical problems that were frequently encountered and those felt to be important was rho=0·38 (P < 0·01). Conclusion The clinical problems appear to be appropriate for defining the content of the PLAB OSCE. We suggest that our problem list is useful in that all the problems are seen by some senior house officers, are felt to be important by some A&E specialists and cover greater than or equal to 94% of the conditions for which patients both attend and are admitted from casualty. The correlation between clinical task importance and the frequency that they were seen was only moderate, partly reflecting the relative seriousness of some uncommon medical conditions, which should not be missed on clinical assessment. The content of the OSCE component of the PLAB examination is being reviewed in the light of the findings of this study. The limitations of the study are discussed. [source] ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomyANAESTHESIA, Issue 9 2010D. S. J. Elliott Summary Cannula cricothyroidotomy is recommended for emergency transtracheal ventilation by all current airway guidelines. Success with this technique depends on the accurate and rapid identification of percutaneous anatomical landmarks. Six healthy subjects underwent neck ultrasound to delineate the borders of the cricothyroid membrane. The midline and bisecting transverse planes through the membrane were marked with an invisible ink pen which could be revealed with an ultraviolet light. Eighteen anaesthetists were then invited to mark an entry point for cricothyroid membrane puncture. Only 32 (30%) attempts by anaesthetists accurately marked the skin area over the cricothyroid membrane. Of these only 11 (10%) marked over the centre point of the membrane. Entry point accuracy was not significantly affected by subjects' weight, height, body mass index, neck circumference or cricothyroid dimensions. Consultant and registrar anaesthetists were significantly more accurate than senior house officers at correctly identifying the cricothyroid membrane. Accuracy of percutaneously identifying the cricothyroid membrane was poor. Ultrasound may assist in identifying anatomical landmarks for cricothyroidotomy. [source] Effects of the European Working Time Directive on anaesthetic training in the United KingdomANAESTHESIA, Issue 8 2004D. J. Sim Summary Decreases in the hours worked by trainee anaesthetists are being brought about by both the New Deal for Trainees and the European Working Time Directive. Anticipated improvements in health and safety achieved by a decrease in hours will be at the expense of training time if the amount of night-time work remains constant. This audit examined the effects of a change from a partial to a full shift system on a cohort of trainee anaesthetists working in a large district general hospital in the South-west of England. Logbook and list analyses were performed for two 10-week periods: one before and one after the decrease in hours. An 18% decrease in the number of cases done and an 11% decrease in the number of weekly training lists were found for specialist registrars. A 22% decrease in the number of cases done and a 14% decrease in the number of weekly training lists were found for senior house officers. Furthermore, a decrease of one service list per specialist registrar per week was seen, which will have implications for consultant manpower requirements. [source] Supervision of trainee anaesthetists: a survey of opinions and practicesANAESTHESIA, Issue 1 2002J. Kerr This questionnaire survey investigated the different degrees of supervision of trainee anaesthetic senior house officers (SHOs) in hospitals across the United Kingdom, and compared it with past practices as well as with The Royal College of Anaesthetists' recommendations at that time. It is apparent that the duration of intensive supervision of new anaesthetic trainees has increased over the last 25 years. This study assesses these changes in order to evaluate whether or not these reforms have achieved their intended outcomes. [source] | ||||||||||