Training and supervision needs and experience: a longitudinal, cross-sectional survey of accident and emergency department senior house officers
Jeremy Dalea b, Susan Williamsb, Amanda Wellesleyc, Edward Glucksmanc
a School of
Postgraduate Medicine, University of Warwick, Coventry, West Midlands
CV4 7AL, UK, b Department of
General Practice and Primary Care, King's College School of Medicine
and Dentistry, London SE5 9PJ, UK, c Department of A&E Medicine, King's College
Hospital, London SE5 9RS, UK
Correspondence to: Prof J Dale, Department of General Practice and Primary Care, King's College School of Medicine and Dentistry, Bessemer Road, London SE5 9PJ, UK
Accepted 2 September
1998
The aim of this study was to investigate senior house
officers' (SHOs) perceptions about their training needs, satisfaction with teaching and supervision, and the relationship this has with psychological distress levels. All 171 SHOs employed within 27 accident
and emergency (A&E) departments in the South Thames region were sent
questionnaires at the start of their attachments in A&E, at the end of
months four and six. The questionnaires asked SHOs to rate on visual
analogue scales their perceived need for further training for 23 clinical and practical activities relevant to A&E practice. At the end
of the fourth month SHOs were asked to indicate who had provided them
with the most valuable teaching and supervision, indicate their
satisfaction levels with training received, and suggest ways to improve
teaching and supervision. SHOs' psychological distress levels were
measured in all three questionnaires.
Overall, satisfaction with supervision and training was
mixed. SHOs perceived greatest need for further training in areas encountered less frequently in A&E. Registrars were the most valued providers of supervision and teaching. Increased numbers of middle grade staff and protected study time were suggested as ways to improve
supervision and teaching. SHOs with higher scores for training need at
the end of their attachment in A&E expressed significantly less
satisfaction with training and higher psychological distress levels.
The variation between SHOs' perceptions of training needs indicates
the importance of tailoring training and supervision to individual requirements.
Keywords: training; accident and emergency medicine; senior house officers; psychological stress
© 1999 by The Fellowship of Postgraduate Medicine
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