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Empowering junior doctors: a qualitative study of a QI programme in South West England
  1. Natasha J Doran1,2,3,
  2. Rob Bethune1,4,
  3. Joanne Watson5,
  4. Katherine Finucane6,
  5. Andrew Carson-Stevens7
  1. 1 South West Academic Health Science Network, Exeter, UK
  2. 2 Medical School, University of Exeter, Exeter, UK
  3. 3 Department for Health, University of Bath, Bath, UK
  4. 4 Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  5. 5 Torbay and South Devon NHS Foundation Trust, Torquay, UK
  6. 6 North Bristol NHS Trust, Bristol, UK
  7. 7 Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
  1. Correspondence to Natasha J Doran, South West Academic Health Science Network, Exeter EX2 5AZ, UK; n.doran{at}


Aim To explore how the South-West Foundation Doctor Quality Improvement programme affected foundation year 1 (F1) doctors’ attitudes and ability to implement change in healthcare.

Methods Twenty-two qualitative interviews were carried out with two cohorts of doctors. The first F1 group before and after their participation in the QI programme; the second group comprised those who had completed the programme between 1 and 5 years earlier. Qualitative data were analysed using thematic analysis techniques.

Results Prior to taking part in the QI programme, junior doctors’ attitudes towards QI were mixed. Although there was agreement on the importance of QI in terms of patient safety, not all shared enthusiasm for engaging in QI, while some were sceptical that they could bring about any change. Following participation in the programme, attitudes towards QI and the ability to effect change were significantly transformed. Whether their projects were considered a success or not, all juniors reported that they valued the skills learnt and the overall experience they gained through carrying out QI projects. Participants reported feeling more empowered in their role as junior doctors, with several describing how they felt ‘listened to’ and able to ‘have a voice’, that they were beginning to see things ‘at systems level’ and learning to ‘engage more critically’ in their working environment.

Conclusions Junior doctors are ideally placed to engage in QI. Training in QI at the start of their medical careers may enable a new generation of doctors to acquire the skills necessary to improve patient safety and quality of care.

  • qualitative research
  • medical education & training
  • quality improvement

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  • Correction notice This article has been corrected since it was published Online First. The affiliation for Joanne Watson was incorrect and has now been corrected.

  • Contributors NJD cowrote the research proposal and contributed to the study design, the acquisition, analysis and interpretation of data and drafted the manuscript. RB cowrote the research proposal and secured funding and contributed to the study conception, design and interpretation of data; AC-S contributed to the study conception and design and interpretation of data. JW and KF secured funding and contributed to the study conception. All authors contributed to the critical revision of the paper and approved the final manuscript for publication.

  • Funding The study was funded by the South West Academic Health Science Network.

  • Disclaimer The study sponsor played no role in study design, data collection, analysis and interpretation, the writing of the article or the decision to submit it for publication.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval According to the NHS Research Ethics Committee decision tool, ethical approval was not required for this study; however, informed consent was given with the anonymity of participants guaranteed.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data generated or analysed during this study are included in this published article.

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