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Prognostic significance of drivers at work and learning styles in surgical training
  1. Katie Mellor1,
  2. Luke Hopkins1,
  3. David Bryan Thomas Robinson1,
  4. Osian Penri James1,
  5. Oliver Luton1,
  6. Chris Brown1,
  7. Richard John Egan2,3,
  8. Wyn G Lewis1,4
  1. 1School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff, UK
  2. 2Department of Surgery, Morriston Hospital, Swansea, Wales
  3. 3Swansea University Medical School, Swansea, Wales
  4. 4Department of Surgery, University Hospital of Wales, Cardiff, Wales
  1. Correspondence to Katie Mellor, School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff CF15 7QQ, UK; katie.mellor{at}


Purpose of the study Drivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical trainees’ (CST) DW and LS on career progress.

Study design DW questionnaires and Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single-statutory education body. Primary outcome measures were membership of the Royal College of Surgeons (MRCS) examination and national training number (NTN) success.

Results Of 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p=0.003). DW spectrum was: please people (25.0%), be perfect (21.3%), hurry up (18.5%), be strong (13.9%) and try hard (0%, p<0.001). DW was either equivocal (n=14) or not provided (n=9) by 21.3% of CSTs. LS were: converging (34.3%), accommodating (28.7%), diverging (23.1%) and assimilating (13.9%, p=0.021). Men were more likely to be convergers (29/70, 41.4%), and women divergers (15/38, 39.5%, p=0.018) also preferring team-based LS (accommodating/diverging, 26/38 (68.4%) vs 30/70 (42.9%), p=0.010). MRCS success was not associated with DW (p=0.329) or LS (p=0.459). On multivariable analysis, NTN success was associated with LS (accommodators 64.5%, divergers 32.0%, OR 10.90, p=0.014), scholarly activity (OR 1.71, p=0.001), improving surgical training programme (OR 36.22, p=0.019) and universal ARCP 1 outcome (OR 183.77, p<0.001).

Conclusions LS are associated with important differences in career progress with accommodator twofold more likely than diverger to achieve NTN.

  • medical education & training

Data availability statement

No data are available. Not applicable.

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Data availability statement

No data are available. Not applicable.

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  • Contributors WGL conceived and designed the study, oversaw the data analysis, refined the reporting of the work and was the guarantor of this work. KM and LH collected the data, analysed the data and reported the work. DBTR, OPJ, OL, CB and RJE contributed to reporting of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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