Transcript Slide 1

National Framework for Induction & Introduction to Histopathology
(England/Wales)
Strand B: Direction and Standardisation of programme for School Leads
Dr Elizabeth Byrne1, Mrs Sue Cossins1, Dr Anna Green2
The Leeds Teaching Hospitals1, Royal Free Hospital, London 2
RESULTS
•The response rate was 57.9% (11/19)
•100% of respondents felt they had a robust
system in place.
Fig. 1: When does departm ental induction take place for ST1 trainees?
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80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
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INTRODUCTION
Histopathology school leads and trainers are
required to provide induction for all new ST1
trainees. Many ST1s starting their training have
limited previous exposure those who are
experienced are likely to have moved to a new
department.
The purpose of this study is to compare current
practice against the mandatory requirements set
out by PMETB’s Generic Standards1 (GMC
became responsible for the functions of PMETB on
1 April 2010) and the Gold Guide2, to ascertain
what criteria are not being met and make
recommendations for improvement in an attempt
to standardise induction practice across the UK –
producing a National Framework for Induction
document.
A trainee survey carried out by the GMC in 20093
comparing
all
specialties
showed
that
Histopathology trainees in the UK rated their
induction at 85.06%.
A parallel survey (Strand A) was carried out to
correlate these findings with the ST1 trainees’
perspective of induction delivered.
Fig. 2: How long does the initial 'inform ation giving' period of your induction
last?
When asked to comment responses included
0%
9%
27%
1 day
27%
up to 3 days
1 week
more than 1 week
2 weeks
37%
more than 2 weeks
‘3 day induction … then launching into clinical teams has worked well
for the past 5 years’
‘…In reality at small centres it isn't sharply demarcated.’
‘The whole Year is an introduction to Histopathology’
DISCUSSION
PMETB's Mandatory Requirements for Induction and The Percentage of
Schools That Cover these at Induction
Given physical orientation eg, maps and/or guided tour
Information of basic terms and conditions of service, ie hours of work,
instructions on reporting in sick, annual leave entitlement etc
100.0%
METHODS AND TECHNOLOGY
A questionnaire was created within Survey
TM and sent to Training School lead
Monkey
trainers in England and Wales. This asked about
the information they provide, what elements make
up the histology introductory period and how it is
delivered.
The outcome will enable a direct correlation with
PMETB’s1 mandatory requirements, give direction
to School Leads and set minimum standards for a
national framework.
Told where to find key policies and protocols
100.0%
Informed how they fitted into the team within dept
90.9%
Given instructions on how to apply for annual/study leave
90.9%
Introduced to key members of the department
100.0%
Provided with health and safety information eg, fire safety, lab safety
100.0%
Given training/instructions on IT and communications arrangements
Informed of clinical governance, complaints handling and risk management
related to their roles
Given information on the organizations history, services, culture and values,
including an appreciation of equality and diversity issues
100.0%
QUESTIONNAIRE
This was divided into the following sections:
•The induction;
• Was there a robust programme in place?
• When was it delivered and how long did it last?
• Did they give generic information eg, maps,
where to find policies/SOPs etc?
• Information relating to training & education
• Information relating to the RCPath
•Histology Introductory period
• When, how and length of introductory period
HISTOLOGY INTRODUCTION
Following the initial information giving part of the
induction:
-54.5% put trainees straight into diagnostic teams
-100% of trainees had intro to normal histology
-54.5% have a dedicated ST1 teaching programme
-45.5% have a programme with a mixture of
dedicated ST1 teaching, and sessions with more
senior trainees
-81.8% have formal autopsy training
-63.6% felt time pressures of their ordinary work load
had an impact on the quality of induction given
-81.8% felt that if the induction period it would
negatively impact on the ability to deliver curriculum
100.0%
45.5%
54.5%
Histopathology specific points to cover at induction and the percentage of
schools covering these
Include a clear outline of the job and its requirements
100%
Information on how structured training will be provided in line with national
standards
90.9%
Requirement to register with RCPath
100%
Requirement to complete an on-line portfolio
81.8%
Stages of training to CCT
72.7%
The need to be aware of minimum datasets
81.8%
The timing (and approximate costs) of RCPath events such as WBAs, MSF,
HY1A, ARCPs etc
100%
•18.2% felt that it was not necessary to provide the information
listed above. Reasons given for this:
‘Awareness of minimum dataset information will be addressed
when they start reporting. There is a lot of info to cover at
induction and some things can be left to a later date.’
‘Organisational history may be interesting but is not essential’’
‘Provide guidance for year 1, after that to year 2-5 Programme
director for guidance’
Although all schools felt that they had a robust
programme in place, this audit highlights that some
PMETB/MMC requirements are not being covered and
that induction practises/trainees experiences after the
initial induction vary between schools.
We recommended a national framework for induction
be created, incorporating PMETB/MMC standards, to
guide school leads so as to standardize the induction
period and ensure all trainees receive a good quality
induction.
It is hoped this will also cut down time trainers need to
spend preparing induction.
RECOMMENDATIONS
The ‘national framework’ will be implemented and act
as a checklist for schools. A re-audit will take place in
Autumn 2010 after implementation of the framework.
LIMITATIONS
The national framework only covers the generic
standards and not school specific information.
REFERENCES
1Postgraduate
Medical Education and Training Board Generic Standards for training.
July 2008 and September 2009.
2Modernising Medical Careers. A Reference Guide for Postgraduate Specialist Training
in the UK. The Gold Guide Third Edition June 2009.
3GMC Trainee Survey: core and specialty training UK-wide (2009)