Abstract
We established an innovative Foundation placement in peri-operative medicine for older patients in response
to the need for training in ‘whole patient’ medicine and the challenge of fewer Foundation doctors in acute
surgical roles. The placement and underpinning curriculum were co-designed with junior doctors and other
clinical stakeholders. This resulted in a modular design offering acute and community experience and
dedicated quality improvement project time. To evaluate the placement we used a mixed methods study based
on Kirkpatrick’s model of workplace learning. Level 1 (trainee reaction) was evaluated using Job Evaluation
Study Tool questionnaires and nominal group technique. Levels 2 and 3 (trainee learning/behaviour) were
assessed using a Likert-style survey mapped to curriculum objectives, e-portfolio completion, nominal group
technique and documentation of completed quality improvement projects and oral/poster presentations. Sixtyeight
foundation trainees underwent the new placement. A similar-sized ‘control’ sample (n = 57) of surgical
Foundation trainees within the same Trust was recruited. The trainees in the peri-operative placement attained
both generic Foundation and specific peri-operative curriculum competencies, and gave higher job satisfaction
scores than trainees in standard surgical placements. The top three ranked advantages from the nominal group
sessions were senior support, clinical variety and project opportunities. Universal project completion resulted in
high rates of poster and platform presentations, and in sustained service changes at hospital level.
to the need for training in ‘whole patient’ medicine and the challenge of fewer Foundation doctors in acute
surgical roles. The placement and underpinning curriculum were co-designed with junior doctors and other
clinical stakeholders. This resulted in a modular design offering acute and community experience and
dedicated quality improvement project time. To evaluate the placement we used a mixed methods study based
on Kirkpatrick’s model of workplace learning. Level 1 (trainee reaction) was evaluated using Job Evaluation
Study Tool questionnaires and nominal group technique. Levels 2 and 3 (trainee learning/behaviour) were
assessed using a Likert-style survey mapped to curriculum objectives, e-portfolio completion, nominal group
technique and documentation of completed quality improvement projects and oral/poster presentations. Sixtyeight
foundation trainees underwent the new placement. A similar-sized ‘control’ sample (n = 57) of surgical
Foundation trainees within the same Trust was recruited. The trainees in the peri-operative placement attained
both generic Foundation and specific peri-operative curriculum competencies, and gave higher job satisfaction
scores than trainees in standard surgical placements. The top three ranked advantages from the nominal group
sessions were senior support, clinical variety and project opportunities. Universal project completion resulted in
high rates of poster and platform presentations, and in sustained service changes at hospital level.
| Original language | English |
|---|---|
| Pages (from-to) | 1392–1399 |
| Number of pages | 8 |
| Journal | Anaesthesia |
| Volume | 73 |
| Publication status | Published - 2018 |