In terms of quality of the current teaching programme, the feedback was largely positive, being described as as ‘generally good’, ‘often useful’ and ‘up to date’. It was clear from the responses the teaching was well received, especially by the Trust grade SHOs for whom this teaching programme represents their only formal regular teaching, epitomised by the comment ‘please continue! It is the only regular formal teaching we receive’.
Not unexpectedly given the diverse range of educational needs of this heterogeneous learning group, opinions on the utility and content of the teaching programme were somewhat more varied. The majority of Trust grade SHOs felt the ‘teaching programme relevant’ to their educational needs and contained an appropriate content which ‘helped improve knowledge’, covered ‘relevant topics’ and found it ‘useful to be taught concepts which have clinical applications’. This was not universal however and in particular the ‘Core’ surgical trainees and some of the more experienced Trust SHOs suggested the teaching is ‘at times a little basic’ and does not always cover ‘orthopaedic/surgical topics’ making them feel it was not always ‘directly relevant to my educational needs’ and would therefore prefer ‘more orthopaedic subjects’.
There was an appreciation demonstrated by the more senior trainees however regarding the reasons for this, commenting on the difficulty in ‘juggling ortho core trainees and general practice trainees’ meaning that inevitably ‘it’s difficult to gain enough specific teaching matching my needs’ and although ‘orthopaedic trainees would prefer orthopaedic teaching aimed at a higher level’, this would be ‘difficult to arrange’ and is ‘impossible for teachers to keep the topic relevant for everyone’.
In terms of the learner perspectives on the person delivering the teaching, it was generally felt the programme ‘benefits from teaching being delivered by senior clinicians’ and there was a preference towards ‘consultant lead teaching’. Sessions delivered by non-Consultants were also well received however, with a suggestion being made to ‘encourage registrars to give more teaching sessions’ and indeed the potential of near-peer teaching to enhance the training of junior doctors is widely described in medical education literature (7).
There was also a demand for more ‘hands on’ teaching sessions and it was expressed ‘more interactive media’, ‘slide shows’ and ‘videos demonstrating surgical procedures’ would be well received. This demonstrates a variety of preferred learner styles within the group, as described in Flemming’s VARK model (8).
In order to enhance the teaching programme, the general theme was compromise is required to make it relevant to all and that ‘topics should be interesting for most the SHOs’ and ‘not focused on specific areas’. In keeping with this, suggestions were made for a greater emphasis on ‘learning in related fields like pathology and haematology’ and for ‘more radiology teaching’ to be included as part of the programme.
Barriers to attending post-graduate medical education programmes are well recognised (9–11). Workplace related barriers such as clinical commitments were the most frequently cited barriers to attendance in this study. Reasons for not being able to attend included ‘teaching falls on theatre days’, ‘on-call’, ‘busy doing ward jobs’ and ‘sometimes it’s my clinic day and I am therefore unable to attend’. There was an appreciation expressed by those who did make it to the teaching sessions however that the ‘teaching is bleep protected’ and it is ‘good that it is bleep free’.
Physical barriers to attendance were not frequently cited to be an issue within this study as the ‘teaching is on-site, therefore generally convenient to attend’. Despite this, attendance at the teaching programme has anecdotally been described as being ‘quite variable’ with a suggestion therefore made to ‘make teaching compulsory as will improve attendance’. Although the current teaching programme is bleep protected and provided for the benefit of all SHOs within the Trust, individual attendance is not currently closely scrutinised.
The non-educational benefits of the teaching programme were identified by numerous trainees. The social benefits of what is ‘often the only chance’ to ‘get to know other SHOs in the hospital’ was cited by many as a positive aspect of the teaching programme and ‘lunch being provided’ was described as a ‘nice gesture’. Its value in terms of peer support was also noted as it ‘provides an opportunity to discuss work and training related issues with colleagues’.
Given half the SHO within the Trust completed the survey, we feel this study does provide a realistic insight into their perspectives of the current teaching programme and aspects of it they would like to enhance. There may inevitably be an element of volunteer bias affecting the outcome, as the views expressed by the trainees who took the time to complete the questionnaire may not necessarily reflect the views of those who did not complete the questionnaire. In order to minimise this bias, the option of participating in the study remotely was conveyed to all SHOs and the questionnaires were circulated at multiple teaching sessions to allow even infrequent attenders an opportunity to submit as response. Despite these measures however, it is unlikely that all bias was completed eliminated.
It is unfortunately not possible to draw a like for like comparison between this and any other study due to the absence of any other published studies which address the exact same question. It does however illustrate the teaching programme in question is generally well received and is felt to provide multiple benefits, both educational and non-educational to those that attend. It also highlights the difficulties in delivering a teaching programme to a learner group with such diverse educational needs and has demonstrated that barriers to attendance do still exist which are similar in nature to those described in previous studies.