Aim Transition - in paediatrics a term commonly used to describe changes in healthcare provision from paediatric into adult services. However, trainees also go through periods of transition throughout their training. The trainee-consultant transition can be a stressful and difficult time. Many newly-appointed consultants report feeling adequately prepared for medical/clinical aspects of work but unprepared for non-clinical competencies including supervision, leadership and management. Perceived lack of preparedness correlates with higher scores for burnout and emotional exhaustion in consultants. Time spent Acting Up into consultant duties have long been recognised by the RCPCH but availability is variable and dependent on local circumstances. The aim of the Acting Up as a Consultant (AUC) Pilot Programme was to determine whether a formal training programme aided ST8 transition to consultant role.
Methods An NHS Foundation Trust developed a three month pilot AUC programme and one ST8 trainee was selected. The programme was divided into 80% clinical time (attending weeks, outpatient clinics and out-of-hours daytime/evening cover) and 20% non-clinical time, for development of leadership and management experience. This included regular consultant and management meetings and planned mentoring with Service Line leads, Divisional and Clinical Directors and the operational team. Outcomes were drawn from structured feedback at end of programme.
Results Attending weeks were important clinical opportunities as being the responsible and accountable physician developed trainee self-belief and stronger negotiation and decision-making skills. The trainee reported timetabled non-clinical time enabled greater development of leadership and management skills including critical thinking, diplomacy and collaborative working and stronger practical understanding of the department’s operational and financial structures and challenges. Consultant supervision and mentorship emphasised non-clinical learning including situational awareness. The trainee experienced first-hand what is expected from a newly-appointed consultant. Consultants requested further focused training on supporting trainees through transition. Furthermore all recognised the benefits of mentorship for senior trainees and newly-appointed consultants.
Conclusion The AUC Pilot Programme successfully prepared the ST8 trainee for transition to consultant. The most successful aspects of the programme for effective transition were having allocated non-clinical time and mentorship. We recommend that more AUC programmes are developed within ST8 training to facilitate smooth stress-free transition.
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