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G/THUR/EDU1 AN AUDIT OF SPR TRAINING AT A LARGE DISTRICT GENERAL HOSPITAL: IS IT POSSIBLE TO MEET THE RCPCH STANDARDS FOR CORE TRAINING WITHIN THE CONSTRAINTS OF THE EWTD, ON A FULL SHIFT ROTA?
K. Lamb, M. Zalkin.North Middlesex University Hospital (Great Ormond Street Hospital for Children NHS Trust), London, UK
Aims: To determine if the Standards and Criteria for Core Higher Specialist Training as laid down by the RCPCH are being met by core trainees working a band 2a rota in a large district general hospital.
Methods: Audit forms were sent out and returned by email weekly over 10 weeks. Shifts worked by each registrar were analysed retrospectively from the rota over the same time period.
Results: Time spent at work between 8.30–5.30; 49%. Time spent out of designated clinical areas; 20% (when out of hours work excluded) 61% (as proportion of total time at work). Clinic attendance; 41% of the recommended number of clinics were attended within the 10 weeks. Teaching; amount attended (weeks audit returned) 42%, bleep rate 75%. Reasons given for non-attendance were: cancelled 18%, leave 16%, nights 11%, rostered off 12%, clinic 1%, late evening shift 7%. Ward rounds; 3 out of 8 registrars met the standards for ward round attendance. 10% of ward rounds were registrar led.
Conclusions: It is not possible to meet the current RCPCH recommendations for training whilst working this full shift rota. Simple changes can improve training but still leave RCPCH standards a long way off being met. The factors contributing to lack of training are nights/twilight shifts, rostered time off and the fact that the amount of time spent at work when most training occurs is less than 50%. These factors are difficult or not possible to change. Other hospitals employ similar rotas so we therefore anticipate that these problems with training would be encountered by other core trainees, but further audits are needed to look at this. As the EWTD is here to stay we need to be more innovative with …
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