Article Text
Abstract
Aims Breaks from clinical practice are increasing and attrition rates are high in Paediatrics. The 2012 Academy of Medical Royal Colleges’ ‘Return to Practice Guidance’ highlights that skills and knowledge decline with absences longer than three months and doctors, employers and designated bodies should share responsibility for patient safety by facilitating supportive processes.
Methods In 2012 our School designed a ‘Returning to Training after Maternity Leave’ course, using low fidelity. This developed into a one-day course, ‘Paediatric Returning to Acute Clinical Practice’ (PRACP course), embedding high-fidelity simulation among related talks. Funding was secured for 60 places, three courses a year, corresponding with changeover dates. Utilising ‘Survey Monkey’, qualitative data was collected for a two-year period (2015, 2016), using pre course, immediate post course and four-month post course questionnaires.
Results Pre course data from 98 responders, indicated 98% were doctors, with 22% returning to level one, 34% level two, 40% level three and 4% post CCT. The mean time out was 18 months and median 12 months, corresponding with the high numbers post maternity leave (60%). Other reasons for breaks included research (12%), fellowships, out of programme experience/training, ill health and caring responsibilities. Course priorities for learners included practice of emergency skills (34%), overall confidence (23%), guideline/practice updates (21%), work life balance advice (7%) and peer support (5%).
86 post course responders assessed usefulness (percentage strongly agreeing or agreeing) of various sessions: 100% simulation, 99% hot topics, 88% WPBA, 88% LTFT and 74% work life balance. Overall, 99% felt the course met their educational needs and 95% felt more prepared for acute practice.
Four-month post course feedback from 2015 revealed that 90% felt the course aided their transition back to work and 90% felt skills were applicable to their new roles.
Conclusions Trainees were acutely aware of their loss of skills and confidence. This model of embedding simulation with targeted sessions, allowed learners to practice and update skills in a supportive environment. The evidence supports the course has a positive impact on transition back to the clinical practice and similar courses should be made available in other regions.