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1133 ‘Are you ok?’
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  1. Sarah L Williamson1,
  2. Hannah Vawda2,
  3. Jessica Gosney3,
  4. Matthew Nash1,
  5. Paediatric Research Across the Midlands (pram)4
  1. 1Birmingham Women’s and Children’s NHS Foundation Trust
  2. 2The Royal Wolverhampton NHS Trust
  3. 3University Hospitals of Leicester NHS Trust
  4. 4West Midlands Deanery

Abstract

Background Trainee recruitment and retention are significant issues currently faced by paediatrics in the UK. In 2020, the GMC survey reported that 40% of trainees reported their work to be emotionally exhausting. Within paediatrics, symptoms of post-traumatic stress disorder have been reported in up to 81%.

The debrief process aims to provide an environment for reflection and learning, but also allows the team to process and better understand their response to a high-stress situation.

Objectives To explore paediatric trainees’ views and experiences of significant events and the debrief process in the West Midlands.

Methods An online questionnaire was designed and distributed to paediatric trainees in the West Midlands region (specialty trainee grade 1 – 8). Responses were collected between 16th October and 17th November 2018. The questionnaire addressed three main areas;

  1. Impact of involvement in significant events on trainees

  2. Trainees’ previous experience of debrief in clinical practice

  3. Trainees’ opinion on the use of debrief in clinical practice

Results The response rate was 46% with 118 responses analysed. Prior involvement in a significant event was perceived to have had a negative impact on 29% (n=34) of respondents. Trainees reported disruption to personal relationships, mood, energy levels and sleep following a significant event. They also reported an impact on work life; including feelings of insecurity and self-doubt, in addition to reduced confidence and self-esteem.

Previous experience of clinical debrief was described by 75% (n=89) of trainees. Of these, 57% (n=51) experienced a hot debrief, within 24 hours of the event; 35% (n=31) a cold debrief, greater than 24 hours after the event, and 8% (n=7) multiple debrief episodes. The debrief process was felt to be useful by 84% (n=75), however 20% (n=18) reported having a negative debrief experience. Reasons for this included; apportion of blame and responsibility, inability to voice concerns and emotional upset.

A majority of trainees felt that a combination of both hot and cold debrief would be most beneficial (75%, n=88), and that this should be attended by members of the multidisciplinary team, either those directly involved in the event (60%) or the wider team (35%). Over half of trainees felt that these sessions should be led by the consultant who had been directly involved. 78% (n=92) felt that a formal debrief tool would be useful.

Conclusions Significant events can negatively impact on trainees’ wellbeing; affecting them both personally and professionally. This can have long term implications on trainees’ mental health, as well as workforce retention. It is therefore essential we ask ‘are you ok?’ If delivered appropriately, the debrief process can provide us with this opportunity ensuring the well-being of our trainees.

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