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Introducing modular training to improve patient care

In partnership with Health Education England, Guys’ and St Thomas’ NHS Foundation Trust designed a modular training rota in gynaecology and oncology to improve training and patient care.


Related themes

  • Rotas and scheduling

Background

Traditionally, hospital rotations for core trainees are based on firm (where a team of doctors in training corral around a particular consultant ) – or service-focussed cover.  The project team found that this led to varied exposure to modules in the Royal College of Obstetricians and Gynaecologists (RCOG) education and training curricula with a few trainees spending six months in a particular subspecialty such as gynaecology oncology. There were also a small number of trainees finishing their core training without enough exposure to or experience in all the modules in the RCOG curriculum.

As a means to improve training and patient care, the project team piloted a training project with rotation based on training modules. The feasibility of this approach was tested by specifically focusing on the gynaecology oncology training module.

How they did it

The team designed a new rota to allow for continuity of care and training, supported by the core gynaecology and oncology module. The trainees carried out a knowledge pre-test and post-test, and regular teaching sessions were undertaken by both trainees and trainers to cover the theoretical component of the module.

In order to accommodate the full programme, the night shifts previously allocated to the trainees were covered by other staff and day time labour ward and gynaecology on-calls remained integrated into the programme to maintain essential core skills.

What they achieved

  • After just eight weeks of training in the modular training block, trainees in the project acquired knowledge that was equivalent to those who spent six months in traditional training.
  • Trainees completed more workplace-based assessments as part of the pilot project compared with what they completed during ‘traditional’ training in the same year.
  • More than a 50% increase in trainee confidence.
  • The project increased trainees’ ability to attend training sessions.
  • Trainees achieved 100% of RCOG logbook requirements.
  • The project saw an improvement in the confidence levels of the trainers.
  • Improved care and management of patients due to a reduction in incidents and improvement to clinical outcomes.
  • Improvement in multi-professional team working with the integration of the trainee as part of the team.

What they’ve said

“I have a much greater appreciation for the experience gynae-oncology patients have. This has allowed me to have a greater empathy for these patients and also to manage them in a more effective way when encountering them in other areas such as A&E and emergency on-calls. Being a part of the team also allowed a greater rapport with the trainers and allowed the training to be more individualised over the time-period.” Trainee

“As a junior registrar I felt this experience has been one of the most valuable in my training to date. The consultant leading the module took me under their wing and for the first time I felt like a ‘real trainee’, whose learning and skill development no longer came second to service provision.” Trainee

“It made trainees who were really not comfortable working in gynae-oncology department more confident to handle common gynaecological referrals and conditions. It gives patients confidence in doctors if they have knowledge and experience.” Trainer

“See at first-hand how to deal with difficult clinical scenarios when patients may disagree with management plans, or have difficulty coming to terms with a cancer diagnosis… I felt part of a team and valued in my position.” Trainer

Toolkit

Please look at the toolkit materials in the documents section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects. Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

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