Induction in Foundation

1. Induction in Foundation A Trainee–led workshop Forging Foundations Together April 2014

2. Why talk about induction today?

3. Why talk about induction today? • An issue much talked about by us

4. Why talk about induction today? • An issue much talked about by us • Sets us up to do our best work

5. Why talk about induction today? • An issue much talked about by us • Sets us up to do our best work • Creates a first impression of the hospital and medical education department

6. Why talk about induction today? • An issue much talked about by us • Sets us up to do our best work • Creates a first impression of the hospital and medical education department • Many forces affecting what goes into it

7. What do we offer? Survey results from LEPs

8. Days of Induction

9. Shadowing • Trusts generally are allowing FDs to arrange additional shadowing periods • Wide variation in percentage of doctors 20-100% • F2s generally only get 1 day of induction • Courses offered include ALS, BLS and ALERT

10. E-learning

11. E-learning • “Timesaving for some but issue with elearning as much is only available when within the Trust premises.” • “Some teething problems with new system but mostly positive, e-learning preferred to lots of face to face talks” • “They prefer face-to-face sessions and access is sometimes difficult • “From informal feedback some feel time consuming but they may not have appreciated the time saved from face to face inductions. F1s tend to find the online induction good as they can do this before they start which may alleviate some concerns”

12. Good practice • “Workshops for working with AHPs - they rotate around each AHP who have a chat about working together. We also run workshops with current F1s about the practical side of being an F1 and dealing with common emergencies and a workshop on pharmacy. 5 full days of shadowing (which does usually include their local induction in their clinical setting)” • “FY1 e-guide - compiled by FY1s e- 'How To' guides” • “We allocate a half day for the trainees on the wards with the nursing teams”

13. Challenges • “For F2s issue with very limited time to undertake a thorough induction programme due to clinical rotas and requirements” • “People in the Trust want more to be included in induction but we are faced with the challenge of not using their shadowing period and releasing them to their clinical areas”

14. Results from survey of Foundation Reps Based on informal feedback

15. Results from survey of Foundation Reps Based on informal feedback 19 F1s 14 F2s

25. FY1 • Great to meet people, shadow my job, learn how to do the basic aspects of the job (how to use the programme for discharge summaries, how to order investigations e.t.c.); and also actually knowing the patients. • Good run through of clinical situations and what to do, good to refresh memory! Also good in terms of explaining the system and all the technical side of things. • Spending enough time with outgoing f1s and others in the job before starting • Getting-to-know-each-other. Meaningful practical advice about how the hospital works.

26. FY1 • Minimise not overly helpful lectures at a different site about topics we have all just learnt for finals and will be unavoidably challenging when we actually finally face them clinically. • Put ALS in induction - would have increased the confidence of most FY1s and prevented rota issues later in the year when people try to organise study leave. • Perhaps have a "mingle" evening for all the new FY1s and the various teams so that we all get to know each other a little but before starting working together.

27. FY1 Shadowing repeatedly came up as being very useful and several people asked if it could be a longer period. • Also might be useful to intersperse shadowing with lectures rather than all lectures as a block then all shadowing, because training in things such as electronic systems makes more sense once you've seen them in practice.

28. FY2 • There were very helpful sessions about how the radiology requesting system works, and about the Ambulatory Care system which was new to most people. These practical "this is how our hospital works and these are the services on offer for patients" sessions are very helpful. Generic sessions like "You should maintain confidentiality at all times" served little purpose - all doctors should already knows this, and if they don't, these sessions don't bring about behaviour change. • Remove generic sessions. Add more detail about how this specific Trust works.

29. FY2 • Speak to outgoing doctors who we will replace formally or shadow - More formal list of responsibilites – • Dr handbook with important info about the job. • Do 'box-ticking' things like fire procedures, moving and handling, infection control either as lectures or as e-learning rather than both. Unnecessary repetition of information.

30. FY2 Feeling part of a team • Focus on making trainees welcome and supported. Don't just focus on common error or medicolegal issues. • group bonding sessions so we know our F2 year as it can be a quite fragmented and isolating year otherwise

31. Break out groups

32. Thank you