An exploration of the junior doctor's experience of training.
This investigation examines aspects of junior doctor training as perceived by both junior
doctors and their supervisors. The studies were conducted as part of the role of
educational facilitator at a district general hospital.
The first and second studies report on surveys that were used to determine the experience
of formal educational structures and informal training as reported by two cohorts of junior
doctors. Qualities of the supervision relationship were explored using the Barrett Lennard
Relationship Inventory (BLRI, Barrett Lennard 1962). Focus groups and in-depth
interviews were used in the third and fourth studies to explore hospital consultants'
perceptions of medical training.
The main findings of this investigation are as follows. The salient learning experiences
reported by the junior doctors were those referring to their practical experience, learning
relationships and self-assessment methods. The junior doctors preferred learning from
active involvement and informal situations. Associations were found between the junior
doctors' ratings of the training experience and their perceptions of supervision
relationships (BLRI). Those with an individual training plan were more satisfied with
their training than those without. This investigation also highlighted tensions between the
junior doctors' service provider and trainee roles. The functions of the learning
relationship are presented in the discussion these include: teaching, role modelling,
feedback and support. The generic skills (e.g. decision making) and learning practices
(e.g. discussion) described by the hospital consultants in the interviews are discussed with
reference to models of professional development (Eraut 1994), reflective practice (Schon
1983) and medical practice (Britten 1991).
The findings have implications for the development and evaluation of strategies for
training. evidence based medicine and clinical governance because they demonstrate the
processes by which skills for medical practice are formed.