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Title: A mixed methods study of clinician experience with two innovative skills training interventions
Author: Blackhall, Vivienne Isabella Ruby
ISNI:       0000 0004 9355 7042
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2020
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The delivery of modern medical training faces many challenges including restrictions on working hours and an increased emphasis on patient safety. This has necessitated the development of creative training adjuncts in order for trainees to develop the necessary skills for independent practice. This thesis evaluates aspects of two innovative educational interventions: a home-based simulation programme and a video-stimulated debrief technique called iViewExpert, both designed to promote the development of technical skill expertise in medicine. A pragmatic mixed methods approach was adopted in this programme of work. Data were gathered using focus groups, questionnaires, field notes and a small number of semistructured interviews. Analytical methods included thematic analysis, and simple descriptive statistics with non-parametric statistical analysis. An overarching theme was a lack of participant engagement with both of the interventions. Whilst the underlying pedagogical basis and evidence base for each was apparently sound, uptake was poor in practice. Reasons for this were numerous but may have included individual, cultural and organisational influences. In terms of individual factors, preferred learning style was important, with clinicians displaying an apparent preference for practicing on live patients. In addition, more junior trainees appeared to be motivated to engage with tasks which were associated with career progression rather than activities associated with professional development. There was also evidence of disconnect between trainees and trainers which may have affected practitioner motivation and engagement. Systems at play within the clinical workplace were cited as perpetuating these phenomena. Medical training requires innovation to remain sustainable and responsive to current challenges. Only those innovations with a proven track record and robust evidence base should be brought to scale and widely implemented. This requires a thorough outcomes and process based evaluation to understand what works, for whom, in which circumstances, and the underlying mechanisms. For implementation to succeed, not only is a receptive audience required, but so too is a supportive training environment and culture. If the institution values professional development and learning, then so too will the individual. Innovation in medical education could be supported by the introduction of innovation fellowships and faculty development courses to allow trainers to develop the necessary skil-lset to deliver new training approaches. However, fundamentally, a change from the current transactional ‘tick-box’ culture in medical education to a transformational approach which values professional development would be desirable.
Supervisor: Wilson, Philip ; Walker, Kenneth G. ; Cleland, Jennifer A. ; Whiteley, Iya ; Moug, Susan Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Medical education ; Training