I hadn't seen this, but it is very good news for retention of A&E as a training post, whatever the junior
wishes to do, although I don't see haw they drew their conclusion from this that structured training is
inadequate. In the light of the 4 month proposals, it would be very helpful if this could be repeated in
another cohort at 2 and 4 months after the job started:
Eur J Emerg Med 2002 Sep;9(3):244-7
Accident and emergency medicine--still a useful 'apprenticeship'?
Brazil E, Macnamara AF, O'Connor N, Bodiwala GG.
Emergency Department, Mater Misericordiae Hospital, Dublin, Ireland.
The objective of this study was to compare the expressed confidence of senior house officers (SHOs) at
performing practical medical procedures before and after working in an accident and emergency (A&E)
post. The extent of formal teaching of these skills and opportunity for independent performance of them
was also assessed. A postal questionnaire was sent to all SHOs completing an A&E post in the Trent
region of the United Kingdom. Doctors were asked to grade their subjective confidence at performing listed
practical skills before and after working in A&E. Eighty-four replies from 120 questionnaires were received
(70% response rate). There was a significant improvement in confidence ( <0.0001) for all the skills studied
after working in A&E. The proportion of doctors who received instruction varied for each of the skills. The
expressed confidence of SHOs in performing practical procedures improved dramatically after working in
A&E. Although remaining a valuable 'apprenticeship' for junior doctors, structured training is inadequate
in the accident and emergency SHO post.
PMID: 12394621 [PubMed - indexed for MEDLINE]
Best wishes,
Rowley Cottingham
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http://www.emergencyunit.com
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