Training principle of the month 7: Training time and learning opportunities are prioritised

Finding the right balance between training and service needs is more difficult now than ever before. This month, we hear from trainees Dr Joshua Hodgson and Dr Emma Coombe and trainers Dr Sue Laurent and Dr Trisha Radia about the work they have done to achieve this balance in today's NHS.
RCPCH Progress+ Training principle of the month
Last modified
7 April 2022

From children and young people

Engaging the patients you work with is crucial to your clinical practice. Children and young people are supporting your learning with their free module on our QI Central site. This covers children’s rights, the benefits and costs of engagement and some creative, inclusive opportunities.

Foundation doctor and volunteer with our RCPCH &Us programme, Joanna Boxall, interviewed young people about their engagement experiences. When clincians work in partnership with young people, one group told her, this leads to an improved understanding of their care needs, and ultimately improves services. You can read her article on RCPCH Insight

Medicine is an apprenticeship, and reflective spaces - video

Take the time to lift as you climb

In this video, Dr Joshua Hodgson talks to Dr Sue Laurent and Dr Trisha Radia about why they think it's important trainees have quality and meaningful time for training, and how they try to achieve this.

Training opportunities are discussed at handover - case study

Training level: All levels

Setting: All settings

What prompted the change? Trainees flagged to consultant colleagues that they were struggling to find time to complete workplace-based assessments during the working day. Consultants appeared time-pressured on the wards and trainees felt they were “nagging”, having to repeatedly ask for supervised learning opportunities.  

What happened? The department decided to incorporate a new “Training Opportunities” section in the team handover safety briefing each morning. The lead consultant would say, “Who would like to undertake a workplace based assessment today?” The team would review the patient caseload and identify relevant learning opportunities together. These encounters and the subsequent feedback to trainees were then included in the day’s priorities for the team that day.  

How did this support training and trainees? It helped to embed training opportunities as a routine part of the working day in this team. Making a written commitment in the handover safety brief meeting to undertake learning opportunities and planning this activity into the day seemed to increase the likelihood of this supervised training activity taking place on busy days. It also helped raise awareness amongst the nursing team members that this activity needed to take place and was important.  

Time for training is protected - case study

Training level: All levels

Setting: All settings

What prompted the change? The department reviewed their exception reports at the end of a rotation. They noticed that trainees would often report they had to miss fortnightly simulation training since it was difficult to access (it was held in a separate building to the paediatrics department), and if they were able to attend, were often interrupted by bleeps and service pressures.

What happened? The department decided to move to a model of in-situ simulation whenever bed pressures allowed. A consultant would hold the middle grade bleep, and junior bleeps were given to a ward clerk for the duration of the teaching to take messages; interruptions were only made for urgent matters and routine tasks were deferred. Five minutes were reserved at the end of each session so trainees could make real-time, reflective notes to later upload to their ePortfolio.  

How did this support training and trainees? In-situ simulation meant training took place in a more realistic environment, MDT (multidisciplinary team) participation was easier to facilitate and there was no distance barrier to trainees accessing training. There was also improved awareness amongst MDT colleagues of the whereabouts of the medical team during this training and so interruptions were minimised.

The department will now review the exception reporting trends to assess whether these changes have been successful and if further tweaks are needed.  

High quality training doesn’t happen by accident - training presentation

How can you get thinking about the responsibility of trainers and trainees to ensure training time is prioritised? Dr Joshua Hodgson and Dr Emma Coombe have created a slidedeck for you to use - download as a PowerPoint presentation or PDF below. 

Find out more about what to expect from Progress+

Dr Joshua Hodgson is a trainee paediatrician with an interest in PICU and sits on the RCPCH Trainee Committee as representative for north central and east London, and currently working at Sydney Children's Hospital. Dr Emma Coombe Is a trainee paediatrician and sits on the RCPCH Trainees Committee, often advocating for trainees from a recruitment perspective.