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      The first five years: a mixed methods study investigating reflections on working as a hospital consultant

      research-article
      1 , 2 , , 1 , 2 , 3 , 2
      JRSM Short Reports
      SAGE Publications

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          Abstract

          Objectives

          This paper revisits the same cohort of hospital consultants approximately five years after they were first appointed to investigate their reflections on establishing themselves in their role.

          Design

          Mixed methods using a short survey and in-depth semistructured interviews.

          Setting

          The study was conducted within one Deanery in the North of England.

          Participants

          The same 45 hospital consultants who were invited to participate in the study in 2007 were asked to take part in the second stage of the project in February 2011. These 45 consultants started their appointments no earlier than May 2006 within 12 National Health Service (NHS) Trusts in one Deanery. A total of 16 consultants participated. Six consultants who took part in semistructured interviews in 2007–2008 were invited to be interviewed again. Four consented and participated in a further interview in 2011.

          Main outcome measures

          Do consultants feel they have completed their transition into their senior clinical posts? Yes, although the ever changing nature of the consultant role means new challenges are always having to be being addressed. What support mechanisms are valued by consultants? Informal support mechanisms are greatly valued by consultants and these are built up over time. Are consultants satisfied that they made the correct specialty choice? Yes, all respondents reported satisfaction in their specialty choice.

          Results

          After reflecting on five years in post, all agreed that Specialist training prepared them well for the clinical aspects of their role. Ten (62%) felt they were not prepared for dealing with Trust Management issues and 13 (81%) felt unprepared for financial management.

          Conclusions

          consultants learn on the job and eventually fulfil their potential in the role over time. However, the role is regularly changing so informal support mechanisms are valued to help deal with a highly complex role.

          Related collections

          Most cited references3

          • Record: found
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          Transition from SpR to consultant: a survey of training needs in palliative medicine.

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            Subspecialty neonatal trainees views on being prepared for the consultant role.

            Higher specialist training offers an opportunity to focus on non-clinical skills as well as clinical issues. The authors wished to determine whether doctors who complete neonatal higher specialist training in the UK feel prepared for the consultant role with respect to management, research and teaching, as well as clinical activities. A questionnaire related to the preparedness of the consultant to carry out a range of activities was sent to all doctors who were appointed to the UK higher specialist training programme in neonatology from 2002 to 2008 who were currently working as consultants. Seventy-one of the 83 eligible participants completed the questionnaire. Roles that consultants felt extremely well prepared for related to clinical care, communication, team-working, prioritising tasks, teaching and audit. Trainees reported that roles that they had been not at all well prepared for were related to roles in management and service delivery, medicolegal issues and complaints, job planning and personal development, supporting doctors in difficulty and chairing meetings. Four key themes emerged from the analysis of free-text responses regarding specialty training: the influence of shift patterns/service provision, the lack of non-clinical preparation, learning on the job as a consultant later on and problems with grid training itself. This study showed that for neonatal paediatrics in the UK, new consultants feel confident about managing ill babies but are unprepared for other aspects of the consultant's role. Neonatal higher specialist training needs to allow opportunities for non-clinical training.
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              Best evidence topic report. Use of intravenous cyclizine in cardiac chest pain.

              G May, R. Kumar (2005)
              A short cut review was carried out to establish whether cyclizine adversely affected haemodynamic parameters in patients with cardiac disease. A total of 70 papers were found of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of this best paper are tabulated. The clinical bottom line is that cyclizine should be avoided in patients with acute coronary events.
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                Author and article information

                Journal
                JRSM Short Rep
                JRSM Short Rep
                SHR
                spshr
                JRSM Short Reports
                SAGE Publications (Sage UK: London, England )
                2042-5333
                May 2013
                18 April 2013
                : 4
                : 5
                : 2042533313476686
                Affiliations
                [1 ]Evidence-based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, St Helens Road, Ormskirk L39 4QP, UK
                [2 ]Postgraduate Dean, Mersey Deanery, Liverpool L3 4BL, UK
                [3 ]Neonatal Unit, Liverpool Women's NHS Foundation Trust, Merseyside L8 7SS, UK
                Author notes
                [*]Correspondence to: Jeremy Brown. Email: brownjm@ 123456edgehill.ac.uk
                Article
                10.1177_2042533313476686
                10.1177/2042533313476686
                3681229
                23772312
                76be0a81-abfa-4f62-8b6e-e52d3ed8c1ab
                © The Author(s) 2013 This is an open-access article distributed under the terms of the Creative Commons Non-commercial Attribution License ( http://creativecommons.org/licenses/by-nc/2.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.
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                Medicine
                Medicine

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