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      Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation

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          Abstract

          Background

          Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors’ perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency.

          Method

          Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis.

          Results

          Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement.

          Conclusions

          It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes.

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          Most cited references6

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          Foundation doctors' views on whether their medical school prepared them well for work: UK graduates of 2008 and 2009.

          The transition from medical student to junior doctor is a critical stage in career progression. We report junior doctors' views 1 year after graduation on whether their medical school prepared them well for clinical work.
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            Junior doctors prescribing: enhancing their learning in practice.

            This aim of this paper was to explore new doctors' preparedness for prescribing. This was a multiple methods study including face-to-face and telephone interviews, questionnaires and secondary data from a safe prescribing assessment (n= 284). Three medical schools with differing curricula and cohorts were included: Newcastle (systems-based, integrated curriculum); Warwick (graduate entry) and Glasgow [problem-based learning (PBL)], with graduates entering F1 in their local deanery. The primary sample consisted of final year medical students, stratified by academic quartile (n= 65) from each of the three UK medical schools. In addition an anonymous cohort questionnaire was distributed at each site (n= 480), triangulating interviews were conducted with 92 clinicians and questionnaire data were collected from 80 clinicians who had worked with F1s. Data from the primary sample and cohort data highlighted that graduates entering F1 felt under-prepared for prescribing. However there was improvement over the F1 year through practical experience and support. Triangulating data reinforced the primary sample findings. Participants reported that learning in an applied setting would be helpful and increase confidence in prescribing. No clear differences were found in preparedness to prescribe between graduates of the three medical schools. The results form part of a larger study 'Are medical graduates fully prepared for practice?'. Prescribing was found to be the weakest area of practice in all sources of data. There is a need for more applied learning to develop skill-based, applied aspects of prescribing which would help to improve preparedness for prescribing. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.
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              Are medical students adequately trained to prescribe at the point of graduation? Views of first year foundation doctors.

              Drugs are the major therapeutic intervention provided by most doctors throughout their careers. The General Medical Council expects all medical students to be competent to prescribe at the point of graduation. The aim of this study was to assess the views of Foundation Year 1 (FY1) doctors who had recently graduated from the University of Edinburgh about their training and competence in relation to the use of drugs based on their early clinical experience. A questionnaire was constructed based on Tomorrow's Doctors 2002 and distributed to FY1 doctors who graduated in August 2005. Responses were received from 100 (39.8%) of the doctors who graduated in 2005. Only 32% respondents considered themselves 'competent to prescribe' at the point of graduation. Less than 50% of respondents felt comfortable in providing information about possible treatments to allow patients to make informed decisions about their care. The majority of respondents complained about a lack of formal teaching and practice at basic clinical skills relating to drug therapy. Many graduates feel under-prepared to take on prescribing responsibilities after graduation. These findings emphasise the need to ensure that all medical curricula are able to provide sufficient learning opportunities and robust assessment in this important area of clinical practice.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                22 December 2016
                2016
                : 11
                : 12
                : e0168558
                Affiliations
                [1 ]College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
                [2 ]University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, United Kingdom
                [3 ]Health Education England, Edgbaston, Birmingham, United Kingdom
                [4 ]West Midlands Centre for Adverse Drug Reactions, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom
                Waseda University, JAPAN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: HB SKP EH JM JJC RF.

                • Data curation: HB HV CH.

                • Formal analysis: HB SKP EH JM JJC RF.

                • Funding acquisition: JM.

                • Investigation: HB HV CH.

                • Methodology: HB SKP EH JM JJC RF.

                • Project administration: HB SKP.

                • Supervision: RF JM JJC.

                • Validation: HB SKP EH JM JJC RF.

                • Visualization: HB SKP HV CH EH RF JM JJC.

                • Writing – original draft: HB SKP HV CH EH RF JM JJC.

                • Writing – review & editing: HB SKP HV CH EH RF JM JJC.

                Author information
                http://orcid.org/0000-0002-0344-4075
                Article
                PONE-D-16-40393
                10.1371/journal.pone.0168558
                5179017
                28005938
                b1a99559-c6e3-4683-b7df-a91af1e40262
                © 2016 Brooks et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 10 October 2016
                : 2 December 2016
                Page count
                Figures: 1, Tables: 1, Pages: 14
                Funding
                Funded by: Health Education England
                Award Recipient :
                This study was funded by Health Education England’s West Midland Team. This article presents independent research. The views expressed are those of the author(s) and not necessarily those of Health Education England or NHS England. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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