We have had a great response to the questionnaire from across the UK, with around 15% of all FiY1 doctors having completed our questionnaire (this is a very good figure for this sort of online questionnaire).
In order to collect longitudinal data, questionnaires have been distributed on a three-week rolling schedule. Many people have now received two links, and some this week have received a third. We know that many people have come to the end of their FiY1 posts as F1 induction approaches at the end of the month, and so this will mark the end of data collection Phase 1. If you get a questionnaire link and have finished your FiY1 post, please do follow the link – there are options to record that.
Phase 2, where new doctors starting F1 directly will also be included, will begin during F1 induction, and we are working with colleagues at Foundation Schools to make sure everyone is aware of the project.
We will give a round up of Phase 1 on the blog next week.
In coming weeks we will be including some more personal views of the project from members of the research team, and some of our FiY1 partners. In this post Bryan Burford describes the genesis of the project.
As the pace of the covid-19 pandemic changed rapidly in the first weeks of March, I remember thinking what a strange time it must be to be a medical student approaching graduation, unsure of how it may shape the already uncertain period of transition to clinical practice.
When I became aware of the FiY1 initiative, early in lockdown, I was struck by what this would mean for graduates. The acceleration from thinking that there are a few months of medical school remaining, to potentially starting work in a few weeks, with no final exams, must be very unsettling, to say the least!
On the other hand, knowing many medical students and how keen final years are to enter practice and apply all they have learned, I thought that many must be feeling excited at the prospect of having a period of work before starting Foundation Programme.
Conversely, those who do not take on an FiY1 post – either through choice, or because they did not graduate early – must also be having mixed feelings.
These thoughts resonated with much of the work Gill Vance and I have been doing over the last few years around transitions through medical school and beyond – questions of ‘preparedness’ and personal adjustments to practice, and challenges to the wellbeing of medical students and doctors.
We quickly drafted an outline proposal and having already started building relationships with other medical education researchers across the UK as part of the development of the NIHR Incubator in Clinical Education, were soon able to pull together a team and a plan. The GMC agreed to fund the project, and by May we were finalising the questionnaire materials you have seen and approaching other stakeholders to support data collection.
While the rapid development of projects is not new to us, the pace of this felt new – in part because the world was changing to rapidly around us, and so any data we collect would be far more time-critical than in ‘normal’ times (hence the longitudinal design). There’s also an awareness that this is a historic moment, and we have a unique opportunity to hear from the ‘class of covid’ (a phrase I came across on Twitter, used by newly graduating medical students).
We also have to consider that this may not be the last pandemic – and indeed that the current one is by no means over. Understanding the experience of starting work in such unusual circumstances now – whether as FiY1 or as F1 in August – will help ensure that any future changes are informed by the best evidence.
Learning from this unusual set of circumstances may also guide approaches to best address the longstanding challenges of the transition to professional practice in the ‘new normality’.
With the project well underway, it’s a good time to introduce the team undertaking the project. We will have posts from individual team members in coming weeks, but this post will be a quick introduction to us all.
The project is being led from Newcastle University School of Medical Education by Dr Bryan Burford, and Dr Gill Vance. Bryan has a background in social and cognitive psychology, while Gill is a clinician as well as a researcher in medical education. Gill works as a consultant in paediatric allergy at Newcastle’s Great North Children’s Hospital. She is also the Director for the Academic Foundation Programme in Northern Foundation School. Since 2013, Bryan and Gill have completed several projects looking at the work, preparedness and wellbeing of medical students and junior doctors, much of this for the GMC. They are also behind the newly announced NIHR Incubator for Clinical Education. This project represents the first collaboration since the Incubator was confirmed.
At The University of Exeter, Professor Karen Mattick has a particular interest in the links between education, research and practice. She has also completed work for the GMC looking at preparedness, and is a co-lead of the Centre for Research in Professional Learning at Exeter. Karen developed the Care Under Pressure project for the NIHR, which aimed to understand factors shaping doctors’ mental health and to co-produce recommendations that support the tailoring, implementation, monitoring and evaluation of contextually-sensitive strategies to address mental ill-health in doctors. The project was led by Dr Daniele Carrieri, and Karen and Daniele are developing a follow up to that work.
At Plymouth University, Professor Tom Gale combines educational and clinical expertise as a consultant anaesthetist and Professor of Medical Education at the Peninsula Medical School. Dr Nicola Brennan is a social scientist by background, and has been working in medical education research for 13 years. Tom and Nicola lead the education research group, CAMERA, which carries out research focused on the development, recruitment and retention of a sustainable healthcare workforce. They will shortly be launching a study commissioned by the GMC to investigate specific themes underpinning new doctors’ preparedness for practice.
At Queens University Belfast, Professor Tim Dornan has a particular interest in understanding clinical workplace learning. His work has involved many aspects of practice, including doctors’ empathy and readiness for prescribing. A recent publication also looked at another doctors’ adaptation in another natural disaster – the Japanese earthquake and tsunami of 2011. Tim is also a (now retired) physician and endocrinologist.
The team brings together a range of clinical and non-clinical backgrounds, expertise with quantitative and qualitative methods, and interests in all areas of new doctors’ work and wellbeing. Our driving focus is to ensure that the project allows us to understand the experience of doctors starting work in this challenging period so that they, and stakeholder organisations across the UK, can identify challenges – and positive experiences – to learn for future policy and practice.
It’s just three weeks since the first batch was sent out, and those who responded to that will be getting the link to the second questionnaire in the next few days. But if you’ve not yet completed the first questionnaire, or indeed nor signed up, there is still plenty of time.
Since the last post, we’ve been busy sending out the first questionnaire link as people continue to sign up. We’ve also been sending out reminders in case people have missed the first email link – the intention isn’t to hassle, we know how easy it is for emails to get buried!
In this post, we’re going to explain a little about the design of the study and the methods we’re using.
The overall aim of the study is to examine the experience of all medical graduates in 2020. The circumstances of graduating and starting work during and after the peak of the pandemic in the UK are unusual, whether people are starting F1 in August as they would have expected, or started an FiY1 post as early as April. We recognise though that those in FiY1 posts have the additional novelty of working in what is essentially a brand new job role.
The questionnaire study therefore has two elements – a longitudinal examination of the experience of FiY1 as people progress through it, and a comparison of how those who have done an FiY1 post, and those who have not, feel at the start of F1. (Later in the year we will be interviewing some respondents to hear in more detail their reflections on the experience of starting work in these circumstances).
Work and wellbeing
We have described the study as being about the ‘work and wellbeing’ of newly qualified doctors.
The questionnaire people are completing at the moment asks about the work people are doing using items largely derived from the GMC’s Outcomes for Graduates document. These questions are not to gauge competence or confidence, but to establish a picture of what FiY1s are doing in these new roles. Other questions ask about where people are working, and their exposure to different types of clinical uncertainty, and how ‘tolerant’ they are of uncertainty.
The ‘wellbeing’ items are derived from validated scales in the literature. We will talk about those in more detail in later posts, but they all provide measures of different facets of how people are feeling about themselves and their work. They are not clinical tools, and do not make any inferences about mental health, but provide a means of associating emotional wellbeing and other factors.
Our analysis of these questionnaires will consider how these wellbeing measures vary with different clinical experiences, and with demographic variables such as gender and age. As we collect longitudinal data in coming weeks, we will see if these measures change over time, and whether this is affected by changes in clinical work.
Alongside the questionnaire currently being completed, we are also keen to hear FiY1s individual stories. We have a page dedicated to free text stories of the good, bad and indifferent experiences of FiY1 – if you sign up we will send a link directly to that page, as well as that to the questionnaire.
It’s always an exciting/nerve-racking moment when a project moves into a data collection phase. A lot of planning, drafting and discussion goes into designing and developing a questionnaire and working out how to reach participants, but the collection of data is when research goes from being an abstract idea, into something generating new knowledge.
The first questionnaire in this study will be distributed over the next couple of weeks to those who have signed up. The first tranche was sent to over 300 participants on Monday 1 July, and we are pleased to have already had responses from over 20% of that sample, and we expect to see those numbers increasing. A second tranche will be distributed over the next couple of days to those who have signed up since Monday.
The design of our study (of which more in a later post) means that we can collect data throughout the FiY1 period. Even if you miss one questionnaire for whatever reason (because you have not signed up yet, haven’t started FiY1, or just forgot) you can still contribute to the remainder of the study. The more representation we have from FiY doctors across the UK, the more confident we can be that we have a true picture of your experience at this extraordinary time.
We are extremely pleased to have confirmed support for the project from the United Kingdom Foundation Programme Office, and the medical training agencies of the four nations of the UK: Health Education England, NHS Education Scotland, Health Education and Improvement Wales, and the Northern Ireland Medical and Dental Training Agency.
An email invitation to the project has been distributed by the UKFPO, NES, HEIW and NIMDTA, to supplement that already cascaded to medical schools by the Medical Schools Council. We are seeing a good response to these emails, with around 10% of those in FiY1 posts already signed up, but we hope to increase this in the next week or so.
If you are an FiY1 doctor, or a 2020 graduate starting Foundation Programme in August 2020, please do sign up – your contribution to this national study is very valuable.
Welcome to the blog for a research project looking at the experience of ‘the class of COVID’: new medical graduates who are starting work in the UK during the COVID-19 crisis.
The project is being led by Newcastle University School of Medical Education, with colleagues from Exeter University, Plymouth University and Queen’s University Belfast. The project is supported by the GMC, Medical Schools Council and other stakeholders, and will explore with questionnaires and interviews how starting practice at this unprecedented time affects new doctors.
In this blog we will provide updates on data collection, the background to the study, and other news on the project.