Effective foundation trainee local inductions: room for improvement?

BACKGROUND

We aimed to evaluate whether UK foundation trainees receive local unit inductions, and their timing, content and value.

METHODS

We used published literature and guidelines from the UK's General Medical Council (GMC) and National Health Service Litigation Authority (NHSLA) to identify key topics to be covered at the induction. We surveyed all foundation doctors in the North Western Foundation School and used questionnaires to assess inductions for the posts starting in December 2011.

RESULTS

The total response rate was 45 per cent, but this covered 100 per cent of the programmes and departments in the school: 22 per cent received an induction before their post; 10 per cent received no induction whatsoever. There was a large difference between how useful trainees find most topics and how often they were provided. Some departments use more interactive formats in induction, such as e-learning and practical workshops. Overall, trainees expressed very positive views about the potential value of inductions, and 88 per cent felt that inductions should be standardised. Trust monitoring of inductions often appears to be unreliable.

DISCUSSION

Timely, good-quality inductions can potentially reduce service delays and improve patient safety. Inductions currently appear not to be prioritised in the trusts studied, and they are not focused on the needs of trainees. Local inductions are currently suffering from a lack of guidelines into their implementation. From this study we have drawn up a set of guidelines for local induction and a template for an induction booklet. We recommend inductions should contain a minimum set of essential topics, be multidisciplinary, include more trainee input and be monitored more effectively.