Back to the future…

In recent years we’ve grown accustomed to talking about education in medicine and the tension that exists between service delivery.

I get really frustrated by this.  To my mind the two are intertwined.  I accept that some training has to be done separately e.g. procedural skills, advanced life support etc.  There is however a large proportion of it that can and should be done as part of everyday working.

I was trying to cast my mind back to when I was a Senior House Officer (a somewhat misleading term that is now redundant). In terms of training and education there was no defined program.  Sure a couple of times a week we had an X-ray meeting and a talk from the Consultants but that was essentially it.

Only when I became a Registrar did a teaching program begin.  I’ll be honest I wasn’t a fan.  It took me away from the ward and the clinics.  While I didn’t realise it then I think on reflection it took me away from what I considered to be the real learning.

It was also around this time that the full effects of the European Working Time Directive began to kick in.  Rotas were becoming increasingly fragmented.  Continuity of care on the wards was being lost in order to populate the on call rota.  We were also being told that we had to go to teaching days or we would not be signed off at the end of the year i.e. we would not be allowed to progress in our speciality.

Throughout all this we had to deliver safe care to our patients.  It was at the end of my Registrar years that I began to think ‘surely there has to be a better way?’

I’ve always had an interest in education but a watershed moment in my career was when I did the ‘Doctor as Educator’ course run by the RCPLondon.  It properly got me thinking about not just the what we teach, but the how and the why.

Education is the foundation from which any service in medicine should be built on.  Not just as lifelong continuing professional development but as a clinical governance issue.  I also believe that a term that should be made redundant is the idea of ‘training posts’ and ‘service posts’.  If we truly believe that patient safety is at the heart of what we do then all doctors have the right to education regardless of post.  We massively contradict ourselves by separating the two out.

Where the argument becomes muddied is we continue to deliver education programs that simply do not fit the requirements of the service or the doctors working within it.  I found this paper interesting in its perspective on Generation Y or Millennials:


We need to support but also challenge our current workforce educators to think a little differently. There are educational moments everywhere.  Not all of them requiring huge amounts of time either.

We need organisations to keep up with technology which needs investment in connectivity.  There needs to be access to online educational resources, an ability to connect with other learners and most of all the ability to share resources and information in real time.

The shared learning experience begins with connection and not separation…..


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