scholarly journals Why are UK junior doctors taking time out of training and what are their experiences? A qualitative study

2019 ◽  
Vol 112 (5) ◽  
pp. 192-199 ◽  
Author(s):  
Chantelle Rizan ◽  
Julia Montgomery ◽  
Charlotte Ramage ◽  
Jan Welch ◽  
Graeme Dewhurst
Keyword(s):  
Content Analysis ◽  
Qualitative Study ◽  
Unmet Needs ◽  
Junior Doctors ◽  
Loss Of Control ◽  
Data Set ◽  
Time Out ◽  
The Uk ◽  
The Impact ◽  
Depth Interviews

Objectives The number of doctors directly entering UK specialty training after their foundation year 2 (F2) has steadily declined from 83% in 2010 to 42.6% in 2017. The year following F2, outside the UK training pathway, is informally termed an ‘F3’ year. There is a paucity of qualitative research exploring why increasingly doctors are taking F3s. The aim of this study is to explore the reasons why F2 doctors are choosing to take a year out of training and the impact upon future career choices. Design This is an exploratory qualitative study, using in-depth interviews and content analysis. Setting UK. Participants Fourteen participants were interviewed from one foundation school. Participants included five doctors who commenced their F3 in 2015, five who started in 2016 and finally four recently starting this in 2017. Main outcome measures Content analysis was conducted to distill the themes which exemplified the totality of the experience of the three groups. Results There were four predominant themes arising within the data set which can be framed as ‘unmet needs’ arising within foundation years, sought to be fulfilled by the F3 year. First, doctors describe exhaustion and stress resulting in a need for a ‘break’. Second, doctors required more time to make decisions surrounding specialty applications and prepare competitive portfolios. Third, participants felt a loss of control which was (partially) regained during their F3s. The final theme was the impact of taking time out upon return to training (for those participants who had completed their F3 year). When doctors returned to NHS posts they brought valuable experience. Conclusions This study provides evidence to support the important ongoing initiatives from Health Education England and other postgraduate bodies, exploring approaches to further engage, retain and support the junior doctor workforce.

scholarly journals What challenges did junior doctors face while working during the COVID-19 pandemic? A qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056122
Author(s):  
Johanna Spiers ◽  
Marta Buszewicz ◽  
Carolyn Chew-Graham ◽  
Alice Dunning ◽  
Anna Kathryn Taylor ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Coping Strategies ◽  
Lived Experience ◽  
Positive Impact ◽  
Severe Depression ◽  
Junior Doctors ◽  
New Ways Of Working ◽  
Work Related ◽  
The Uk ◽  
The Impact

ObjectivesThis paper reports findings exploring junior doctors’ experiences of working during the COVID-19 pandemic in the UK.DesignQualitative study using in-depth interviews with 15 junior doctors. Interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.12 to facilitate data management. Data were analysed using reflexive thematic analysis.SettingNational Health Service (NHS) England.ParticipantsA purposive sample of 12 female and 3 male junior doctors who indicated severe depression and/or anxiety on the DASS-21 questionnaire or high suicidality on Paykel’s measure were recruited. These doctors self-identified as having lived experience of distress due to their working conditions.ResultsWe report three major themes. First, the challenges of working during the COVID-19 pandemic, which were both personal and organisational. Personal challenges were characterised by helplessness and included the trauma of seeing many patients dying, fears about safety and being powerless to switch off. Work-related challenges revolved around change and uncertainty and included increasing workloads, decreasing staff numbers and negative impacts on relationships with colleagues and patients. The second theme was strategies for coping with the impact of COVID-19 on work, which were also both personal and organisational. Personal coping strategies, which appeared limited in their usefulness, were problem and emotion focused. Several participants appeared to have moved from coping towards learnt helplessness. Some organisations reacted to COVID-19 collaboratively and flexibly. Third, participants reported a positive impact of the COVID-19 pandemic on working practices, which included simplified new ways of working—such as consistent teams and longer rotations—as well as increased camaraderie and support.ConclusionsThe trauma that junior doctors experienced while working during COVID-19 led to powerlessness and a reduction in the benefit of individual coping strategies. This may have resulted in feelings of resignation. We recommend that, postpandemic, junior doctors are assigned to consistent teams and offered ongoing support.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

scholarly journals “There’s a Lot of Support”: Junior Doctors’ Experiences of the Medical Internship

2020 ◽  
Author(s):  
Yvonne Carlsson ◽  
Anna Nilsdotter ◽  
Stefan Bergman ◽  
Matilda Liljedahl
Keyword(s):  
Content Analysis ◽  
Medical Student ◽  
Medical School ◽  
Scientific Knowledge ◽  
Qualitative Content Analysis ◽  
Clinical Work ◽  
Qualitative Description ◽  
Healthcare Organisation ◽  
Junior Doctors ◽  
Depth Interviews

Abstract Background: It is known that the transition from medical school to clinical work can be stressful. In some countries, an introductory service bridges the gap, introducing the doctor-to-be to clinical work. However, there is a lack of scientific knowledge about whether these introductory services serve their purpose as justifiable introductions. To address the gap, this paper aimed to explore experiences that junior doctors hold of the medical internship.Methods: Using a qualitative description approach, data was collected through twelve individual in-depth interviews with volunteering medical interns from three different hospital sites in Sweden. Data were verbatim transcribed and analysed by qualitative content analysis, generating categories and themes. Results: Four main themes were identified in our data. The interns felt increasingly comfortable as doctors (‘finding one’s feet’) through taking responsibility for patients while receiving necessary help and assistance (‘a doctor with support’). Although appreciative of getting an overview of the healthcare organisation (‘healthcare sightseeing’), interns were exhausted by repeatedly changing workplaces and felt stuck in a rigid framework (‘stuck at the zoo’).Conclusions: This study showed that the transition from medical student to clinical doctor does not necessarily have to be characterised by stress and mental exhaustion but can, with extensive support, provide a fruitful opportunity for interns to grow into their roles as doctors.

Pregnancy warning labels on alcohol packaging: results of an exploratory study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Millot ◽  
K Gallopel-Morvan
Keyword(s):  
Content Analysis ◽  
Alcohol Consumption ◽  
Intellectual Disabilities ◽  
Exploratory Study ◽  
Drinking Alcohol ◽  
Thematic Content Analysis ◽  
French Government ◽  
The Impact ◽  
Depth Interviews ◽  
In Pregnancy

Abstract Background In 2017, approximately 11% of pregnant women in France consumed alcohol despite its harmful consequences on the fetus (Andler, 2018). Our research aims at exploring the impact of warnings displayed on alcohol packaging: the current pictogram and alternative possible messages that differ regarding content and design will be explored. Methods In-depth interviews were conducted with 20 French women, including women who did not drink alcohol during their pregnancy, women who drank alcohol, women in pregnancy planning and breastfeeding mothers. Questions were asked about the participants perception of drinking alcohol during pregnancy, alcohol warnings: the current pictogram, new contents (negative and positive) for warnings and new designs (different pictograms combined with or without text). A thematic content analysis was carried out. Results The current pictogram lacks visibility and has no impact on the behaviour of the women. New suggested contents were on the whole welcomed. It can be noted that some participants felt that specific messages (e.g. intellectual disabilities, facial malformations etc.) were a more effective way of preventing alcohol consumption during pregnancy than general ones. On the contrary, other participants felt that a general message such as ’Zero alcohol during pregnancy’, or positive messages such as a cessation service message, was more effective. The majority of participants believed that pictograms with a better visibility; more eye-catching; vivid images of fetuses, etc., would have a greater impact on alcohol consumption. Conclusions This study highlights the need for changes to pictogram currently used on alcohol packaging in France. Our results show that recent changes proposed by the French government (a slight increase in the size of the current pictogram) will most likely have little effect on preventing alcohol consumption during pregnancy. Key messages The current pictogram on alcohol bottles in France has little or no effect. The French government should implement new warnings both in terms of content and design.

Current innovations in otolaryngology medical education in the UK: a systematic literature review

2020 ◽  
Vol 134 (4) ◽  
pp. 284-292
Author(s):  
H M Yip ◽  
T C F Soh ◽  
Z Z Lim
Keyword(s):  
Medical Education ◽  
Objective Assessment ◽  
Final Analysis ◽  
Subjective Assessment ◽  
Junior Doctors ◽  
Synthesis Methods ◽  
Qualitative Synthesis ◽  
Educational Innovations ◽  
The Uk ◽  
The Impact

AbstractObjectiveRecent studies have indicated a lack of ENT training at the undergraduate and post-graduate levels. This study aimed to review the impact of recent educational innovations in improving ENT training for medical students and junior doctors in the UK.MethodsThree independent investigators conducted a literature search of published articles on ENT education. Included studies were analysed using qualitative synthesis methods.ResultsAn initial search yielded 2008 articles; 44 underwent full-text evaluation and 5 were included for final analysis. Most included studies demonstrated benefits for students when compared to existing teaching standards in terms of objective assessment (knowledge and skills gained) or subjective assessment (confidence and preference) following implemented educational innovations.ConclusionThis study identified educational innovations developed in the past 15 years to enhance the teaching of core ENT competencies. More research is needed to establish their impact on the state of ENT medical education in the UK.

scholarly journals A Qualitative Study of the Interaction between Human Rights Defenders and Society in Russia: Assessing the Impact of the 'Foreign Agents' Law

2019 ◽  
Vol 11 (2) ◽  
pp. 1-20
Author(s):  
Polina Malkova
Keyword(s):  
Human Rights ◽  
Qualitative Study ◽  
Global Context ◽  
Adverse Conditions ◽  
World Regions ◽  
The Impact ◽  
Depth Interviews ◽  
Systematic Knowledge ◽  
The Way

In various world regions, human rights defenders (HRDs) often become targets for smear campaigns that seek to discredit and marginalise them. Russia’s “foreign agents” law which brands NGOs as “foreign agents” – a phrase that carries Soviet-era connotations of a spy or traitor – is just one example of states’ attempts to cultivate an unfavorable image of rights defenders in society. Yet, despite the global context of such stigmatising campaigns and their potential to put defenders at further risk, there is very little systematic knowledge about the way citizens react to such rhetoric and whether they express more hostility towards HRDs. This paper seeks to address this gap and explores the interaction of rights defenders with the domestic society in Russia. Drawing upon in-depth interviews with representatives of the domestic human rights community, it demonstrates that while the wider public lacks familiarity with actors in the human rights field, certain social segments do interact with them, both in antagonistic and supportive ways. The paper argues that in the adverse conditions created by the “foreign agents” law, there is a need for rights groups to expand and strengthen the links with their constituencies.

scholarly journals Impact of Universal Credit in North East England: a qualitative study of claimants and support staff

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029611 ◽  
Author(s):  
Mandy Cheetham ◽  
Suzanne Moffatt ◽  
Michelle Addison ◽  
Alice Wiseman
Keyword(s):  
Mental Health ◽  
Local Government ◽  
Qualitative Study ◽  
Low Income ◽  
Welfare Benefits ◽  
North East ◽  
The Uk ◽  
The Impact ◽  
Community Sector ◽  
Roll Out

ObjectivesTo understand the impact of the roll-out of Universal Credit (UC) from the perspectives of claimants and staff supporting them in North East England.DesignQualitative study comprising interviews and focus groups.SettingGateshead and Newcastle, two localities in North East England characterised by high levels of socioeconomic deprivation, where the roll-out of UC started in 2017 as a new way to deliver welfare benefits for the UK working age population.Participants33 UC claimants with complex needs, disabilities and health conditions and 37 staff from local government, housing, voluntary and community sector organisations.ResultsParticipants’ accounts of the UC claims process and the consequences of managing on UC are reported; UC negatively impacts on material wellbeing, physical and mental health, social and family lives. UC claimants described the digital claims process as complicated, disorientating, impersonal, hostile and demeaning. Claimants reported being pushed into debt, rent arrears, housing insecurity, fuel and food poverty through UC. System failures, indifference and delays in receipt of UC entitlements exacerbated the difficulties of managing on a low income. The threat of punitive sanctions for failing to meet the enhanced conditionality requirements under UC added to claimant’s vulnerabilities and distress. Staff reported concerns for claimants and additional pressures on health services, local government and voluntary and community sector organisations as a result of UC.ConclusionsThe findings add considerable detail to emerging evidence of the deleterious effects of UC on vulnerable claimants’ health and wellbeing. Our evidence suggests that UC is undermining vulnerable claimants’ mental health, increasing the risk of poverty, hardship, destitution and suicidality. Major, evidence-informed revisions are required to improve the design and implementation of UC to prevent further adverse effects before large numbers of people move on to UC, as planned by the UK government.

‘Wish YOU Weren’t Here!’: Interpersonal Conflicts and the Touristic Experiences of Norwegian and British Women Travelling with Friends

2011 ◽  
Vol 11 (3) ◽  
pp. 271-290 ◽  
Author(s):  
Bente Heimtun ◽  
Fiona Jordan
Keyword(s):  
Qualitative Study ◽  
Tourism Industry ◽  
Social Identities ◽  
Interpersonal Conflicts ◽  
The Uk ◽  
The Impact

Tourism is often portrayed by the tourism industry, tourists themselves and tourism scholars as a liminoid site of escape, happiness and freedom from constraint. For many, however, holidays do not live up to this expectation. This paper challenges the dominant tourism discourse of holidays as sites of unproblematic pleasure in examining contestation, conflicts and negotiations between women and their travelling companions. Drawing on conceptualizations of in-group interpersonal conflicts and theorization of the mobile social identities of women travellers, we explore the impact of holiday conflicts on women’s holiday experiences and friendships. The findings of this qualitative study of female tourists from Norway and the UK suggest that women adopt various strategies to deal with open and hidden conflicts that may threaten their friendships and holiday experiences. Such strategies include avoidance of conflict through compromise, negotiation of appropriate holiday behaviours prior to travel, or ultimately choosing to travel solo.

scholarly journals WHEN SEXUAL INFIDELITY TRIGGERS MURDER: EXAMINING THE IMPACT OF HOMICIDE LAW REFORM ON JUDICIAL ATTITUDES IN SENTENCING

2015 ◽  
Vol 74 (2) ◽  
pp. 307-328 ◽  
Author(s):  
Jeremy Horder ◽  
Kate Fitz-Gibbon
Keyword(s):  
Case Law ◽  
Law Reform ◽  
Loss Of Control ◽  
Sexual Infidelity ◽  
Before And After ◽  
Key Features ◽  
Homicide Law ◽  
The Uk ◽  
Substantive Law ◽  
The Impact

AbstractIn October 2010, the UK Parliament brought into effect law that replaced the partial defence to murder of provocation with a new partial defence of “loss of control”, applicable to England, Wales, and Northern Ireland. Although it retained some key features of its controversial predecessor, the new partial defence was in part designed better to address the gendered contexts within which a large number of homicides are committed. In examining the impact of the reforms, we will focus on long-held concerns about the treatment of sexual infidelity as a trigger for loss of control in murder cases. The article undertakes an analysis of English case law to evaluate the way in which sexual infidelity-related evidence has influenced perceptions of a homicide defendant's culpability, for the purposes of sentencing, both before and after the implementation of reform. The analysis reveals that, in sentencing offenders post reform, the higher courts have failed to follow the spirit of the reforms respecting the substantive law by effecting a corresponding change in sentencing practice.

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