Accident and emergency medicine specialist registrars' perceptions of the 'essential' aspects of a training placement

This study set out to identify the important aspects of training placements as perceived by specialist registrars (SpRs) in accident and emergency medicine (A&EM). These data were to be used to gain greater insight into the collective wishes of this group in order to inform the development of quality assurance systems. A self-administered questionnaire was developed from repertory grid data and was used to identify what were the 'essential', 'useful' and 'not needed' aspects of A&EM training placements. The questionnaire covered 'the job', 'the department', 'clinical experiences', 'support for learning' and 'training'. SpRs were also asked how frequently they wished certain activities to take place. The questionnaire was completed by 16 of the 17 A&EM SpRs (94%) training in the Northern Deanery. Of the 82 statements submitted to the SpRs, 40% (33) were marked as 'essential' by 75% or more of the registrars. Aspects classed as 'essential' by the highest number of SpRs were concerned with the recognition of their role as learners within a service environment and with how their learning was supported. SpRs felt it was essential to be integrated into the work team with a clear role that was understood to combine 'education' and service provision. Although there was consensus, the findings also showed the SpRs' individuality in terms of their learning and support needs. The study illustrates the complexity of defining quality indicators for evaluating training processes in work placements and suggests that quality lies not just in the components of a system for managing education but also in the flexibility of its application and in aspects of the 'learning culture'.