Do UK postgraduate medical trainees prefer to do mentor supported respiratory quality improvement projects compared to traditional audit?

Abstract

Aim: To explore views of postgraduate doctors of performing mentor supported respiratory quality improvement (QI) projects compared to audit. Background: Two respiratory QI projects took place on 2 acute 30-bedded chest wards in an acute hospital in Essex, UK. 9 FY doctors and a CMT undertook the QI projects. 6 trainees improved the 48-hour antimicrobial stewardship on drug charts (Hobday et al, BHJM 2018), and 4 trainees improved oxygen prescribing and delivery (Choudhury et al, BMJOQ 2018). Both achieved their desired patient outcomes. Methods: A qualitative study was conducted to explore doctors’s views on participating in mentor-supported respiratory QI projects. All 10 participants attended structured focus-group interviews. Analysis was performed using open/category codes and formulated into major themes. One emergent theme was the medical trainee’s view on performing mentor supported respiratory QI programmes compared to audits. Results: Trainee collaboration was a highlight. The were able to “share learning between each other”, and foster “shared responsibility”. Active learning through QI practicum were described; “Everybody who comes through QI, learns from it, and that’s a powerful effect” and “the hands-on experience of QI…was pivotal”. Tradition audit was viewed as “just data collection” and a “big waste of time”. Audit supervisors’ roles were also negatively appraised as “always very personal” with a ”view to publishing stuff’". Conclusions: Trainees reflected positively towards their respiratory QI projects. Their experience of audit was less favourable, questioning both their educational validity and clinical usefulness.