Table 6 Training gaps reported in the specialist training program
Subthemes and description | Selected supporting quotes |
|---|---|
Inadequate teaching and supervision Service delivery pressures compromising training Lack of time for trainers to teach Staff shortages negatively impact clinical training Lack of resources negatively impact on training Lack of assessment, feedback, follow up and clear learning outcomes | Poor guidance and supervision. 4th year anaesthetics trainee More bedside teaching required. More after hours support. Senior paediatric trainee “Insufficient opportunities to attempt difficult procedures under supervision in order to perfect and learn optimal processes. 1st year paediatric trainee With increased workload, [trainees] may not have enough time to reflect and learn theory. [Trainees] are overwhelmed with workload and spend less time perfecting their own skills. Internal medicine consultant [Trainees] are seen as a workforce and no attention is really paid to us studying and excelling and passing our exams…Our academic program doesn’t provide us with high yield teaching. 3rd year pathology trainee Challenges are that lecturers are also clinicians and they are expected to deal with increased clinical load simultaneously with an increased need for teaching reform. Psychiatry consultant Overworked specialists with no time for on the floor training. 4th year radiology trainee Due to being short staffed, there is little training at the bedside on ward rounds, as there is too much work. Also [trainees] often have to miss the specialist clinics as the workload in the wards is too high 3rd year paediatric trainee [Trainee] working conditions and availability of resources impacts training. Emergency medicine consultant Poor infrastructure for training. Forensic pathology consultant We need microscopes that work properly so we can view our own histology slides, which is a vital part of our training. 3rd year dermatology trainee Everyone is busy so you can’t do assessments and feedback. 1st year emergency medicine trainee No feedback on skills and no follow up to see if improvements have happened. Anaesthetics consultant Individualised work-based teaching and assessment is absent. 1st year radiology trainee |
Trainee-trainer relationship dysfunction Bullying, condescending communication by certain trainers with negatively framed feedback Lack of trust and respect Favouritism and nepotism Racism | Bad attitude from consultants when it comes to us [trainees] not coping. 2nd year pathology trainee Improve [trainee] confidence by not belittling and intimidating. Paediatric consultant Training in clinical skills and presentations instead of being ridiculed and told that’s undergrad stuff. 4th year internal medicine trainee Don’t get put on lists that do interesting cases for training–it’s based on favouritism. Some [trainees] get put on the big/important lists more than others, then only those progress in experience. 1st year anaesthetics trainee Less favouritism, nepotism, and bias due to personal grievances of seniors. 4th year neurology trainee Certain consultants protect some [trainees] throughout the length of their training due to being friends, having an affair, etc. This needs to be prevented by having close supervision from the university. Forensic pathology consultant Lack of racial integration. Senior paediatrics trainee Black registrars are not given enough equipment/ teaching/ coping strategies to pass exams and to finish their MMeds on time. Need to assess why such high failure rates in black [trainees] versus the other races. Senior paediatrics trainee |
Lack of communication training and relational competency | Interpersonal communication is lacking. [Trainees] are not trained in breaking bad news, disclosing errors to patients, dealing with difficult patients and families, and dealing with the legal fraternity. Neurology consultant |