Volume 195 - Issue 7
The 2010 Specialist Trainees Survey
Authors: Rob D Mitchell, Alexandra L Markwell, Rick J Fielke, Michael A Bonning, Andrew W Perry and Dror Maor
Med J Aust 2011; 195 (7): 382. || doi: 10.5694/mja11.10825
Published online: 3 October 2011
Published online: 3 October 2011
A view from the front line
In Australia, medical colleges set the standards for specialty education within an accreditation framework managed by the Australian Medical Council (AMC). They also play a critical role in ensuring that vocational trainees are appropriately supervised and supported during their training. Despite the critical value of evaluation in specialty education, it can be difficult to obtain anonymous program feedback from trainees who fear being identified.1-3
In this context, the Australian Medical Association (AMA) Council of Doctors in Training undertook its Specialist Trainees Survey to ascertain trainee opinion on key aspects of vocational education. The April 2010 survey was an online, self-report questionnaire based on the AMC’s standards for specialty education programs. The survey methods are outlined in the footnote to the Box, and the full report is available online (http://ama.com.au/specialist-trainees-survey).
Selected results (Box) show that colleges are performing well in many areas, including selection, alignment of clinical experience with learning objectives, and access to supervision. While there was a high level of satisfaction with work and training, several areas attracted negative results. These included appeals processes, capacity to raise concerns without fear of recrimination, recognition of prior learning, provision of remediation, responsiveness to cases of bullying and harassment, and cost.
Concerns about appeals processes and fears of recrimination are consistent with the findings of a 2010 literature review and discussion at a recent AMC workshop on trainee feedback and course evaluation.3 It is critical that colleges adopt appeals procedures that conform to best-practice models, which characteristically ensure natural justice, have clear criteria, follow due process and minimise the risk of litigation.
A concerning finding of the Specialist Trainees Survey is the perception of inadequate responsiveness to claims of bullying and harassment. Bullying occurs in Australian health workplaces,4 and trainees are at risk because distinctions between workplace and training supervisors can be blurred. It is critical that colleges have well defined and transparent processes for dealing with these matters, which are the responsibility of educators as well as employers. In the absence of such processes, trainees, supervisors and colleges remain vulnerable.
The survey’s findings in relation to recognition of prior learning are not surprising, and reflect suboptimal integration of stages and pathways of training. Efforts to align and recognise components of clinical education will create efficiencies that will benefit trainees, colleges and health services.
The survey’s most negative response was in relation to value for money of training fees. Further, 40% of respondents reported that the cost of their training program had caused them financial hardship. Ensuring reasonable costs for training and assessment is integral to minimising the adverse consequences of study debt.5 It is equally important that colleges are transparent about how they apportion fees.
Notwithstanding the limitations of its methods, the results of this survey should help colleges reflect on their performance against the AMC standards for specialty education. Reassuringly, most areas attracted positive responses. The AMA plans to repeat the Specialist Trainees Survey every 4 years to continue to identify trends and emerging issues.
Selected Specialist Trainees Survey* data
Competing interests
All authors received travel support to attend meetings of the AMA Council of Doctors in Training. Rob Mitchell, Alex Markwell, Michael Bonning and Andrew Perry have received sitting fees from the AMC for acting as trainee representatives on various AMC committees.
Acknowledgements
We acknowledge the members of the AMA Council of Doctors in Training and the specialty trainee committees who contributed to survey development. We are grateful for the assistance of the AMA Federal secretariat in data processing and preparation of the final report. The AMA acknowledges the critical role of the colleges in delivering specialist training.
References
- Kogan JR, Shea JA. Course evaluation in medical education. Teaching Teacher Edu 2007; 23: 251-264. 0_i1115360
- Afonso NM, Cardozo LJ, Mascarenhas OAJ, et al. Are anonymous evaluations a better assessment of faculty teaching performance? A comparative analysis of open and anonymous evaluation processes. Fam Med 2005; 37: 43-47. 0_i1115362
- Nash-Stewart C. Medical training providers obtaining feedback from their trainees: what is best practice? Prepared for the Australian Medical Council (AMC) workshop: Training Program Evaluation and Trainee Feedback 13 November 2010. http://workshop.amc.org.au/wp-content/uploads/2010/10/Trainee-Feedback-Best-Practice-FINAL.pdf (accessed Jul 2011).
- Rutherford A, Rissel C. A survey of workplace bullying in a health sector organisation. Aust Health Rev 2004; 28: 65-72. 0_i1115367
- Moore J, Gale J, Dew K, Davie G. Student debt amongst junior doctors in New Zealand. Part 1: quantity, distribution, and psychosocial impact. NZ Med J 2006; 119: U1853. 0_i1115371