Improving knowledge and confidence in foundation doctors during specialty changeover.

QUALITY PROBLEM Foundation year junior doctors rotate every four months into different specialties. They are often expected to manage patients with complex underlying conditions despite inadequate clinical induction. INITIAL ASSESSMENT No structured induction was offered to junior doctors rotating to hepato-pancreatico-biliary surgery, a complex and highly specialised discipline within general surgery. We hypothesised that junior doctors will be lacking in both knowledge and confidence when managing these patients. CHOICE OF SOLUTION Create a structured induction programme and evaluate its effectiveness in improving knowledge and confidence amongst doctors. IMPLEMENTATION Plan, do, study, act methodology was used along with driver diagrams to map change. A learning resource was developed in the form of a booklet which included relevant clinical information, processes for escalation and referral as well as guidance for managing acutely unwell patients. A structured one-hour teaching programme was delivered to junior doctors alongside this. Pre- and post-session questionnaires and statistical analysis were used to determine effect. EVALUATION Marked improvements in both knowledge and confidence were seen. The intervention showed a statistically significant improvement. LESSONS LEARNED Clinical induction resources can improve junior doctors' knowledge and confidence in managing their patients. Such induction is both valuable and necessary. Similar interventions can be used with allied health professionals and can involve the use of technology and virtual learning.