Table 2

Topics of answers related to ‘three wishe… to improve trainee experience and working conditions’ with illustrative verbatim comments

Topics of comments with examples (no. of comments)Suggestions for implementation (no. of comments)
Foundation programme (FP) doctors
  • Rota design (n=6): ‘Rationalise the need to put everyone on an emergency rota’; ‘less nights and less intensity’; ‘build more leave into the rota’

  • Organisation of redeployment/staffing (n=5): ‘more nurses’; ‘set structure of working’

  • Education and training (n=4): ‘increased ability to do procedures’; ‘formal teaching’; ‘teaching ward rounds needed’

  • Team working (n=3): ‘Keep people in teams who they work with regularly’; ‘more continuity between teams, consultants changed (too frequently)’

  • PPE (n=2): ‘less time in PPE’; Environment (n=1); ‘more physical space’.

  • Clinical care (n=1): ‘proning—how to reduce harm’

(Total n=22)
  • Rota design (n=3): ‘Standby teams’; ‘self-rostering’; ‘keep areas with consultant group’

  • Teaching (n=1): ‘Teaching ward rounds’

  • Proning (n=1): ‘QIP for proning’

  • PPE (n=1): ‘more variety’

(Total n=6)
Core trainees (CTs)
  • Team working/support (n=5): Suggestions included handing over in teams (all grades together); ‘include senior registrars in management decisions’ so we know who to go to; Refining the pod system ‘better to know double the number (of patients)… so you could cover each other’

  • Rest and refreshments (n=4) ‘rest facilities overnight—can we use outpatients?’; ‘more effort put into rest facilities’

  • Rota design (n=3): ‘more engagement with trainees regarding emergency rota implementation’

  • Education and training (n=3): ‘Continue weekly teaching meetings’; ‘teaching rounds’

  • PPE (n=1): ‘more hoods’

  • Preparedness (n=1)

(Total n=17)
  • Rota design (n=2): ‘shorter bursts of shifts spread out (more evenly)’ ‘include 8 hour days’

  • Well-being/Appreciation (n=4):

    ‘Teaming up with life-coach/counsellor’; ‘Recognise trainee body as a group of valued staff’; ‘formal certificates/commemorative items’

  • Access to teaching (n=2): ‘Zoom teaching’; Communication (n=2): ‘continue daily updates’

(Total n=10)
Junior registrar
  • Rest facilities (n=9): ‘relaxation of anti-nap policy at night’; ‘designated rest facilities—so much space in the hospital poorly used’; ‘bigger well-being area’; ‘keep well-being room’.

  • Preparedness/organisation/staffing (n=6): ‘more trained nurses’; ‘greater variety in job allocation’

  • Teamwork/debriefing/support (n=5): ‘I want to feel included in discussions with consultants’; ‘more trainee involvement (with COVID Assessment Consultant)’; ‘Remember we are senior trainees’

  • Education and training (n=4): ‘Continuous training by reflecting on cases’; ‘comprehensive plan for getting normal modules signed off’

  • Rota design (n=3): ‘change the rota to be more balanced’.

  • PPE (n=2) ‘greater appreciation of juniors spending hours in PPE’

  • Communication (n=1)

    (Total n=30)

  • Rest facilities (n=4): ‘designated rest facility’

  • Rotas/organisation (n=3): ‘more breaks rather than a complete week off’

  • Teaching (n=1): ‘consultants to designate rounds for teaching’

  • Communication (n=1): ‘remind us at the beginning of the shift which staff have no ICU experience’.

(Total n=9)
Senior registrar
  • Rota design (n=15): ‘no imposed rota changes’; ‘more days off’; ‘parity and fairness with COVID-19 ICU allocation’; ‘if consultants are not on an emergency rota nor should trainees be on one’.

  • Leadership and management (n=9): ‘involve anaesthetic trainees in the assessment and intubation of patients’; ‘consider stepping senior registrars to leadership roles’; ‘allow senior trainees to have a level of autonomy, for example, make them area leads’.

  • Rest and refreshment facilities (n=5); preparedness and PPE (n=5)

  • Communication and debriefing (n=5): ‘better communication regarding stepping us up or down, honesty and clarity for doing so’; ‘one location for important at a glance changes’; ‘improve command structure and handover process’.

  • Education and training needs (n=5): ‘rotate us around different teams’; ‘involve senior trainees in the bunker meetings’; ‘time back for missed training—I want to get more experience and ensure I’m appropriately trained.’

  • Team-working/support (n=3)

    (Total n=47)

  • Leadership experience (n=3): ‘make senior trainees area leads’; ‘get senior trainees in designated supportive roles to help junior trainees’.

  • Teaching (n=3): ‘capitalise on the educational opportunities at hand (respiratory, renal, heart failure)’; encourage ‘(redeployed) specialists provide formal teaching on these topics’

  • Role allocation (n=2)

  • Rota design (n=2)

    (Total n=10)

  • ICU, intensive care unit; PPE, personal protective equipment; QIP, quality improvement project; ST, specialty trainees.