How the national training survey helped to improve cultures at Glangwili Hospital
In 2022, the national training survey results for the obstetrics and gynaecology department at Glangwili Hospital in Wales deteriorated significantly. For the first time, the department received below average scores in eleven areas, including clinical supervision, teamwork, and supportive environments.
The results of the survey prompted discussions between the medical education manager at the Health Board and trainees. They revealed that several issues were contributing to this, including:
- poor rota communication, which caused difficulties for trainees taking leave and planning time outside work
- unequal allocation of training and learning opportunities between trainees
- trainees feeling their concerns would not be taken seriously and being discouraged from raising them formally
- ineffective teamwork and working relationships between different specialties and groups of staff.
What action was taken?
The department used the survey results and feedback from trainees to develop a comprehensive action plan to address training and cultural issues. This included workshops for trainees on conflict management, leadership, and raising concerns, which aimed to create a more open and collaborative culture across the department.
The department also took several steps to address trainees’ other concerns. This included:
- clarifying the escalation route should trainees encounter a situation above their competence or wish to raise a concern
- introducing a fixed-rota that outlines trainees’ shifts 12- weeks in advance and is overseen by educational supervisors
- time for study leave and departmental teaching
- investing in learning resources, such as simulation-based training and new tablets
- introducing a training feedback form so the department management team can regularly check that trainees have access to sufficient learning opportunities.
What was the outcome?
To assess the impact of these actions Health Education and Improvement Wales (HEIW) visited the department in January 2023. Trainees were positive about the improvements and reported that the department was friendly and organised and there was now an open and honest culture. They also noted that changes to the rota and learning environments improved their access to training and they were able to meet their learning requirements.
As a result of the positive feedback, HEIW was able to reduce the department’s risk rating. While routine monitoring will continue, the 2023 national training survey results will help them to demonstrate the impact of the improvements and identify where further work is required. These results will also play a key role in monitoring any changes and ensuring that all improvements are sustained.
