One-fifth of training time for specialist registrars is allocated to research training. Training schemes vary in the support offered to trainees, but many trainees experience difficulties (Reference Williams and CurranWilliams & Curran, 1998; Reference Smart and CottrellSmart & Cottrell, 2000; Reference Allsopp, Allen and FowlerAllsopp et al, 2002; Reference Petrie, Anderson and HarePetrie et al, 2004). In a survey of programme directors and specialist registrar peer group representatives of training schemes in general and old age psychiatry, Vassilas et al (Reference Vassilas, Tadros and Day2002) found that only 38% of programme directors and 30% of trainees agreed with a statement that ‘specialist registrars use the research day satisfactorily’, and 46% of programme directors felt that the research day in its present format should be abolished.
The Collegiate Trainees’ Committee (CTC) believes that clear objectives should be set for trainees’ research time, but that flexibility is needed with regard to the methods by which training objectives are met (Reference Davies, Davison and SharpDavies et al, 1995; Reference Sullivan, Cornwall and CormacSullivan et al, 1997; Reference Ramchandani, Corby and GuestRamchandani et al, 2001).
Even where a research project is unsuccessful, much can be learnt from the experience (Reference VaidyaVaidya, 2004). Hull & Guthrie (Reference Hull and Guthrie2004) draw attention to the wider benefits of undertaking research, including the development of negotiating, project development and IT skills, and gaining increased understanding of ethical issues.
A cross-sectional survey, carried out in 1999, of the views of specialist registrars on the Wessex training scheme in general adult and old age psychiatry (with a response rate of 20 out of 30, 66%) identified considerable overall dissatisfaction and a number of major difficulties with their research training and experience. The results are summarised in Table 1 (adapted from Rathod & Wenzerul (Reference Rathod and Wenzerul2001), with permission).
Summary of results of the 1999 survey on research training1
| Major difficulties | n | % |
|---|---|---|
| Getting started and organising the research day | 15 | 75 |
| Not knowing who to approach for guidance | 14 | 70 |
| Inadequate knowledge regarding: | ||
| research grants | 18 | 90 |
| writing a protocol | 14 | 70 |
| getting published | 15 | 75 |
| ethics committees | 12 | 60 |
Mentoring process for research training
In response to this, a new process was introduced for mentoring specialist registrars’ research training, ensuring support, supervision and regular monitoring of progress on an individual basis (Reference Gregoire, Rathod and WenzerulGregoire, 2001). The process is led by a research coordinator who sends all new trainees a questionnaire enquiring about past research experience and future aspirations. An appropriate research mentor (professor, senior lecturer or consultant with an interest in research) is then appointed by the research coordinator. The mentor meets with the specialist registrar at the beginning of their training to discuss research interests and career aims, to offer initial guidance, and to agree objectives and an action plan. If the specialist registrar wishes to engage in research, a research supervisor is agreed, to provide regular individual supervision, following an agreed plan. The mentor oversees the progress made on research objectives throughout training and meets at least annually with the specialist registrar to discuss developments and provide feedback and advice (Reference Gregoire, Rathod and WenzerulGregoire, 2001). Six-monthly reports to the mentor are provided jointly by the supervisor and trainee and are discussed in a mentors’ group which meets quarterly. The group also oversees the overall process and deals with wider issues, such as ensuring that dedicated research time is maintained in all posts and reviews of research are integrated into the record of in-training assessment process, and organising an annual research conference for trainees and supervisors.
A book was also produced (Reference Rathod and WenzerulRathod & Wenzerul, 2001) which contains advice on undertaking research projects, as well as information on courses and higher degrees for those wishing to carry out activities other than research.
Following the establishment of this process, a further survey was undertaken to assess specialist registrars’ views regarding the effectiveness of research training.
Method
Anonymous questionnaires were distributed to all 38 trainees in general adult and old age psychiatry on the Wessex rotation in 2004 with an enclosed prepaid envelope. This was followed by a reminder email, which was sent 1 month later.
Results
A total of 34 trainees (89.5%) returned questionnaires. Questionnaire items and responses are shown in Table 2. Of respondents, 15 were in their first year on the rotation and 12 in their second. Three were in their third year and 1 was in his or her fifth year on the rotation and had, therefore, started training before the introduction of the mentoring scheme. Three did not specify their year of training.
Results from the 2004 survey of research training
| Yes (%) n | No (%) n | Other response (%) n | |
|---|---|---|---|
| 1. Did you receive information from the Deanery about research supervision arrangements and a questionnaire to return? | 28 (82.4) | 4 (11.8) | ‘ Cannot remember’, 2 (5.9) |
| 2. Did you receive a copy of the book, Surviving the Research Day? | 34 (100) | ||
| 3. Did you have, or do you have an appointment for a meeting with a research mentor? | 26 (76.5) | 8 (23.5) | |
| 4. Have you agreed with a mentor a plan for how best to use your research day? | 26 (76.5) | 8 (23.5) | |
| 5. For the 26 trainees who had met their mentor | |||
| (a) Was the meeting with the mentor helpful to you? | 25 (96.2) | 1 (3.8) | |
| (b) Is the plan agreed clear to you? | 24 (92.3) | 2 (7.7) | |
| (c) Are you happy with the plan agreed? | 23 (88.5) | 2 (7.7) | Not specified, 1 (3.8) |
| 6. What will you be/are you using the research day for? | |||
| Research project | 24 (70.6) | ‘ Later on’, 1 (2.9) | |
| Literature review | 5 (14.7) | ||
| Further degree | 7 (20.6) | ||
| Research course | 4 (11.8) | ||
| Other course | 6 (17.6) | ||
| Not taking up — using time for clinical training | 1 (2.9) | ||
| Other | 8 (23.5) | ||
| 7. Do you have supervision for this from an identified person? | 27 (79.4) | 5 (14.7) | Not specified, 2 (5.9) |
| 8. Are you making good use of the research day for the purposes identified in question 8? | 31 (91.2) | 1 (2.9) | ‘ Undecided’, 1 (2.9) ‘Not started yet’, 1 (2.9) |
| 9. Is the research day protected time? | 30 (88.2) | 2 (5.9) | Not specified, 1 (2.9) ‘Sometimes’, 1 (2.9) |
| 10. Of the 24 trainees undertaking research | |||
| (a) Do you feel adequately supported and supervised? | 21 (87.5) | 2 (8.3) | ‘ Still early days’, 1 (4.2) |
| (b) Are you interested in the research you are doing? | 20 (83.3) | 2 (8.3) | Not specified, 1 (4.2) ‘Mostly’, 1 (4.2) |
| (c) Are you enjoying it? | 16 (66.7) | 3 (12.5) | Not specified, 3 (12.5) ‘Neutral’, 1 (4.2) ‘Mostly’, 1 (4.2) |
| (d) Are you gaining research knowledge and/or skills? | 21 (87.5) | 1 (4.2) | Not specified, 2 (8.3) |
| (e) Once you have completed the planned research, are you confident that you will have enhanced your knowledge/skills in the following: | |||
| (i) research design and methodology | 22 (91.7) | Not specified, 1 (4.2) ‘Don’t know yet’, 1 (4.2) | |
| (ii) practicalities of research | 23 (95.8) | ‘ Don’t know yet’, 1 (4.2) | |
| (iii) data collection | 23 (95.8) | ‘ Don’t know yet’, 1 (4.2) | |
| (iv) data entry | 19 (79.2) | 3 (12.5) | ‘ Don’t know yet’, 2 (8.3) |
| (v) analysis | 18 (75.0) | 2 (8.3) | Not specified, 1 (4.2) Mixed views, 1 (4.2) ‘Don’t know yet’, 2 (8.3) |
A total of 28 (82.4%) trainees had received information from the Deanery about arrangements for rotation research supervision and a questionnaire when they joined the scheme. All respondents had received a copy of the book, Surviving the Research Day (Reference Rathod and WenzerulRathod & Wenzerul, 2001). Twenty-six (76.5%) had attended an appointment with a research mentor and all of these had agreed a plan with the mentor on the use of their research day. Of those who had not, 1 had contacted a research supervisor directly and another had discussed research activities with their educational supervisor. Of the 26 trainees who had met their mentor, 25 (96.2%) found the meeting helpful and 24 (92.3%) thought that the plan agreed was clear. Two reported that they would have benefited from more assistance and direction regarding alternatives to research. However, 23 were happy with the plan agreed. Overall, 24 (70.6%) trainees were engaged in a research project and another was planning one later in training. Five (14.7%) were involved in a literature review. Seven (20.6%) were using the time to take a further degree (for example, a masters degree in medical law and a postgraduate diploma in neuropsychiatry), 4 (11.8%) a research course and 6 (17.6%) another course. One trainee was using the research day for clinical training and 8 (23.5%) for other activities. Other courses and activities specified included audit projects, European Computer Driving Licence courses and meetings. One trainee was preparing a fellowship application and writing papers emanating from a PhD. Twenty-seven (79.4%) trainees received supervision for these activities from an identified person and 31 (91.2%) believed that they were making good use of the research day for identified purposes. For 30 (88.2%), the research day was protected time (although 4 of these commented that this was usually the case). Of 2 trainees who responded that the research day was not protected, 1 commented that this was through their own choice.
Of the 24 trainees undertaking research, 21 (87.5%) felt adequately supported and supervised, 20 (83.3%) were interested in their research, 16 (66.7%) were enjoying it and 21 (87.5%) stated that they were gaining research knowledge and/or skills. Twenty-two (91.7%) were confident that, once they had completed the planned research, they would have enhanced their skills in research design and methodology, 23 (95.8%) in the practicalities of research and data collection, 19 (79.2%) in data entry and 18 (75.0%) in data analysis.
Discussion
Overall, the results of the survey reflect considerable improvement in the effectiveness of, and satisfaction with, research training following the introduction of a mentoring and supervision scheme. However, there is room for further improvement in implementation of the changes to the training system, with only 26 respondents (76.5%) receiving an appointment and agreeing a plan with a research mentor. Some of those who did not receive an appointment with a mentor may have only recently joined the rotation, and at least 4 started on the rotation before the changes to research training had been made.
For the 24 (70.6%) trainees who were undertaking a research project, levels of perceived support and supervision, interest and development of skills were high, although only two-thirds were enjoying the experience. Research training should give trainees knowledge of basic research principles and methodology to allow them to engage effectively in evidence-based clinical practice and clinical governance (Reference Ramchandani, Corby and GuestRamchandani et al, 2001). The present study did not specifically evaluate whether those who were not involved in a research project were gaining these skills, although these objectives should have been covered within the plan agreed with their research mentor. Nevertheless, 91.2% of trainees reported that they were making good use of their research day for specified purposes. These results appear to compare very favourably with the results of other surveys carried out in other psychiatric specialties and rotations.
Limitations of the evaluation include the possibility that the questionnaire may have produced a positive response bias. Some protection from this was ensured by anonymity and the fact that it was being conducted by a trainee. Although the number of specialist registrars involved was small and a few respondents did not answer all the questions posed, the overall response rate was good. The questionnaire did not record objective outcome measures, such as the type and number of publications achieved. Finally, direct comparison with the previous Wessex survey and other surveys in the literature is limited by the differences in questions posed. Nevertheless, in the absence of more vigorous scientific evaluation, and given the acknowledged need to improve research training, a mentoring and supervision such as this appears to offer a significant improvement in research training.
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