Ewch i’r prif gynnwys

Past research

Mae'r cynnwys hwn ar gael yn Saesneg yn unig.

Medical education and training

A longitudinal study of the WCLT Fellowship Programme

The Wales Clinical Leadership Fellowship (WCLF) Programme is a 12-month programme designed for core, higher specialist trainees.

The WCLF is aimed at those trainees who are able to take a year out of their training programme, and who have an interest in clinical leadership and health service management.

Three cohorts have completed the programme so far, in 2013/14, 2014/15 and 2015/16. During the programme, trainees undertake a project within their host organisation and attend structured leadership training provided by Academi Wales.

Our principle aim is to evaluate the longer term impact of the fellowship on the careers of past Fellows. We will establish how they have applied the knowledge and skills acquired during their fellowship year to their clinical practice and what impact, if any, the programme has had on their day-to-day clinical practice and patient care.

We will conduct semi-structured one-to-one telephone or face-to-face interviews with trainees from the three cohorts who have completed the programme.

Lead contactAlison Bullock
FunderThe Wales Deanery
Start dateApril 2017

A scoping study for an extension of the EdSA for Named Clinical Supervisors in Wales

The General Medical Council (GMC) call for medical practitioners who are also trainers to be formally recognised includes both Named Clinical and Educational Supervisors.

The Wales Deanery’s Approach to formal recognition of medical practitioners, as articulated through the Educational Supervision Agreement, focused on Educational Supervisors in the first instance.

Now that the Agreement has been implemented, while still undergoing formative evaluation to assess its impact and inform its development, attention has turned to Named Clinical Supervisors.

Principal aim

To drive up standards of education and training provided to and by Named Clinical Supervisors by scoping for an appropriate Agreement.

Lead ContactKatie Webb
FunderThe Wales Deanery
Start DateAugust 2014

Credentialing is a new process that has been proposed by the GMC as a means of recognising doctors’ capabilities in specific areas.

The process will entail the evidencing and formal accreditation of the knowledge, skills and performance in a defined area. The credential will demonstrate a doctor’s fitness to practice in that area. This development fits with the direction of travel set out in the Shape of Training Review (Greenaway 2013).

We have been commissioned by the Academy of Medical Educators and Wales Deanery to develop a credential in medical education. The credential in medical education will demonstrate how educators use their knowledge and skills within the workplace to support patient safety by their excellence as educators.

Our work for this project includes developing a reflective portfolio which sets out the required knowledge, skills and professional attitudes and exploring how they can be evidenced.

To achieve this we will consult with an advisory group, survey a wide range of medical educators about their views on how to recognise and assess evidence in medical education, and organise an event for prominent medical educators to share their views on how the credential should be developed.

Lead contactAlison Bullock
FunderAcademy of Medical Educators / The Wales Deanery
Start dateSeptember 2015

Educational Supervision Agreement Evaluation Project (EdSA)

This ongoing evaluation focuses on the roll-out of the Educational Supervision Agreement, the Wales Deanery's approach to promoting high standards of postgraduate education and training, and supporting the GMC's implementation plan.

This is a signed agreement between three parties: an individual Educational Supervisor; a Local Education Provider and the Wales Deanery. The implementation and evaluation of the EdSA has been both a pragmatic and innovative response to the task set by the GMC implementation plan.

Dissemination of this of this work has been greeted positively by other health service providers both nationally and internationally. To this end, we have received interest from other parties to replicate our approaches (ie Health Education England).

This project will prepare the EdSA and its evaluation as a replicable model and we will collaborate with HEE regarding their version of the EdSA.

This work will be a comparative analysis of both quantitative and qualitative data.

Lead contactKatie Webb
FunderWales Deanery
Start dateOctober 2013

The two-year Broad-Based Training (BBT) programme recruited between 2013 - 2015 in LETBs across England.

Final Report - Evaluation of Broad Based Training (BBT)

5 July 2017

Read our final report on our AoMRC evaluation of the Broad Based Training Programme.

DownloadPDF

Following Foundation training, BBT provided 6-month placements in four specialities, and aimed to develop practitioners adept at managing complex, patient-focused care. Evaluation methods included focus groups, interviews, and questionnaires (to participants and comparator groups).

Lead contactAlison Bullock
FunderAcademy of Royal Medical Colleges/Health Education England
Start dateOctober 2013
Health Education England Logo
AOMRC Logo

The Annual Review of Competency Progression (ARCP) process operates inconsistently across specialties with differences in how processes are followed.

The Wales Deanery is phasing in virtual ARCPs for unproblematic trainees over two years. In this study, we are seeking to understand both positive and negative responses to using a virtual ARCP system.

We are adopting a mixed methods design, collecting data from telephone interviews and focus groups with ARCP panel members and surveys of trainees.

Lead contactAlison Bullock
FunderThe Wales Deanery
Start dateApril 2017

The Wales Clinical Leadership Fellowship Programme is a 12-month programme designed for core, higher specialist medical and dental trainees.

They are aimed at those trainees who are able to take a year out of their training programme, and who have an interest in clinical leadership and health service management.

We will evaluate the 4th cohort (2016-17) of Fellows on this programme to understand Fellows’ perceptions of the programme, their motives for undertaking and expectations of the Fellowship, enablers and barriers to ensure the programme is effective and fit-for-purpose.

A mixed methods approach of focus groups, observation of project presentations, individual telephone or face-to-face interviews with Fellows and Supervisors will be used to assess the efficacy of the programme.

Lead contactAlison Bullock
FunderThe Wales Deanery
Start dateApril 2017

Foundation doctors use of mobile technology in the workplace - Phase 2 2009 - 2011

The Wales Deanery has provided trainee doctors with a Smartphone device enabling access to accurate medical information

Background

The Wales Deanery has provided trainee doctors (between October 2009 and March 2011) with a Smartphone device and a micro SD card and software application containing 17 medical textbooks, enabling access to accurate medical information such as the BNF, Netter’s Atlas of Human Anatomy and the Oxford Handbook of the Foundation Year.

Aims

The project aims are:

  1. for Trainees to use the device for information gathering which may in turn lead to improvements in patient care
  2. to assess the usefulness of the device and to guide further improvement in both information delivery and just-in-time learning

Data sources

Data will be drawn from literature and internet search, on-line surveys, baseline and exit questionnaires, case reports, oral and poster presentation days.

Further information

This project was funded by the Wales Deanery and is led by Dr. Mark Stacey, Associate Dean for New Initiatives, in collaboration with Professor Alison Bullock.

The iDoc project is a longitudinal study, providing newly-qualified doctors (F1/F2) in Wales with an internet-free app giving ready access to a selection of key medical textbooks, downloaded to their own smartphone.

The evaluation uses mixed and creative methods to explore the value and impact of the iDoc app in the workplace.

Lead contactAlison Bullock
FunderWales Deanery
Start dateJuly 2014 (Phase 5)

MedTRiM: An evaluation of a training programme to enhance doctors’ resilience

Doctors are under increasing pressure to perform without making mistakes in an environment that expects perfection. As a result, incidences of errors increase along with risks to wellbeing.

Enhancing doctor resilience reduce errors and increase wellbeing. Informed by our previous work exploring issues and strategies relating to mental toughness, ‘MedTRiM’ (Medic Trauma Risk Management) is a targeted and supportive resilience training programme for doctors. 


Resilience training aims to improve cognitive workload and distraction management, mental toughness and recognition of when to call for help.

Since July 2015, we have been conducting a formative evaluation using a multi-method approach to further inform development of MedTRiM and explore the value and impact of this training programme for doctors.

Lead contactKatie Webb
FunderWales Deanery
Start dateJune 2015

The aim of this study is to systematically explore the views of trainees on what makes a good clinical placement.

We are using Q methodology to examine the reasoning behind trainees placement preferences. In the first phase our participants were CT1 and CT2 trainees. In the second phase we focus on Foundation trainees.

Q sort methodology is a research tool designed to explore individual subjectivities. Participants are presented with a question (e.g. what are the things that you value most about your clinical placements?) and given a set of statements that are all possible answers to this question, for example:

  • being close to friends and family
  • a supportive supervision team
  • a department/unit with a good reputation
  • a flexible rota, access to social
  • cultural and sporting activities in the vicinity
  • a pro-active supervisor who seeks out opportunities for me.

They then arrange the statements into a normal distribution according to how important they think each one is.

From the analysis we identify not only what is important but also whether these priorities are different for different groups.

Lead ContactAlison Bullock
FunderThe Wales Deanery
Start DateAugust 2014

Quality Improvement Skills Training

In 2015, the Wales Deanery launched the Quality Improvement Skills Training (QIST) programme.

This approach is seen as a sustainable educational strategy that supports and builds confidence in leadership and management skills, including those of quality improvement (QI) for trainees. This programme aims to empower trainees to develop the knowledge, skills and values necessary to improve the quality of care to patients.

By equipping trainees with QI skills, improvements in service provision will impact on patient care by making healthcare more effective, efficient, equitable and above all safer.

This project provides a coordinated all-Wales needs assessment and programme evaluation of the QIST programme within primary care, secondary care and dentistry.

Lead contactKatie Webb
FunderWales Deanery
Start dateApril 2017

The 12-month Programme ran for the second time in 2014-15. It is designed for core, higher specialist trainees who have an interest in clinical leadership and health service management.

Success of the programme was facilitated by: a flexible approach to the projects; regular contact with supervisors; peer support from other Fellows on the programme; workplace introductions and being valued as a member of the team; and Academi Wales training.  Trainees also benefitted from a visit to MIT, Boston. Of particular value were the action learning sets, which also provided a network of people to whom Fellows could turn to in the future.  Challenges to the programme included fiscal and practitioner disengagement for projects which constrained project progress; a need to maintain clinical skills which limited involvement in Fellowship activities.

Fellows benefitted from the Fellowship programme and developed skills which set them up to be future leaders in the NHS.  Host organisations reported gaining from the input of the Fellows. Attendance at high profile events helped to enhance the appeal of the Fellowship scheme and develop its world-class status.

The third year of the programme is also being evaluated.

Lead contactAlison Bullock
FunderWales Deanery
Start dateAugust 2014

Dental education and training

An Evaluation of the Foundation Training Scheme for Dental Therapists

The dental therapists scheme is designed to support consolidation of skills and aid transition to work.

Background

There is considerable scope to delegate routine treatments to dental therapists.  In the UK the full extent of permitted duties is not widely used in practice.  Under-use of the skills of therapists affects their confidence and risks de-skilling.  Similar to foundation training for dentists (DFT), the dental therapists scheme (TFT) is designed to support consolidation of skills and aid transition to work.

Aims

Two evaluations of this scheme have been undertaken. The first provided a formative evaluation of the new TFT programme in its first year of operation (when it was referred to as TVT), identifying strengths and areas for development. A follow on evaluation updates that earlier evaluation, drawing comparison between the 2010/11 and 2008/09 cohorts and providing a longitudinal review from contact with previous cohorts, reporting on their current work and retrospective reflections on the value of the scheme. Suggestions for further development are included.

Data sources

Both evaluations drew on interviews with the Associate Dean and Scheme Adviser; questionnaire to all course participants (n=9) distributed face-to-face on a study day and group discussion; extracts from portfolios on treatments undertaken. The first evaluation included interviews with the trainers (n=9) and the follow-on evaluation contacted participants who had completed the programme in 2009 and 2010.

In collaboration with 1000 Lives Plus, the School of Postgraduate Medical and Dental Education and the School of Dentistry, we have developed an antimicrobial prescribing audit for dentists.

Antimicrobial resistance represents a serious threat to public health.This programme of work aims to address inappropriate or inaccurate prescribing in general dental practices in Wales. This is the second cycle of the national audit.

Through the analysis of general dental practitioners’ prescribing data we will support the most effective clinical use of antimicrobials and reduce the number of unnecessary prescriptions.

Participating dentists are asked to consult the Scottish Dental Clinical Effectiveness Programme (SDCEP) formulary and record their prescribing practices for either 3 months or for 20 patients, whichever is first.

Lead contactEmma Barnes
FunderWales Deanery
Start dateDecember 2013

The dental postgraduate section of the Wales Deanery supports postgraduate education and training for a range of dental professional roles in Wales.

The activities provided are underpinned by educational research and quality assurance to ensure that they are relevant, appropriate and support safe patient care.

The principal aim of the study is to inform Wales Deanery’s Continuing Professional Education (CPD) provision for General Dental Practitioners (GDPs) and to attract current non-attenders.

The specific objectives of the project are:

  • to provide a profile of the use of Deanery-provided CPD by all GDPs across Wales and a profile of who is not taking up Deanery-provided CPD.
  • to explore the motives for sourcing CPD from other providers.
  • to identify the learning needs of dental professionals that currently source their verifiable CPD from outside the Deanery.
Lead contactEmma Barnes
FunderWales Deanery
Start dateApril 2017

Dental Nurses views on CPD in Wales

Mandatory registration with the General Dental Council (GDC) was introduced in July 2008, to bring dental nurses (DNs) in line with other health personnel.

As a requirement of registration DNs have to complete a set number of hours of continuing professional development (CPD) annually.

Aims

To seek the views of Registered Dental Nurses (RDNs) in Wales regarding CPD and registration. To identify perceived barriers that may impact on participation and engagement.

Data sources

Letters were sent to all dental nurses throughout Wales (general practice and hospital and community dental services) on the mailing list held by the Wales Deanery, Dental section, Cardiff University inviting them to complete a paper questionnaire (returned via FREEPOST) or an online version.

Development of the Maturity Matrix Dentistry: A practice-development tool for general dental teams

The Maturity Matrix (MM) was originally designed as a self-evaluation practice development tool for Primary Care and Pharmacy teams.

The MM was designed as a means of measuring current practice, allowing the practice team to identify key areas for improvement, prioritise any interventions and support improvements in quality.

Aims

To adapt the Maturity Matrix for dentistry, creating the Maturity Matrix Dentistry (MMD), a clinical governance tool for general dental practices.

Data sources

The MMD grid was developed by a multi-organizational dental steering group, the domains being informed by GDC core topics, and run from within the Dental Section, PGMDE Wales. It was piloted with 31 practices (212 participants) and rolled out in phase 2 with 36 practices (351 participants, 104 using the MMD for the 2nd time).

After the session each participant completed a feedback questionnaire which asked for views on refining the MMD matrix and the group sessions, its usefulness and for those who were using it for the second time, what changes had occurred in their practice since using the MMD.

The Wales Deanery is piloting and funding an initiative where dental trainees are offered an app comprising four key dental textbooks.

Four key textbooks, Clinical Dentistry, Traumatic Dental Injuries, BNF and the BNFc, are specially configured for mobile devices, the Medhand Mobile Libraries software functions independently of the internet and also possesses a cross-search facility.

Our ongoing evaluation will examine how the Medhand mobile libraries app supported Dental Trainees in primary, community and secondary and care dentistry, looking specifically at uptake, use and perceived value of the app.

Lead contactEmma Barnes
FunderWales Deanery
Start dateApril 2017

Harmonization and standardization of European dental schools' programs of continuing professional development for graduate dentists

Continuing Professional Development (CPD) is essential to the maintenance of dentists' knowledge and skills, underpinning safe clinical practice.

However, there is no harmonisation on the 'essential' content or regulation of CPD for graduate dentists in the EU. CPD is provided by a variety of enterprises, including dental schools in higher education institutions (HEIs), as well as public sector organisations and industry.  Not all are subject to quality management.

Aims and outcomes

This project aimed to identify agreed essential CPD requirements of an EU graduate dentist and provide guidelines for the management and delivery of high quality CPD by European dental schools. The specific objectives were to:

  1. produce an inventory of existing CPD programs and providers, agreeing essential components and identifying areas of best practice;
  2. develop guidelines for dental schools on organization and quality management of CPD programs, including methodology, innovative delivery modes and desired learning outcomes;
  3. provide guidelines for dental schools to deliver competence-based CPD, employing modern technological advances in pedagogy and develop an exemplar teaching  module on a core CPD topic;

Data sources

An extensive literature/internet search collected data on dentists' engagement in CPD, delivery methods, topic preferences and effectiveness. A survey, circulated widely to dental educational stakeholders gathered data on existing CPD programmes, requirements, providers, accreditation and opinions about CPD provision in European countries. A consensus process, including Special Interest Groups at ADEE conferences, sought agreement on core dental CPD topics.

Further information

Part-funded (75%) by the European Commission, this project was led by Cardiff University (Cowpe and Bullock) and undertaken in collaboration with partners from National and Kapodistrian University of Athens, University of Helsinki, Finland, Academic Centre for Dentistry, Amsterdam, Association for Dental Education in Europe and Rīga Stradiņš University.

Skill-mix in Dentistry in Wales

Changing patterns of disease and patient care needs have prompted a review of dental care delivery.

Changes in roles provide potential for dentists to focus on complex therapeutic activities while dental hygienists/therapists, for example, deliver preventive, educational and general health promotion services. However, studies have shown that role-extension and delegation of tasks is not widespread within the UK.

Aims

This study aimed to examine the use of extended duties for DCPs within general dental practices in Wales. We explored patterns of DCP employment, their range of duties and reasons for, and barriers to, role extension.

Data sources

All dental practices holding an NHS contract within Wales were invited by email to complete a survey. Participants were requested to submit only one survey per practice.

Pharmacy education and training

Ovrhead view of doctor on laptop

In order to register as a pharmacist in the UK, the General Pharmaceutical Council requires pre-registration pharmacist trainees to complete 52 weeks of training, demonstrate competency against a set of performance standards, and pass a national registration exam.

The Wales Centre for Pharmacy Professional Education (WCPPE) is piloting an electronic portfolio (e-portfolio) that is designed to support learning from the pre-registration training programme.

Portfolios are commonly used and well suited to assessing complex elements of educational development within the healthcare profession. However, their value is dependent on the quality and scope of the information and evidence they hold. The Wales Centre for Pharmacy Professional Education (WCPPE) have commissioned a formative evaluation of the e-portfolio pilot in Wales.

The purpose of the study is to provide a formative evaluation of the e-portfolio pilot that is being introduced for use with pre-registration pharmacists. The specific objectives are:

  • to explore participants’ views on their experience of using the e-portfolio: does it meet their needs? Is it a good option?
  • to identify perceived advantages and disadvantages of this e-portfolio
  • to compare findings with a wider review of the benefits and drawbacks of e-portfolio use amongst other healthcare professions
  • to suggest areas for further development or improvement.
Lead contactAlison Bullock
FunderHealth Education and Improvement Wales Pharmacy (HEIW Pharmacy)

Enhancing skill-mix in community pharmacies: understanding barriers and proposing solutions

Focused on community pharmacies, this study seeks to explore obstacles to developing the role and responsibilities of pharmacy technicians and other members of the team.

It also considers ways to address barriers to developing the skill-mix.

Lead contactAlison Bullock
FunderPharmacy Research UK
Start date1 May 2014

We have developed a new collaboration bringing together practitioners from dentistry, general practice and pharmacy.

We developed events which address topics relevant to all three groups. These events, delivered by invited guest speakers, have been warmly welcomed by participants in post-course evaluations.

We will undertake a formative evaluation to support this programme by reporting on the motivations of the different professional groups and identify the future educational content each group wishes to see in the events.

Our specific objectives are to:

  • report on the motivations of the different professional groups (dental, GP, pharmacy)
  • report responses to events, by professional group
  • identify the future needs (educational content) of each group.
Lead contactEmma Barnes
FunderWales Deanery
Start dateApril 2017

This study is based on the premise that the deployment of improvement skills results in improved patient care. However, we know that many who are trained in quality improvement do not go on to apply these skills in practice.

The role of practice-based pharmacists is relatively new and are generally fulfilled by lone practitioners working in isolation from their professional peers. Given the increasing prominence of this role in the UK, it is judicious to examine how pharmacists in these positions improve patient care through the application of Quality Improvement techniques and exploring barriers to them doing so. While exchanging ideas for improving practice with peers is an effective way to develop individuals’ clinical skills, a Community of Practice also fosters an increased sense of community and shared professional identity.

In this study, we explore how and in what circumstances being part of a Community of Practice supports Practice-Based Pharmacists to use their improvement skills to improve their practice.

Lead contactAlison Bullock
FunderHealth Foundation
Start dateApril 2016

Optometry education and training

The All-Wales Case-based discussion initiative in Optometry: An evaluation

As of January 2013 the General Optical Council states that all optometrists must engage in at least one case-based discussion (CbD) per cycle.

The purpose of the re-accreditation case discussions is to improve the optometric management of WEHE/ PEARS cases with an emphasis on reporting and referrals to secondary care and GPs.

Aims

The aim of this project was to explore the acceptability, effectiveness and long-term impact-on-practice of the method as a mode of continuing education delivery.

Data sources

The focus of the evaluation was all participants in their first CbD groups in the two month period January to February 2012, the knowledge they develop and how this is applied to their practice. Participants attended an evening session comprising a lecture and a group discussion. Three questionnaires were completed: prior to the session (demographic information, self-rating of current knowledge and opinions on attending the session), immediately post-session (items of learning and future learning needs, planned changes to practice and views on participating in the session) and 3-4 months post-session (learning from the session and changes made to practice). All questionnaires were individually coded to allow matching.

Further information

The project was funded by The General Optometry Council and carried out in collaboration with Wales Optometry Postgraduate Education Centre (WOPEC).

Knowledge mobilisation

Knowledge and Innovation Transfer

Knowledge and innovation transfer (KIT) is a complex, dynamic and evolving process and a long-standing international challenge for organisations.

A new role is increasingly being used to help overcome this problem by linking-up those with important knowledge with those who should use it. We call these people knowledge and innovation transfer (KIT) “agents”.

The research, conducted in 2014-2015, used an in-depth qualitative case-study design, focused on a sample of KIT agents from Academic Health Science Networks in England and an Academic Health Science Partnership in Wales.

Our research addressed the following questions:

  • What are commonly shared expectations of the KIT agent role?
  • What, in practice, do KIT agents do?
  • How does the work of KIT agents impact on healthcare planning and practice?
  • How can KIT agents be best supported?

Conclusions

The KIT agent roles were varied, complex and evolving. Common to all roles was how they strengthened relationships with researchers, patients and others who are a source of helpful knowledge. These roles were valued by the people the KIT agents assisted. The KIT agents’ expertise, flexibility and “can-do” attitude were also valued.

Insufficient time for the role sometimes made it difficult for the KIT agents; given the sheer scale of the task and the environment in which they currently operate, the effectiveness of KIT agents needs a long-term view.

Demonstrating the impact of their work was often a concern for agents, particularly when formal evaluations were rarely used. Having a supportive manager and team, time to do the job, and a clear purpose all helped their work.

Lead contactAlison Bullock
FunderNational Institute of Health Service Research
Start date1 June 2013

Knowledge Transfer and Mobilisation: the Wales scoping study

The main purpose of this scoping study is to find out how findings from research are currently used to inform and improve healthcare practice in Wales in order to inform future knowledge transfer and exchange initiatives.

Lead contactAlison Bullock
FunderAneurin Bevan and Cwm Taf University Health Boards
Start date1 January 2013
KT Wales Infographic
A visual summary of our KT Wales Scoping report

As the Wales Deanery sits within Cardiff University, trainees and their trainers are afforded access to a range of Cardiff University e-resources, including an extensive library of e-journals.

Previous Wales Deanery surveys have found the resources are valued but that many were unaware of them and wished to know more. In light of the Deanery’s upcoming move out of Cardiff University, it is timely to find out more about views on the value and quality of the resource and the impact of a potential reduction in access.

We are employing a mixed-methods approach to data gathering, including focus groups, an online survey and telephone interviews.

Lead contactAlison Bullock
FunderThe Wales Deanery
Start dateApril 2017