6072 MMEGA: making medical education great again

Objectives The London School of Paediatrics (LSP) surveys trainees regarding their placements and there is wide variation in satisfaction. We explored the last five years of data to identify predictors of overall trainee satisfaction. Methods The survey is distributed annually to London paediatric trainees (approx. 1200) with response rates of 88–90%. It explores overall placement satisfaction, followed by key questions covering staffing, supervision, teaching, facilities and other facets. The survey blends both quantitative and qualitative (free text) feedback. Satisfaction levels were analysed using time series trend analysis. Overall levels were compared using t-test. Associations between satisfaction and components of the survey were identified using a convergence of multiple regression and other multivariate analyses. Results Overall trainee satisfaction increased steadily until 2020 (figure 1). There was considerable variation across sites, some having consistently higher or lower scores than the median while others showed an upward or downward trend or very variable pattern. By training levels, in the past 2 years. ST1 trainees and ST5 were least satisfied overall, recording 68% and 67% good or excellent ratings respectively (2022). Conversely 94% of ST6 trainees rated placements good or excellent. To understand the influences on overall satisfaction, regression coefficients were derived between specific metrics vs overall satisfaction using multiple regression and then normalised to 100% (figure 2). The explanatory power of this list to explain satisfaction overall is high at 82% R2. Trainee satisfaction was most strongly correlated with workplace atmosphere and consultant support. Staffing, educational supervision, facilities and wider MDT support are associated with overall satisfaction, but to a lesser degree. Conclusion Trainee satisfaction is crucial, affecting patient safety,1 retention,2 and trainee mental health. Our analysis identified significant associations with satisfaction including modifiable elements such as consultant engagement and team morale. Staffing levels were less related to satisfaction. Experimental data exploring the components of clinical training in real world situations is lacking. This data uses the natural experiment of placing trainees in different training locations to explore the factors that relate to their overall experience. We have analysed trainee opinion rather than actual measurements of training (skillset or performance of trainees). Our findings do not indicate causality. This analysis highlights that when parameters such as staffing or workload are challenging, focusing on workplace environment and consultant support is likely to still improve overall satisfaction. The variation between placement and peer comparison and learning has been seen to be highly motivational in supporting this change. References Barton, et al. Hospital mortality and trainee experiences: how general medical council survey findings correlate with summary hospital-level mortality indicator. J Patient Saf. 2023 Mar 1;19(2):79–85. Bimpong KAA, et al. Relationship between labour force satisfaction, wages and retention within the uk national health service: a systematic review of the literature. BMJ Open 2020; 10:e034919. doi: 10.1136/bmjopen-2019-034919