RAFT survey 2022: a national survey on the experience of research and quality improvement during anaesthesia training in the UK
In November 2022 RAFT launched a survey looking at the experience that developing anaesthetists have in research and quality improvement in the UK during their training to understand the current state of play and identify any areas in which support can be improved.
Results
Thank you to everyone who took the time to complete this survey. In total we had 141 responses and so although we cannot say this adequately represents the anaesthetic trainee community there were some interesting findings.
Of those who responded to the survey:
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48.9% were female, 47.5% were male, 0.7% were non-binary, 2.8% preferred not to state their gender
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81.6% were on the 2021 RCoA curriculum, 16.3% were on the 2010 RCoA curriculum
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69.5% were working full-time (48 hours per week), 29.8% were working LTFT, 1 person responded 50% clinical & 50% research
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80.1% had never been an academic trainee or done a research/QI fellowship and 80.9% had not undertaken a postgraduate qualification in research/QI
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59.5% of responses came from 4 deaneries, the rest of the UK deaneries were therefore underrepresented in this cohort
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70.2% of those surveyed knew that they had a lead within their department for QI opposed to 51.8% for research
Number of years that respondents reported having worked as an anaesthetist
Quality Improvement
Average the number of projects respondents do per year
Experience of QI activity
Research
Average the number of projects respondents do per year
Proportion of those who have done the NIHR Good Clinical Practice (GCP)
Proportion of those who have done the NIHR Associate PI Scheme
Experience of research activity
Barriers to conducting research &/or QI
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Below are a list of barriers that were raised:
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Time and balancing other training requirements and commitments
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Rotational training
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Lack of opportunities, or not knowing how to find opportunities
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Lack of support from departments including MDT 'buy in'
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Training gaps in research & QI skills
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Difficulty negotiating required approval processes
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Funding
Summary of results
The main limitation to these results is the small sample size. This may be due to survey fatigue, incomplete survey dissemination and trainee research networks needing time to re-establish after the effects of the pandemic. It is also important to note that almost 60% of survey responses came from 4 training deaneries. These limitations mean that it is difficult to draw firm conclusions. However despite this we have identified some interesting and important findings and disparities between experiences surrounding research and QI that warrant further investigation.
The majority of survey responses came from those training with the 2021 RCoA anaesthetic curriculum (81.6%). More trainees were aware of having a lead for QI (70.2%) than research (51.8%) and more​ were actively involved with at least one QI project (93.6%) per year compared to research (51.8%). In general confidence rates were higher for QI than for research despite a significant proportion reporting insufficient training in both. Most trainees reported not having enough time to do QI (61.7%) or research (67.4%) with less than half of trainees stating that they feel supported to take SPA/study leave in order to do these activities despite most agreeing that being involved in these activities will improve patient outcomes and help with career progression.
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What we are doing...
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Sharing these results widely including decision makers
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Encouraging TRNs to make sure that all training anaesthetists know about TRNs and RAFT with a commitment to the RCoA recommendation that all trainees join their local TRN for the opportunity to get involved in the development and delivery of both regional and national projects
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RAFT will commit to providing opportunities to get involved with research and QI by sharing and disseminating high quality opportunities from TRNs and other networks
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With RAFT 4: the POPPY study
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we have worked hard to ensure that over 140 hospitals have signed up so that rotating anaesthetists have the opportunity to be involved
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we have ensured that getting buy in from departments will be easy along with research and development departments by the POPPY study becoming adopted on the NIHR portfolio
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the POPPY study is a snapshot study which is easy for people to do despite having time constraints, people can be involved to varying degrees from a day of data collection to being involved with the whole process at their hospital
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the POPPY study is affiliated with the NIHR Associate PI scheme
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Finally we hope to repeat this survey in the future to try to understand in a more representative group across the UK what the needs and challenges that the trainee anaesthetist community face regarding research and QI.