Abstract:

Background:
In July of each year new interns, Senior House Officers, registrars and senior registrars commence new hospital-based posts, often with limited experience and knowledge of the speciality they join. This “learning curve” can cause significant disruption to both efficient service provision and patient care. Feeling ill-prepared and dealing with uncertainty within posts are major contributing factors in trainee burnout. Previous Irish studies have found that psychiatry Non Consultant Hospital Doctors (NCHD) find the on-call especially stressful, with many identifying lack of induction into their post as a major factor.
Induction across many hospital sites in Ireland has improved in recent years, however it remains face to face, didactic teaching. Change over of posts do not always happen at the same time for all NCHD's and a face to face programme means that it is not accessible to all NCHD's at the right time. We aimed to develop a web resource to enhance the local induction for NCHDs which would also be available to those unable to attend face to face induction.

Objective:
Develop an online induction program for psychiatry NCHD’s and evaluate its use in Psychiatry in two Irish hospitals.

Method:
This quality improvement project was conducted using the PDSA (plan, do, study, act) cycle.

Results:
Stage 1- Needs analysis.
In the initial stages, 20 NCHDs (across multiple sites) and 10 consultants were surveyed to assess attitudes towards local induction and areas for improvement. These improvements included, practical site-specific information, and management of common clinical scenarios. 85% felt an online component could complement the current induction.
Stage 2- Content creation
Relevant content was identified and created by four senior psychiatrists in the initial phase. Learning units were designed with a focus on practicality, problem solving, interactivity and achieving deep learning.
Stage 3- Stakeholder consultation and Analysis
Extensive stakeholder consultation regarding the relevance of content, design and user-friendliness of content was then conducted. Stakeholders included interns, training and non-training registrars, Senior Registrars, consultants and nurses across sites. Verbal and written feedback was collected.
Written feedback was collected from 12 NCHDs including interns, General Practice trainees, training and non-training registrars and Senior Registrars. All found it helpful in complimenting the local induction process, found the content relevant, felt it was an efficient use of time, and found it interactive. Other specific feedback provided was also incorporated in further updates to the induction content.

Conclusion:
Feedback received from those surveyed demonstrated an appetite for a user-friendly online induction program. Access to induction information prior to commencement allows NCHDs to learn using self-directed, interactive material was of particular benefit. At present, the website is being piloted in two major hospitals in Ireland. A further PDSA cycle is being completed in December 2023.If found helpful this online induction interactive learning resource could be considered for use in other hospitals in the specialty of Psychiatry.

Keywords:

Induction, doctors, e-learning, mobile application, interactive learning material.