Using a self-regulated learning-enhanced video feedback educational intervention to improve junior doctor prescribing

Abstract

Introduction: Medical school graduates in the UK consistently report feeling underprepared for the task of prescribing when embarking on practice. The effective application of self-regulated learning (SRL) approaches and feedback on complex tasks are associated with improved outcomes in practice-based clinical skills.

Aims: This study aimed to investigate the effectiveness of an educational intervention using SRL-enhanced video feedback for improving the prescribing competency of junior doctors.

Methods: A prospective cohort study was designed to compare intervention and control cohorts of junior doctors undertaking simulated clinical encounters at the beginning and end of their 4-month rotation through renal medicine.

Results: The improvement in prescribing competency for the intervention cohort was significant (p < 0.001) with large effect size (d = 1.42). Self-efficacy improved in both cohorts with large (control cohort p = 0.026, r= 0.64) and medium (intervention cohort p = 0.083, d = 0.55) effect sizes. Goal setting and self-monitoring skills improved in the intervention cohort only with medium effect size (p = 0.096, d = 0.53).

Conclusions: SRL-enhanced video feedback is effective for improving prescribing competency and developing SRL processes such as goal setting and self-monitoring skills in simulated clinical encounters. Further research is required to evaluate transferability to other clinical sub-speciality contexts and investigate the effectiveness of the intervention for improving prescribing in non-simulated settings.

Keywords:

• Self-regulated learning
• foundation training
• junior doctors
• patient safety
• prescribing
• video-enhanced feedback

Acknowledgements

Thanks to the Leicester Kidney Patient Association for supporting and participating in this study. We also thank the doctors who participated in the research and senior clinicians and managers who supported this research.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This work was funded by Health Education England East Midlands grant number LEI0085.

Notes on contributors

Rakesh Patel

Dr. Rakesh Patel, MBChB, MRCP, MD, MMed, SFHEA, is Clinical Associate Professor in Medical Education and Honorary Consultant Nephrologist, Faculty of Medicine & Health Sciences at the University of Nottingham.

William Green

Dr. William Green, BSc, PhD, FHEA, is an Associate Professor (School of Business) and Deputy Dean of Research (College of Social Sciences, Arts and Humanities) at the University of Leicester.

Muhammad Waseem Shahzad

Dr. Muhammad Waseem Shahzad, BA, PhD, is a Research Associate in the School of Business, University of Leicester.

Helen Church

Dr. Helen R. Church, MBChB, MRCA, is a Clinical Assistant Professor in the Faculty of Medicine & Health Sciences at the University of Nottingham and an Anaesthetics & Critical Care Doctor at Chesterfield Royal Hospital, UK.

John Sandars

Professor John Sandars, MSc, MD, MRCP, MRCGP, FAcadMEd, is Professor of Medical Education at Edge Hill University,UK.