Improving the standard of practical pleural procedures teaching for junior doctors: A quality improvement project

Introduction: Junior doctors in the UK are required to gain pleural procedural competencies during their 2-3 year core training program, but their exposure to these are highly variable and they struggle to meet their curriculum requirements. Objectives: By scheduling attendance at pleural clinics for our trainees, we aimed to formalise and improve the overall quality of pleural procedural teaching and increase their confidence at performing and caring for patients undergoing these procedures. Action: All 11 core trainees at Kingston Hospital were invited to attend consultant delivered pleural clinics between February and August 2018. Questionnaires were completed pre and post intervention to measure the trainees’ experience and their confidence level regarding various aspects of pleural procedural management. Outcome: Pre intervention, 0 of the 11 trainees had received regular bedside teaching of pleural procedures and only 2 trainees felt their training requirements had been met adequately by their exposure so far. Post intervention, all trainees felt their training requirements for pleural procedures had been met. Their self reported confidence levels across all aspects of medical pleural procedures had increased; including pleural procedure indications, equipment use, procedural skills and management of complications. Conclusion: Through this simple intervention we have successfully improved the confidence of our trainees in performing and caring for patients undergoing practical pleural procedures. This intervention was effective, cost-neutral and can be easily adapted to other practical procedures and services in which a daycase or outpatient service is already established.