Accident and emergency training perspectives in Scotland

To determine the perspectives of Scottish accident and emergency (A&E) trainees and trainers on current training in the speciality, in order to help develop a simulator based training programme to complement existing training.

Questionnaires were sent to all Scottish A&E trainees and consultants responsible for training. They were presented with various clinical challenges. Trainees were asked to rate their confidence, experience, knowledge, and training on a Likert scale of 1 to 5. Trainers were asked to identify those areas where they felt trainees' performance consistently failed to meet a desired standard, and whether this was the result of lack of training, lack of exposure, or both.

Trainees' response rate was 75%; consultants' was 59.4%. Overall trainees gave scores of 4/5 for confidence and knowledge, 3/5 for experience, and 2/5 for training. The highest scores were for medical, anaesthetics, and interpersonal skills. Consultants attributed lack of exposure to underperformance more frequently than lack of training.

Trainees and trainers agree on the level of exposure to various clinical challenges, but disagree on training. Trainees' levels of confidence and knowledge outweigh their experience and training, suggesting that trainees associate knowledge with clinical competence.