Good Training Should Be Patient-Centred: An Analysis of Patient-Centredness Among Trauma and Orthopaedic Trainees in...

Patient-centred care (PCC) is a model of healthcare which encourages collaboration and shared decision-making (SDM) between patients, families and healthcare providers; to provide holistic and bespoke care. This study assessed the current state of PCC and its training among trainees on a Trauma and Orthopaedic (T&O) rotation in Wales, UK.

A survey was designed to elicit this in three domains: attitudes and self-perceived competencies; formal training and support; administrative support and barriers faced. After trialling in a pilot group, the questionnaire was electronically circulated among trainees and anonymised responses collected.

69% trainees (43/62) responded to the survey. Most believed that PCC was very important in orthopaedic surgery and had moderate-to-high self-perceived confidence in their abilities (abilities to communicate, address patient fears/anxieties, and provide culturally-sensitive care). Most respondents (>80%) 'often' or 'always' practiced SDM, elicited patient ideas/concerns/expectations, and considered lifestyles/goals when discussing treatments. There was moderate agreement among respondents that the current training programme adequately prepared them to provide PCC, although 74% reported they had not received any formal PCC training. Trainees expressed moderate agreement on receiving "support/guidance" and "constructive feedback on communication skills" from supervisors. 63% trainees expressed interest in training on PCC skills. "Adequate implementation of PCC practices in hospital policy/administration" generated mixed responses. High patient volumes, time constraints, lack of resources and systemic barriers were the commonly cited obstacles to providing PCC.

Orthopaedic trainees in Wales are cognisant of PCC and are reasonably confident in providing it, but would welcome further training and development of resources.