New terms used for trainee doctors stump nurses and patients

Nurses and patients are struggling to identify qualified doctors or to grade their seniority from their generic name badges, finds a survey of one hospital in England, published online in BMJ Quality & Safety.

The findings prompt the researchers to call for a review of currently used terminology, deployed since the Modernisation of Medical Careers initiative in 2009, which revamped the length of training and introduced a range of new job titles.

Staff and patients must be able to correctly identify professional status and communicate effectively, if optimal care is to be provided, they say.

The researchers gave 114 patients and 67 nurses from a variety of outpatient clinics 11 name badges, reflecting current training grade job titles used by and one , to see if they knew what these meant. The accompanying photographs were removed to exclude bias by age or sex.

The job titles included 'medical student,' 'foundation year 1' (FY1), 'foundation year trainee 2' (FY2), 'specialty trainee' (ST), 'core trainee' (CT), 'consultant,' and 'general practice vocational trainee scheme' (GPVTS).

Participants were asked to say whether the badges indicated a qualified doctor or a medical student, and to rank them by level of seniority.

They were also asked to identify four ID badges formerly used by doctors before the Modernisation of Medical Careers initiative to see if the terms 'house officer,' 'senior house officer,' 'registrar' and 'consultant' were better understood.

Participants were again asked to identify which indicated a doctor and which a medical student, and to rank them according to their seniority.

The results showed that patients were in the dark about the meaning of current professional terminology.

Seven out of 10 thought that an FYI was a medical student, while over two thirds (67.5%) also believed this to be the case for FY2. A further one in five (19%) and one in four, respectively, ticked the 'no answer' or 'neither' boxes.

Additionally, over half the patients (54%) thought a CT was a medical student, while 38% identified an ST as a medical student. Only the terms 'consultant,' 'GP trainee,' and 'medical student' were well recognised by most patients.

Although almost half of patients failed to correctly rank the formerly used terms, they were more likely to understand which term indicated a qualified doctor.

While most (88%) correctly ranked the badges formerly used by doctors, less than half (45%) were able to rank the new terms. Furthermore, around 40% didn't know that FY1 and FY2 indicated trainee doctors, while half failed to recognise CT as a qualified doctor.

"The findings suggest that the current system in place around the UK has made it much more difficult for healthcare professionals to identify their doctor colleagues," write the researchers.

"And it would appear that the inclusion of the word trainee suggests to the patient that they are dealing with a medical student," they add.

They call for a national review of the currently used terms, emphasising that this must involve patients.

Any new terminology should be simple, include words such as 'doctor,' 'senior,' and 'junior,' and be kept short to allow for big bold writing that can easily be seen by staff and , they suggest.

More information: The interpretability of doctor identification badges in UK hospitals: a survey of nurses and patients, BMJ Quality & Safety, Online First, DOI: 10.1136/bmjqs-2013-002445

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