Training and supervision needs and experience: a longitudinal, cross-sectional survey of accident and emergency department senior house officers

The aim of this study was to investigate senior house officers'' (SHOs) perceptions about their training needs, satisfaction with teaching and supervision, and the relationship this has with psychological distress levels. All 171 SHOs employed within 27 accident and emergency (A&;E) departments in the South Thames region were sent questionnaires at the start of their attachments in A&;E, at the end of months four and six. The questionnaires asked SHOs to rate on visual analogue scales their perceived need for further training for 23 clinical and practical activities relevant to A&;E practice. At the end of the fourth month SHOs were asked to indicate who had provided them with the most valuable teaching and supervision, indicate their satisfaction levels with training received, and suggest ways to improve teaching and supervision. SHOs'' psychological distress levels were measured in all three questionnaires.  Overall, satisfaction with supervision and training was mixed. SHOs perceived greatest need for further training in areas encountered less frequently in A&;E. Registrars were the most valued providers of supervision and teaching. Increased numbers of middle grade staff and protected study time were suggested as ways to improve supervision and teaching. SHOs with higher scores for training need at the end of their attachment in A&;E expressed significantly less satisfaction with training and higher psychological distress levels. The variation between SHOs'' perceptions of training needs indicates the importance of tailoring training and supervision to individual requirements.