Challenges and Issues in Junior Doctors' Workplace Learning: A Report

This report examines the learning issues faced by junior doctors in their early career development. It identifies key challenges, including communication barriers between junior and senior doctors, deficiencies in training and selection processes, the impact of invisible hierarchical structures, and difficulties in knowledge transfer. The report highlights that communication breakdowns, lack of effective training, and complex organizational structures hinder junior doctors' learning experiences. It suggests recommendations such as implementing team-building courses, promoting peer-led teaching, integrating management skills into medical curricula, rewarding senior doctors for mentoring, reducing workloads, and improving nurse-patient ratios. The study emphasizes that addressing these issues can significantly improve the learning environment and support the professional development of junior doctors, ultimately enhancing patient care.

Learning and developing junior doctors
Student name
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Introduction
Junior doctors face diverse challenges during their early years of career development.
Despite hospitals and medics scheduling mentorship program, the majority of junior doctors find
these programs inefficient and ineffective to support them in their early days of workplace
exposure. Furthermore, without effective learning support, junior doctors struggle with diverse
organizational challenges such as communication barriers during their daily routines. In addition,
scholars suggest that some junior doctors also end up experiencing frustration in their career
development and others fail significantly to utilize their abilities as expected and provide
effective customer delivery Schaufeli, Bakker, Van der Heijden and Prins, 2009 p.155-157). It is
due to these negative experiences faced by junior doctors in the early stages of their career
development that the paper seeks to examine learning issues faced by junior doctors in their
workplaces.
Issues
The learning issues faced by junior doctors that will be discussed in the report include
communication barriers, training and selection, invisible hierarchy structure and knowledge
transfer. The paper will also offer a recommendation for suitable approaches that can handle the
issues.
Communication barriers
Communication is a complex, multidimensional and dynamic process. Failure of
practicing effective communication hinders the provision of standardized services in a patient
care setting. Lack of effective communication can lead to dissatisfactions among the
participants’ parties, possible maltreatment and exposure to complication and misunderstanding.
Furthermore, employing effective communication skills between junior and senior doctors in a
workplace context is a valuable tool for assessing patient needs and providing them with

appropriate knowledge transfer and exchange of information, emotional support and physical
care.
A communication barrier creates a wide gap between junior and senior doctors in
workplaces that significantly affects customer delivery. A research conducted by Johnston (2015
p.45) shows that the gap between junior and senior doctors as a result of communication
breakdown contributes to 60 percent of junior doctors failing to air their concerns to appropriate
personnel. Furthermore, the research also showed that the majority of these junior doctors
preferred written communication over oral communication and they had little contributions
during the departmental meetings. Therefore, lack of confidence is a significant issue challenging
junior officers when conversing with senior doctors. For example, a junior doctor may encounter
a scenario that requires consultation of senior members but due to fear he or she may fail to ask
questions regarding the scenario.
Lack of effective guidance significantly influences the way communication converses
between junior doctors and senior doctors. For example, with senior doctors having a busy
schedule of providing patient care, time for guiding junior staff and teaching them effective
communication skills is always limited. In addition, with limited guidance, junior doctors fit in
workplace environment through self-learning (Weller, Barrow and Gasquoine, 2011 p.478) and
therefore, they end up lacking desired effective communication skills which are physically
learned from senior doctors. For example, junior doctors may lack communications skills of
presenting patient care reports (mediocre description of core ideas) although they have self-
learned on how to communicate fluently to the public
Training and selection
Training and selection are key human resource components towards the development of
an effective learning organization. However, several factors affect how training and selection

process is ethically conducted in an organization. Some of the factors affecting effective training
among senior and junior doctors include huge paperwork, too much work and formalities of
senior doctors and a lot of writing such as writing medical reports or patients’ notes.
Despite emerging technologies such as ERP, there is still a lot of paperwork experienced
in a clinical context that significantly affects how senior doctors offer effective training to junior
doctors. The huge paperwork that involves keying in details (Data entry) from forms into
existing automated computer systems and analysis of diverse document such as medical
laboratory results slows down the ability of doctors to offer training to junior staff. Furthermore,
a high concentration of paperwork slows down the ability of senior doctors to focus on other
clinical aspects such as career development of junior doctors and themselves. Further research
conducted by Qureshi, Ross, Maxwell, Rodrigues, Parisinos and Hall (2013 p.118-123) on
“Developing junior doctor
‐delivered teaching “ shows that senior doctors want to teach and
junior doctors are eager to learn and therefore with the huge workload in workplaces there are
ample opportunities for junior doctors to learn but limited time for senior doctors to teach.
Busy schedule or too much work that involves a lot of writings such as patient’s notes
and medical reports significantly affects the extent to which senior doctors participate in the
training of junior medical doctors. For example, a survey conducted by Reece and Klabe (2012
p.61-67) on “daily ward round” shows that senior doctors feel that “ward round” offers an
effective opportunity for senior doctors to teach and junior doctors to learn but the concern is the
time needed to complete each round teaching new things. Furthermore, the research emphasized
that senior doctors do not take time to provide effective teaching during the rounds as they have
a lot of writing regarding results obtained in the rounds wards, In addition, they have to allocate
more time for analysis and conclusion. On the other hand, junior doctors also feel so much

pressure with the workload to an extent that they fail to ask questions relating to their clinical
work and requesting for learning time from authorities.
Invisible hierarchy structure
Complex organization structures that include invisible hierarchy systems are learning
barriers to junior doctors. For example, the invisible hierarchical structure may be formed in such
a way that junior doctors may lack specific senior doctors to report to. This invisible hierarchical
structure creates confusion of roles and power struggle among the management. Furthermore,
with this invisible hierarchical structure, it becomes difficult in determining the responsibility of
senior doctors towards enhancement of junior training. In addition, with the confusion of roles
and responsibility, junior doctors experience learning difficulties as there are not specific senior
doctors to handle their concerns, give appropriate feedback and provide close monitoring and
evaluation of their progress. Bureaucracy may also be an invisible hidden structure that may
increase the time required for senior doctors to respond to diverse questions from junior doctors.
Lack of giving appropriate and timely feedbacks hinders the learning of junior doctors.
Knowledge transfer
Hectic work affects how knowledge is transferred to junior doctors. For example, with
bulky workloads and strict deadlines, junior doctors find limited time to attend brainstorming and
career development programs such as team building, seminars and conferences. Furthermore,
with some of these programs being expensive, junior doctors who are not well compensated and
rewarded due to their skills and education experience difficulties of going an extra mile and fund
for these opportunities. With junior doctors not interacting with other skilled doctors through
these programs, they end up failing to share their knowledge and experiences with others and
also learning of new things from diverse experts.

Recommendation to overcome
In order to overcome all the barriers associated with the leanings of junior doctors, health
facilities should come up with an effective program of sending junior doctors to team building
courses. This will ensure junior doctors are exposed to a new learning environment which in turn
will boost their experiences and skills of curbing diverse workforce barriers. Furthermore, the
practice of more peer-led teaching should be encouraged for junior doctors to learn from each
other. Research conducted by Jackson and Evans (2012 p.192) showed that peer-led teaching and
learning is highly effective. Therefore, through peer-led teaching and learning, junior doctors
will be able to receive training or induction from senior doctors.
The management skills that are required in the clinical workplace should be infused in the
medical course in order to prepare the junior doctors for the problems they are likely to
encounter in workplaces and how they will handle them. With effective management skills,
junior doctors will require minimum support from senior doctors when enhancing their skills.
Rewarding and compensating senior doctors should be used in order to boost morale and
motivation of guiding and teaching junior officers. Furthermore, hospitals should ensure the
workloads of both senior and junior doctors’ are significantly reduced in order to create more
time for learning. To reduce workloads which limit opportunities for developing learning, more
nurses should be employed in order to meet nurse-patient ration. Furthermore, management
teams in charge of both senior and junior doctors should use the patient-care approach to govern
junior and senior doctors’ in order to promote effective communication and deliverance of
standardized quality patient-centered care. In addition, reduction of workload ensures there is a
conducive environment for both senior and junior doctors to facilitate effective learning.

Conclusion
In conclusion, the schedule is a key factor that determines the extent to which senior
doctors teaches junior doctors. Workloads also influence the rate at which junior and senior
doctors interact effectively in the organization. Sending of junior doctors to team building,
provision of management skills, effective reward and compensation of senior doctors and
support of peer-led teaching and learning are effective strategies of addressing workplace
information.

References
Jackson, T.A. and Evans, D.J.R., 2012. Can medical students teach? A near-peer-led teaching
program for year 1 students. Advances in physiology education, 36(3), pp.192-196.
Johnston, M.J., King, D., Arora, S., Behar, N., Athanasiou, T., Sevdalis, N. and Darzi, A., 2015.
Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical
teams. The American Journal of Surgery, 209(1), pp.45-51.
Qureshi, Z., Ross, M., Maxwell, S., Rodrigues, M., Parisinos, C. and Hall, H.N., 2013.
Developing junior doctor‐delivered teaching. The clinical teacher, 10(2), pp.118-123.
Reece, A. and Klaber, R., 2012. Maximizing learning on ward rounds. Archives of Disease in
Childhood-Education and Practice, 97(2), pp.61-67.
Schaufeli, W.B., Bakker, A.B., Van der Heijden, F.M. and Prins, J.T., 2009. Workaholism,
burnout and well-being among junior doctors: The mediating role of role conflict. Work &
Stress, 23(2), pp.155-172.
Weller, J.M., Barrow, M. and Gasquoine, S., 2011. Interprofessional collaboration among junior
doctors and nurses in the hospital setting. Medical education, 45(5), pp.478-487