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Shadowing and peer mentoring: avoiding grey Wednesdays

A project run in University Hospitals Coventry and Warwickshire NHS Trust

Related themes

  • Handover
  • Out-of-hours care (24/7)
  • Rotas and scheduling


A Department of Health (DH) initiative involving a shadowing programme for new foundation doctors one week prior to commencing their role as foundation year 1 (FY1) doctors proved successful. However, this identified an unmet need for improving handover during further rotations throughout the year.
Grey Wednesday’s was designed to develop a FYI inter-rotation shadowing and peer mentoring week to improve patient safety, trainee competence and the clinical learning environment.

Project objectives

  • Pilot inter-rotation shadowing and peer mentoring
  • Better prepare trainees for their rotations, identify learning requirements and fulfil their training needs earlier.
  • Collect pre and post intervention data for the above initiatives to assess whether this leads to improved outcomes.
  • Spread the interventions regionally/nationally if successful.


  • Demonstrated that inter-rotation shadowing generates statistically significant improvements to patient safety, quality of care and trainee learning.
  • Project successfully piloted over two junior doctor rotation changes with positive feedback obtained from trainees across all three hospitals involved.
  • Pre and post data collected and presented nationally including to the United Kingdom Foundation Programme Office (UKFPO) demonstrating clear benefits of inter-rotation shadowing.
  • Approved for regional and national adoption.
  • Out of the trainees who took part: 94% found shadowing day ‘very useful’ or ‘useful’, 77% better understood the roles and responsibilities of their second post (83% increase), 76% felt prepared to start their second rotation (55% increase) and 63% believe the shadowing day significantly improved patient safety.

What they’ve said

“Great idea! Alleviates Anxiety” 


“Really helped me feel more confident about starting my new job and to know the little things that no one tells you about” 


“Was amazing for building confidence and most importantly for patient safety” 


“Serves as an ideal opportunity to ask questions and meet the team” 



Please look at the materials in the related documents section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects.
Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

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