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Enhancing the trainee experience through the e-learning VITAL project

In partnership with Health Education England, the Heart of England NHS Foundation Trust aimed to enhance the transition from medical student to Foundation Year 1 doctor (F1), and specialty placements for Foundation Year 2 doctors (F2), to promote excellence in safe patient care through e-learning and assessment.

Related themes

  • Multi-professional team working
  • Improving training programmes and pathways


The pilot focused on improving patient safety and the annual changeover process of foundation doctors. This was supported by e-learning through a system called VITAL (Virtual Interactive Teaching and Learning) and the STEPPS[1] (Systems Training for Emotional Predictability and Problem Solving) programme, which aimed to improve mentoring during the shadowing week and support trainees in difficulty. Particular emphasis was placed around educating foundation doctors on key patient safety areas, such as acute care and prescribing, to enhance the development of knowledge and skills and to improve patient care and safety.

How they did it

Eleven patient safety e-learning modules were developed for F1 doctors, which included a focus on prescribing and a further fifteen modules were developed for F2 doctors. Working in collaboration with experts, the team then developed a variety of educational materials including concise reading material (PDF and HTML), short audio podcasts, short video clips, forums/Wikis and an assessment question bank, which was accessed through the VITAL environment. F1 doctors also received extended STEPPS mentoring sessions during their induction/shadowing period.

The pilot examined outcomes using a before and after study of the intervention and control groups of F1 doctors.  Each group was assessed at three time points regarding their knowledge. Key outcomes were their VITAL assessment scores and a metric looking at safety of electronic prescribing at an individual doctor level. The project team combined the VITAL and prescribing scores to provide a skills measure to be fed back to the foundation doctors and their supervisors. They also identified and offered early support for doctors in difficulty, and awarded excellence certificates to the top 20% of doctors in training. The design of the project and outcome measures showed that e-learning can both enhance the transition for doctors and improve patient safety.

What they achieved

  • Increased trainee knowledge in patient safety areas.
  • A 4.5% improvement in learning assessment score of trainees across key patient safety areas.
  • Early identification of trainee doctors requiring professional support and an improvement in assessment scores after remedial action.
  • A 6% increase in the use of antibiotic stop date prescriptions (antibiotics documented on the electronic prescribing system with a stop date) was reported.

What they’ve said

“I think that the information on the VITAL website is quite useful to being a junior doctor, some of the modules were really good” Trainee

“There were quite a few things that you could link to your portfolio, say if you were doing a reflection on discharge planning, there were quite a few modules that I couldn’t have got evidence for learning from other places” Trainee

“There was a lot of information in it that perhaps we didn’t learn at medical school” Trainee


Please look at the toolkit materials in the document 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.

[1] The team STEPPS programme focuses on four competency areas that lead to improved team performance, safer practices, and change in culture:

  • Leadership – how to direct and coordinate, assign tasks, motivate team members, facilitate optimal performance.
  • Situation monitoring – how to develop common understandings of team environment, apply strategies to monitor teammate performance and maintain a shared mental model.
  • Mutual support – how to anticipate other team members’ needs through accurate knowledge and shift workload to achieve balance during periods of high workload or stress.
  • Communication – how to effectively exchange information among team members, regardless of how it is communicated.

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