Bryan Burford

• PhD
• Lecturer at Newcastle University

Background NHS dentistry is experiencing significant recruitment and retention challenges, particularly in rural, coastal, and deprived urban areas. Issues have been exacerbated by the Covid-19 pandemic, leading to unequal distribution of dental professionals across UK geographies. Despite workforce policy initiatives, issues persist. This study ex...

Objectives Explore what is known about the impact of changes made at a national level to UK postgraduate medical education during COVID-19. Design A scoping review, following Arksey and O’Malley’s framework, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist....

Background The healthcare workforce is in crisis. Despite a competitive selection process, a substantial number of doctors leave specialty training (ST) programmes prematurely. This attrition causes increased costs for the National Health Service, exacerbates workforce shortages and threatens quality and safety of care. It also increases pressure o...

Background Patient contact is integral to undergraduate medical training. While political strategies emphasise the ‘patient’s voice’ in medical education, the literature on how to enhance the active involvement of real-time patients is sparse. Increased demands for real-time patient interactions in primary care poses a challenge for educators to pr...

Background: Global and United Kingdom (UK) primary care face significant General Practitioner (GP) workforce shortages. Worldwide strategies to address this issue include the introduction of additional healthcare professionals and increasing technology utilisation, to reduce GP workload. However, whether these strategies can sustain the GP workforc...

Context The COVID-19 pandemic led to an increase in numbers of patients dying at home in the UK, meaning that general practitioners (GPs) were exposed to more patient death than would be pre-COVID. This project aimed to gain insight into GP trainees’ experiences of patient death between March and July 2020. This insight can inform support for GPs,...

Background Social Media (SoMe) as a learning tool, though ubiquitous in society and popular within medical education, is often criticised as superficial. Its limitless output has been blamed for encouraging shorter attention spans and shirking in‐depth reflection. The evidence base is itself superficial and lacking rigour or meaning. We aimed to co...

Objectives This study addressed two research questions: What factors do doctors in training describe as influencing their choices to apply (or not apply) for specialty training during their Foundation Year 2? Which of these factors are specific to the context of the COVID-19 pandemic, and the unique experiences of the cohort of doctors who qualifie...

Background UK general practice has been described as being in crisis. A shortage and exodus of GPs is an urgent and challenging problem, attracting significant media attention, widespread public debate, and policy action. Aim Our review aims to examine which aspects of the healthcare system affect GP workforce sustainability, how, why, and for who...

Background Role models encountered during undergraduate training play an important part in shaping future doctors. They can act as powerful attractants towards, and deterrents away from a career in general practice. Many general practitioner (GP) educators who act as role models are burnt-out and wish to leave the profession which may limit their a...

Introduction There are not enough general practitioners (GPs) in the UK National Health Service. This problem is worse in areas of the country where poverty and underinvestment in health and social care mean patients experience poorer health compared with wealthier regions. Encouraging more doctors to choose and continue in a GP career is a governm...

Background Ambiguity and uncertainty are inherent within the practice of medicine. While theory suggests the construct may be multidimensional, scales such as the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) act unidimensionally, at least in a local population. Therefore, the dimensionality of the Tolerance of Ambiguity (ToA) con...

In a rapidly changing healthcare environment, we need a robust evidence base to inform effective education and training. This study aimed to examine factors perceived to determine career progression in clinical education research in the UK. Six online focus groups were conducted, with 35 participants from a range of medical, dental, nursing, and al...

Objectives This study considered a novel ‘interim’ transitional role for new doctors (termed ‘FiY1’, interim Foundation Year 1), bridging medical school and Foundation Programme (FP). Research questions considered effects on doctors’ well-being and perceived preparedness, and influences on their experience of transition. While FiY1 was introduced i...

Problem: There are not enough General Practitioners (GPs) in the UK National Health Service. This problem is worse in areas of the country where poverty and underinvestment in health and social care mean patients experience poorer health compared with wealthier regions. Encouraging more doctors to choose and continue in a GP career is a government...

Introduction: The goal of medical education is to develop clinicians who have sufficient agency (capacity to act) to practise effectively in clinical workplaces and to learn from work throughout their careers. Little research has focused on experiences of organisational structures and the role of these in constraining or affording agency. The aim...

Background and Aims Interprofessional simulation has the potential to enhance the perceived realism of clinical simulation in the education of different healthcare professionals. This study considers how the inclusion of more than one profession in clinical simulation contributes to this psychological fidelity, defined as the subjective perception...

Purpose: Medical students providing support to clinical teams during Covid-19 may have been an opportunity for service and learning. We aimed to understand why the reported educational impact has been mixed to inform future placements. Methods: We conducted a cross-sectional survey of medical students at UK medical schools during the first Covid...

Role modelling has been identified as an important phenomenon in medical education. Key reports have highlighted the ability of role modelling to support medical students towards careers in family medicine although the literature of specific relevance to role modelling in speciality has not been systematically explored. This systematic review aimed...

Introduction In response to the disruption to medical education caused by COVID-19, there is a need for wide-scale robust medical education research and the generation of research capacity for the future. Trainee research collaboratives have demonstrated they can nurture the research skills of students and trainees while delivering high quality res...

Introduction COVID-19 led to global disruption of healthcare and many students volunteered to provide clinical support. Volunteering to work was a unique medical education opportunity; however, it is unknown whether this was a positive learning experience. Methods The COVID Ready 2 study is a national cross-sectional study of all medical students a...

Introduction Patients presenting with undifferentiated illnesses provide valuable learning opportunities for medical students. Evidence detailing the factors that affect patient participation in undergraduate medical education is limited. This study examines how patients regard their participation in teaching consultations in primary care. Methods...

Introduction: COVID-19 led to global disruption of healthcare and many students volunteered to provide clinical support. Volunteering to work was a unique medical education opportunity; however, it is unknown whether this was a positive learning experience. Methods: The COVID Ready 2 study is a national cross-sectional study of all medical student...

Introduction: In response to the disruption to medical education caused by COVID-19, there is a need for wide-scale robust medical education research and the generation of research capacity for the future. Trainee research collaboratives have demonstrated they can nurture the research skills of students and trainees while delivering high quality re...

Bystander action has been proposed as a promising intervention to tackle workplace bullying, however there is a lack of in-depth qualitative research on the direct experiences of bystanders. In this paper, we developed a more comprehensive definition of bullying bystanders, and examined first person accounts from healthcare professionals who had be...

Abstract Background To help promote a flexible and sustainable workforce in dentistry, it is necessary to access accurate and timely data about the structure and nature of the evolving dental team. This paper considers the results and learning from a region-wide dental workforce survey conducted in one area of Health Education England and how the t...

Background: Participation in simulation-based interprofessional education (sim-IPE) may affect students' attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the 'fit' of group membership). We examined this in two questionnaire studies involving students from four univ...

Background Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four univer...

Background Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership by performing a role). We examined this in two questionnaire studies involving two...

Background The ‘patient’s voice’ is increasingly emphasised in educational strategies. However, much of this has focused on patients who have been recruited to have a primary educational role. Students also benefit from interaction with ‘real-time’ patients who attend the clinical settings with diverse health problems. The involvement of these pati...

Objectives To examine what activities constitute the work of Foundation doctors and understand the factors that determine how that work is constructed. Design Cross-sectional mixed methods study. Questionnaire survey of the frequency with which activities specified in curricular documents are performed. Semistructured interviews and focus groups....

Background: Under-representation of some socio-economic groups in medicine is rooted in under-representation of those groups in applications to medical school. This study aimed to explore what may deter school-age children from applying to study medicine. Methods: Workshops were undertaken with school students aged 16-17 years ('Year 12', n = 12...

Background: Digital storytelling ('digistories') offers a way of sharing the personal impact of a condition, if students have limited direct contact. Autistic spectrum disorder (ASD) exemplifies a common condition, where there is need to improve practise in primary care. Hence, we chose this condition to develop and evaluate a digistory. We consid...

Background The emergence of medical students’ professional identity is important. This paper considers this in a snapshot of the early years of undergraduate medical education. From the perspective of social identity theory, it also considers self-stereotyping, the extent to which individuals associate with attributes identified as typical of group...

Background Little is known about how best to implement portfolio-based learning in medical school. We evaluated the introduction of a formative e-portfolio-based supervision pilot for final year medical students by seeking views of students, supervisors and graduates on use and educational effects. Methods Students and supervisors were surveyed by...

In order to gain experience of the skills required when they begin practice, all final-year medical students in the UK undertake a 'student assistantship', working alongside first-year postgraduate doctors. In this study, we examined the learning opportunities open to students in one locality during two periods of assistantship: one in medicine; on...

Alongside providing a knowledge base and practical skills, undergraduate medical education must prepare graduates to immediately begin practice as qualified doctors. A significant challenge is to provide safe learning opportunities that will optimise students’ preparedness to start work. This study examined UK graduates’ preparedness for clinical p...

ContextDespite a growing and influential literature, ‘professionalism’ remains conceptually unclear. A recent review identified three discourses of professionalism in the literature: the individual; the interpersonal, and the societal–institutional. Although all have credibility and empirical support, there are tensions among them. Objectives This...

To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors' experience of fatigue. Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors...

Objectives To examine the prevalence and impact of bullying behaviours between staff in the National Health Service (NHS) workplace, and to explore the barriers to reporting bullying. Design Cross-sectional questionnaire and semi-structured interview. Setting 7 NHS trusts in the North East of England. Participants 2950 NHS staff, of whom 43 took...

Background: Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training. Aim: To examine whether Hofstede's cultural model...

Abstract Newly qualified doctors spend much of their time with nurses, but little research has considered informal learning during that formative contact. This article reports findings from a multiple case study that explored what newly qualified doctors felt they learned from nurses in the workplace. Analysis of interviews conducted with UK doctor...

Objectives: To identify what healthcare organisations, including medical regulators, can do to address the issues and concerns faced by overseas-qualified doctors when moving to the UK. Methods: Qualitative interviews were conducted with sixty-six doctors who had qualified outside the UK and who were entering the first year of the UK Foundation Pro...

Background: There is evidence that graduates of different medical schools vary in their preparedness for their first post. In 2003 Goldacre et al. reported that over 40% of UK medical graduates did not feel prepared and found large differences between graduates of different schools. A follow-up survey showed that levels of preparedness had increas...

Background: The trainee-held learning portfolio is integral to the foundation programme in the UK. In the Northern Deanery, portfolio assessment is standardised through the Annual Review of Competence Progression (ARCP) process. In this study we aimed to establish how current trainees evaluate portfolio-based learning and ARCP, and how these attitu...

Workplace bullying is a persistent problem in the NHS with negative implications for indiduals, teams and organisations. Bullying is a complex phenomenon and there is a lack of evidence on the best approaches to manage the problem.

To measure new consultants' perceptions of their preparedness for different clinical and non-clinical aspects of the role of consultant. A cross-specialty questionnaire was developed and validated, containing items asking how well specialty training had prepared respondents for the role of consultant in a number of clinical and non-clinical areas....

The clinical workplace in which doctors learn involves many social groups, including representatives of different professions, clinical specialties and workplace teams. This paper suggests that medical education research does not currently take full account of the effects of group membership, and describes a theoretical approach from social psychol...

Earlier research indicated that medical graduates feel unprepared to start work, and that this varies with medical school. To examine the extent to which graduates from different UK medical schools differed in their perceptions of preparedness for practice, and compare their perceptions with those of clinical team members. An anonymous questionnair...

This aim of this paper was to explore new doctors' preparedness for prescribing. This was a multiple methods study including face-to-face and telephone interviews, questionnaires and secondary data from a safe prescribing assessment (n= 284). Three medical schools with differing curricula and cohorts were included: Newcastle (systems-based, integra...

To explore perceptions of clinical consultations and how they relate to questionnaire-based patient feedback. Telephone interviews with 35 junior doctors and 40 general practice patients who had used the Doctors' Interpersonal Skills Questionnaire (DISQ). Doctors and patients had similar views of 'good consultations' as relying on doctors' listenin...

Aim: To assess the impact of the National Clinical Assessment Service (NCAS) on governance activity for medical and dental practitioners in Northern Ireland. Method: Telephone interviews were conducted with a purposive sample of referrers to NCAS in Northern Ireland. Results: Twenty-two referrers agreed to take part and nineteen were interviewed. R...

Feedback from colleagues and patients is a core element of the revalidation process being developed by the General Medical Council. However, there are few feedback tools which have been specifically developed and validated for doctors in primary care. This paper presents data demonstrating the reliability and validity of one such tool. The CFEP360...

The effectiveness of multi-source feedback (MSF) tools, which are increasingly important in medical careers, will be influenced by their users' attitudes. This study compared perceptions of two tools for giving MSF to UK junior doctors, of which one provides mainly textual feedback and one provides mainly numerical feedback. We then compared the pe...

Patient feedback has increasing importance in medical careers This paper describes practical issues in the collection of patient feedback Access to the clinical setting varied between hospital and GP environments Personal anxiety about hearing patients' views was offset by its perceived value It is vital that the introduction of patient feedback is...

Questionnaires provide a useful and versatile tool for new and occasional researchers, and can be applied to a wide range of topics. This paper provides simple guidance on some of the potential pitfalls in developing and running a questionnaire study, and how to avoid them. Each tip is illustrated with a real-life example from the development of a...

A learning portfolio was developed to support the development of trainee doctors piloting Foundation Programme prototypes across the Northern Deanery in 2004 and 2005. Trainee doctors and their educational supervisors were surveyed about their experiences of using the portfolio in the clinical workplace. The evaluation consisted of semi-structured...

Surprisingly little is known about how different users conduct image searches. As a result, even the most sophisticated systems available have limited appeal to the end-user. This paper describes a study eliciting user requirements for future image databases through an online questionnaire. 125 experienced image searchers were questioned about the...

Image database (IDB) systems are at present often designed to test technology and the efficacy of retrieval algorithms, rather than being oriented towards delivering functionality to users. Research is necessary to design interfaces geared towards human usage of images. The starting point of this research needs to be consideration at a fundamental,...

Many people are now influenced by the information and advice they find on the Internet, much of it of dubious quality. This article describes two studies concerned with those factors capable of influencing people’s response to online advice. The first study is a qualitative account of a group of house-hunters attempting to find worthwhile informati...

While a great deal of research has demonstrated that users' self-efficacy beliefs have a major impact upon both their attitudes to technology and their performance, a related construct, self-confidence, has been largely ignored within the domain of human–computer interaction. This is surprising given the vast literature on the calibration of confid...

Many people are now influenced by the information and advice they find on the Internet, much of it of dubious quality. This paper is concerned with those factors capable of influencing people's response to online advice. It describes a survey of over two and a half thousand people who had actively sought advice over the Internet. A framework for un...