How might we best support dyslexic medical students and foundation doctors in safe and effective prescribing?

Background:

Foundation doctors are responsible for most of the prescribing of medicines in the acute care setting in the United Kingdom, and unsurprisingly they also have the highest prescribing error rate in comparison to more experienced prescribers. Furthermore, medical students do not feel adequately prepared for prescribing in the foundation years after graduation. Dyslexia is a specific learning difference that related to reading and writing without impacting on intelligence. Prescribing is a complex task and may be more challenging for dyslexic doctors than for their non-dyslexic peers. One study has demonstrated that medical students requiring reasonable adjustments underperform in the national Prescribing Safety Assessment in terms of both score and pass-rate. Further research is required to better understand the possible reasons for this.

Little is known about the social world of dyslexic doctors in relation to both the learning and undertaking of the prescribing of medicines. This PhD studentship is aimed at beginning to fill this dearth of research. The successful applicant will be supported in undertaking both qualitative and quantitative approaches to research in this subject area, which will culminate in a national survey of the experiences of dyslexic medical students and foundation doctors in relation to the prescribing of medicines.

Methods:

1) Literature review. This will include transferable concepts from related disciplines.

2) Focused ethnographic study. The doctoral candidate will recruit 15-25 dyslexic FY1/FY2 doctors for this stage. Data will be collected in the following ways:

•          Direct participant observation in clinical settings.

•          In situ interviews.

•          Focus group discussions.

3) Questionnaire validation study. The doctoral candidate will create and validate an online questionnaire, using the findings from the ethnographic study. The primary aim of this survey will be to quantify our qualitative findings. This will be piloted and validated for the following:

•          Content validity.

•          Face validity.

•          Test-retest reliability.

4) National survey of medical students and foundation doctors using the validated questionnaire.

Research Plan:

Phase 1: A review of existing policy and literature surrounding prescribing education, the act of prescribing in clinical settings and dyslexia in medicine/medical education. (4 months)

Phase 2: Utilising focused ethnography, an exploration of the culturally grounded experiences of dyslexic foundation doctors will be performed. This aims to generate a rich description of their world in relation to safe and effective prescribing. (12 months)

Phase 3: This will entail the creation and validation of an online questionnaire, using the findings from the ethnographic study. The main aim of this survey will be to quantify qualitative findings. (6 months)

Phase 4: This will entail the distribution and analysis of the online questionnaire nationally to dyslexic medical students and foundation doctors (8 months).

Phase 5: Analysis of data, thesis write up and publications. (6 months)

Support:

The doctoral candidate will benefit from a diverse supervisory team and the supportive collaboration of John Anderson. Our backgrounds and interests span across medicine, disability studies, critical autism studies, sociology, medical education, social justice, and participatory research. Our supervisory team includes lived experience of neurodivergence. SS (second supervisor) is dyslexic/autistic/ADHD. We strive to create a supportive, neurodiversity-affirmative research/educational environment.

Applicants:

We encourage applications from a wide range of backgrounds, not just medical/healthcare. We particularly encourage applications from those with social science backgrounds and/or those with previous experience in ethnography or wider qualitative research approaches. We also actively encourage applications from neurodivergent candidates. 

How to apply

In order to apply, please visit the University of Brighton website (StudentView (brighton.ac.uk), and select “Doctoral College” as the School. You should then select the project that you wish to apply for. 

Interviews will take place on Friday 14 June 2024.