Article Text

Download PDFPDF
Distilling the core meaning of medical engagement to three junior doctor staff groups in a Welsh Health Board
  1. Thomas Cromarty1,
  2. Rachel Rayment1,
  3. Patti Mazelan2,
  4. Fred Barwell2,
  5. Peter Spurgeon3,
  6. Graham Shortland1
  1. 1 Cardiff and Vale University Health Board, Cardiff, UK
  2. 2 Applied Research Ltd, Birmingham, UK
  3. 3 Medical School, University of Warwick Warwick Medical School, Coventry, UK
  1. Correspondence to Dr Thomas Cromarty, Paediatrics, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; thomas.cromarty{at}


Background Health systems demonstrate that levels of staff engagement correlate with a variety of performance indicators, including mortality, morbidity, staff sickness. The purpose of this paper is to help healthcare managers and clinical leaders gain greater clarity in understanding the core concepts which drive medical engagement for junior doctor staff groups.

Methods A total of 245 members of medical staff completed the Medical Engagement Survey (MES) with a local focus in a participating Welsh University Health Board in April 2018. In this paper a mixed-methods research approach is described. Both quantitative and qualitative data have been collected and analysed as part of the MES and these are interpreted and integrated with the aim of highlighting insightful links between the various methodological perspectives (as described by Shorten and Smith).

Results The findings reported are the results of the first purposive sample from an application of the MES targeted specifically at junior doctors.

Though improvements in medical engagement often require a cultural change over the longer term, trainees have highlighted to the organisation valuable opportunities for quick wins. These capture the essence of what medical engagement really means to Junior Doctor Staff groups.

  1. Being kept informed in a flexible and timely manner about any changes in systems, job roles and rotas.

  2. Having more time outside ward duties to develop and progress effectively through training.

  3. Being undervalued by senior management and poor communication with medical staffing.

Conclusion The systematic surfacing of these core issues may potentially help keep sight of fundamental staff priorities when attempting to enhance levels of medical engagement. Although these views are from one Health Board, they mirror findings elsewhere. Disengaged junior doctors may be part of continuing the wider problem of lack of engagement in senior staff as they themselves become more senior and influential.

  • medical leadership
  • trainees
  • doctor
  • engagement
  • performance management

Data availability statement

Data may be obtained from a third party and are not publicly available. Data are available with Applied Research, please contact

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data may be obtained from a third party and are not publicly available. Data are available with Applied Research, please contact

View Full Text


  • Twitter @tomcromarty

  • Contributors TC and the Engagement Team (RR and GS) worked with Applied Research (PS, PM and FB). TC and RR adapted and developed the survey. PM and FB provided the data analysis. GS, PS and TC wrote the article.

  • Funding This research was undertaken as part of a Welsh Clinical Leadership Fellowship.

  • Competing interests TC is a junior doctor, training in NHS Wales. PS, FB and PM provide MES on national basis.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.