title: Perceptions of the learning environment in higher specialist training of doctors: implications for recruitment and retention.
abstract: BACKGROUND
  Career choice, sense of professional identity and career behaviour are influenced, subject to change and capable of development through interaction with the learning environment. In this paper workplace learning discourses are used to frame ongoing concerns associated with higher specialist training. Data from the first stage of a multimethods investigation into recruitment into and retention in specialties in the West Midlands is used to consider some possible effects of the specialist learning environment on recruitment and retention.
  
  
  METHODS
  The aim of the study was to identify issues, through interviews with 6 consultants and questionnaires completed by specialist registrars from specialties representing a range of recruitment levels. These would inform subsequent study of attributes and dispositions relevant to specialist practice and recruitment. The data were analysed using NVivo software for qualitative data management.
  
  
  RESULTS
  Participants' perceptions are presented as bipolar dimensions, associated with: curriculum structure, learning relationships, assessment of learning, and learning climate. They demonstrate ongoing struggle between different models of workplace learning.
  
  
  CONCLUSIONS
  Changes in the postgraduate education of doctors seem set to continue well into the future. How these are reflected in the balance between workplace learning models, and how they influence doctors' sense of identity as specialists suggests a useful basis for examination of career satisfaction and recruitment to specialties.
authors.affiliation: School of Health, University of Wolverhampton, Wolverhampton, UK. vinette.cross@wlv.ac.uk
authors.forename: Vinette
authors.initials: V
authors.lastname: Cross
authors.forename: Carolyn
authors.initials: C
authors.lastname: Hicks
authors.forename: James
authors.initials: J
authors.lastname: Parle
authors.forename: Stephen
authors.initials: S
authors.lastname: Field
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D004503:Education, Medical, Graduate; D004739:England; D007588:Job Satisfaction; D008505:Medical Staff, Hospital; D010465:Perception; D010560:Personnel Selection; D017009:Professional Autonomy; D013038:Specialization; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*