Foundation Doctors and Dyslexia
A total of 800 invitations were emailed to FY1 doctors in Scotland; nine doctors responded and seven agreed to telephone interviews during their fifth to tenth month of employment as doctors in the NHS. Six participants were women, and one man; current ages ranged from 23 to 31 years, with diagnoses made at between 7 and 20 years of age (Table 1).
Interview data underwent a process of thematic coding according to a constructivist grounded theory approach. This approach acknowledges the value and a priori knowledge and experience brought to the process by the researchers, while focusing the interpretation on the data, thus 'grounding' the analysis on what emerges from the data, rather than applying analysis to preconstructed frameworks. This process involved independent immersion in the data, and constant comparison of emergent themes. As a result, three broad categories, with six to seven themes in each, were refined in a process of concept mapping.
Several common themes describing difficulties perceived to be linked to dyslexia emerged from the interviews (Table 2). These themes represent the perceived manifestation of these doctors' difficulties in a uniquely specific context. Some difficulties were thought to be solely attributed to dyslexia while others difficulties were recognised by interviewees as being common to all FY1 doctors but felt to be exacerbated by dyslexia. Of particular note were concerns about reading speed and reading handwriting as opposed to typed text; using numbers particularly relating to patient identification; writing immediate discharge letters and prescribing; and also prioritising. These specific difficulties caused a lot of anxiety and stress on ward rounds and educational events, and difficulties in taking telephone messages.
Seven themes for coping strategies emerged where each of the foundation doctors described strategies that they had devised or learnt to enable them to cope with the stressors of the job specifically relating to dyslexia (Table 3). One of the most common strategies described by the participants involved a process of safety-netting, spending extra time double and triple checking work and preparing for tasks. Information technology assistance was occasionally used but did not provide dramatic solutions.
Foundation doctors' acceptance of their diagnosis and difficulties associated with dyslexia emerged as a category, in which six themes were identified (Table 4). The most frequently occurring themes were those of disclosure and insight. Participants had a level of insight into their difficulties that enabled them to reflect on whether a difficulty was likely to be caused by their dyslexia, exacerbated by it or if it was something they felt everyone (dyslexic or not) would experience.
The doctors were specifically asked whether they had disclosed their dyslexia to others; the majority had not done so. One interviewee commented that if they disclosed that they had dyslexia their colleagues might think that this was an example of 'help-seeking behaviour' and that dyslexia was being used as an excuse for underperformance or poor performance.
Results
Participants
A total of 800 invitations were emailed to FY1 doctors in Scotland; nine doctors responded and seven agreed to telephone interviews during their fifth to tenth month of employment as doctors in the NHS. Six participants were women, and one man; current ages ranged from 23 to 31 years, with diagnoses made at between 7 and 20 years of age (Table 1).
Development of Themes
Interview data underwent a process of thematic coding according to a constructivist grounded theory approach. This approach acknowledges the value and a priori knowledge and experience brought to the process by the researchers, while focusing the interpretation on the data, thus 'grounding' the analysis on what emerges from the data, rather than applying analysis to preconstructed frameworks. This process involved independent immersion in the data, and constant comparison of emergent themes. As a result, three broad categories, with six to seven themes in each, were refined in a process of concept mapping.
Dyslexic Difficulties
Several common themes describing difficulties perceived to be linked to dyslexia emerged from the interviews (Table 2). These themes represent the perceived manifestation of these doctors' difficulties in a uniquely specific context. Some difficulties were thought to be solely attributed to dyslexia while others difficulties were recognised by interviewees as being common to all FY1 doctors but felt to be exacerbated by dyslexia. Of particular note were concerns about reading speed and reading handwriting as opposed to typed text; using numbers particularly relating to patient identification; writing immediate discharge letters and prescribing; and also prioritising. These specific difficulties caused a lot of anxiety and stress on ward rounds and educational events, and difficulties in taking telephone messages.
Coping Strategies
Seven themes for coping strategies emerged where each of the foundation doctors described strategies that they had devised or learnt to enable them to cope with the stressors of the job specifically relating to dyslexia (Table 3). One of the most common strategies described by the participants involved a process of safety-netting, spending extra time double and triple checking work and preparing for tasks. Information technology assistance was occasionally used but did not provide dramatic solutions.
Acceptance
Foundation doctors' acceptance of their diagnosis and difficulties associated with dyslexia emerged as a category, in which six themes were identified (Table 4). The most frequently occurring themes were those of disclosure and insight. Participants had a level of insight into their difficulties that enabled them to reflect on whether a difficulty was likely to be caused by their dyslexia, exacerbated by it or if it was something they felt everyone (dyslexic or not) would experience.
The doctors were specifically asked whether they had disclosed their dyslexia to others; the majority had not done so. One interviewee commented that if they disclosed that they had dyslexia their colleagues might think that this was an example of 'help-seeking behaviour' and that dyslexia was being used as an excuse for underperformance or poor performance.
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