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24 July 2018
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Junior doctor representative groups (JDRGs) and communities of practice (CoPs)

Junior doctor representative groups (JDRGs) are a more dynamic way for junior doctors to engage with their employing organisation and contribute to its wider organisational priorities. JDRGs are not defined by contractual requirements or other guidance, and their membership is not limited to doctors who currently work at the host trust.
Many JDRGs have existed for a number of years prior to the implementation of the 2016 TCS, some have been created more recently. There is no national, formal review of their structure and function, but anecdotal evidence suggests that most have been launched by or with the support of the DME.

Early JDRG models were similar to informal JDFs. Junior doctors would discuss training concerns as a homogenous group and these would be addressed by the DME and postgraduate centre manager. More recently these forums have evolved due to emergent leadership from junior doctors and a need to address training concerns raised by LETBs (Local Education Training Boards) or Deaneries, the GMC, or trainee surveys.

JDRGs, especially those launched or re-designed by junior doctors’ leaders, are in keeping with communities of practice (CoPs). A CoP has three components that distinguish it from other forums or networks – a domain, a community, and a practice:

  • Domain – a clearly defined shared interest and a commitment to that end (eg improving junior doctor training, improving patient safety etc)
  • Community – members of a specific domain interact, collaborate, and share information with each other. Community co-ordinators (or representatives) are key to maintaining the group dynamic
  • Practice – members share resources which can include stories, tools, experiences and solutions. Problems are shared and solved together in the social learning environment. Community co-ordinators and community librarians are responsible for making sure these conversations are ‘cutting edge issues’ for expert members. More junior members are often inspired by expert problem solving and gaps between member knowledge can be bridged by mentoring or buddying to keep the CoP together.

This model has been replicated in NHS settings (see Case Study: Oxford University Hospitals JDRG and Case Study: Leeds Teaching Hospital Trust JDB). JDRGs can still get senior management and executive buy-in if they are linked to organisational outcomes such as patient safety (Case Study: Hull) and morale and leadership (Case Study: Nottingham University Hospital). JDRGs that evolve from the top of organisational hierarchies produce more sustainable change and improvement in outcomes (Wathes & Spurgeon, 2016). 

JDRGs are an excellent vehicle for organisations to improve engagement with junior doctors and empower them to contribute to the organisation’s objectives. JDRGs in a variety of structures across the country have contributed significantly in domains of quality improvement, leadership training and workforce engagement. Their role can encompass much of the contractual responsibility required of JDFs and provide additional value to trainees as well as their organisation. JDRGs can also provide junior doctors who no longer work at the trust a way of continuing to contribute to ongoing improvement work.

Suggested further reading

CoPs are a concept evolved from a learning theory on the idea of legitimate peripheral participation (Lave & Wenger, 1991). CoPs are “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis” (Wenger et al, 2002).

CoPs are organic and distinct from a hierarchical line management structure. They can exist within large organisations in order to yield innovation over time. In corporate settings, employers have hired knowledge managers and provided resources for employees to create a CoP, eg Google (Bates, 2017) and Shell (Wenger et al, 2002).

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