Table 1
Participant distribution by training level and country.
| TRAINING LEVEL | NUMBER OF PARTICIPANTS | ANAESTHETISTS IN SWEDEN | ANAESTHETISTS IN ENGLAND |
|---|---|---|---|
| Year 1–2 | 8 | 6 | 2 |
| Year 3–7 | 10 | 4 | 6 |
| Consultants | 11 | 5 | 6 |
[i] Table showing participant distribution by training level and country.
Table 2
Contextual features of postgraduate anaesthesia training in England and Sweden.
| DIMENSION | ENGLAND | SWEDEN |
|---|---|---|
| Regulatory locus | Curriculum developed by the Royal College of Anaesthetists and approved by the General Medical Council. | National specialist training regulation issued by the National Board of Health and Welfare, with specialty-specific recommendations developed by the Swedish Society of Anaesthesia and Intensive Care. |
| Supervision structure | Named educational supervisor and clinical supervisors; structured appraisal and documentation processes. | Principal supervisor and director of studies; supervision embedded within clinical service and local structures. |
| Assessment culture | Use of workplace-based assessments alongside national summative examinations (e.g., FRCA) within a nationally defined framework. | Assessment of competence embedded in supervised clinical service, together with completion and documentation of mandatory educational activities, including required courses. |
| Progression logic | Formal review of progression conducted within a nationally standardised Annual Review of Competence Progression (ARCP) process. | Formal review of progression conducted locally through documented fulfilment of nationally regulated learning outcomes, typically discussed within a local specialist review meeting (ST-kollegium). |
Table 3
Summarises the three conceptions of the implicit curriculum and their variation across five dimensions of learning.
| CONCEPTIONS → | ORIENTATION TOWARD THE EXPLICIT CURRICULUM | AWARENESS OF THE IMPLICIT CURRICULUM | ENGAGEMENT WITH THE IMPLICIT CURRICULUM |
|---|---|---|---|
| DIMENSIONS OF VARIATION ↓ | |||
| Communication | Communication learned through formal frameworks and feedback. ‘…break down into physical dexterity skills and leadership and communication skills’ (E2) | Communication shaped by observation and peer interactions. ‘You see how people de-escalate tension in a team or how they clarify misunderstandings…’ (E9) | Communication adapted flexibly to team, patient, and context. ‘…able to tailor that communication both to the surgeon that they’re working with, the rest of the theatre team, the patient, the trainees…’ (E5) |
| Collaboration | Collaboration defined by hierarchical roles. ‘There’s a lot of time spent one-to-one with your seniors, which is an amazing way to learn skills really thoroughly…’ (E2) | Collaboration involves mentorship and dialogue, but within structured roles. ‘I never feel that I’m standing there pondering and coming up with things on my own….’ (S2) | Collaboration experienced as shared expertise and flat hierarchy. ‘…it’s the flattening of hierarchy and saying, well as a consultant, I don’t necessarily know more.’ (E2) |
| Decision-making | Decisions follow protocols and authority. ‘I think about physiology and pharmacology and then I think about the guidelines…’ (S10) | Decisions integrate situational awareness and team input. ‘…most of that sort of procedural learning has a relatively baseline standard…There are other more challenging things…’ (E5) | Decisions balance pattern recognition, flexibility, and judgement. ‘It’s that feeling that guides all my choices…. It’s of course the sum of previous experiences’ (S13) |
| Autonomy | Autonomy = structured supervision. ‘…there are a number of core skills that you need to establish and get under your belt…’ (E2) | Autonomy grows through incremental responsibility. ‘You learn where your limits are. At first, you ask for help with everything. Then you start making small decisions on your own.’ (E8) | Autonomy = self-directed learning and confident judgement. ‘…if one had been completely passive, I don’t think one would have gotten there…’ (S3) |
| Emotional intelligence | Emotional intelligence framed by formal feedback. ‘Even better, afterwards we can sit down and discuss what I found difficult, and he can give me feedback’ (S10) | Emotional intelligence refined through reflection and peer input. ‘Okay, well, what would I do differently in that scenario again?’ (E8) | Emotional intelligence developed through empathy, resilience, and self-awareness. ‘Allowing your own reactions to the challenges we face to influence the treatment, actions, or how you lead the team…’ (S12) |