bluuebunny/crossref_metadata_2025_split huggingface dataset:
383 An International Comparison of Competency-Based Orthopaedic Curricula and Minimum Operative Numbers
Authors: Tahir M , Rahman U , Gulati A 
Published: May 2021

Abstract

Introduction
The requirements for completion of surgical training can vary across different countries. This review aims to assess key differences among orthopaedic curricula in selected high-income countries, focusing on their criteria for assessing technical competence for completion of training.

Method
Current orthopaedic training curricula in the UK, USA, Canada, Australia, and Germany were reviewed. Data extracted included training duration, minimum or desirable operative experience requirements, methods, and timing of in-training assessments.

Results
The overall training duration ranged between 9-10 years in the UK and Australia, compared to 5-6 years in all other countries. While operative logbook was an essential component of formative and end-of-training reviews in all countries, minimum indicative numbers in index operations were a requirement only in the UK (minimum total required; 1800, index operations; 365) and USA (minimum total required; 1000, index operations; 455). On average, USA residents performed 1,700 procedures compared to German residents performing 730 procedures before completion of training.

Conclusions
There is a lack of robust data describing the operative experiences of orthopaedic trainees outside of the UK and USA. Contrary to common perception, surgeons exiting training and entering independent practice in the above countries are not trained to the same minimum standard.
394 An Anatomy Near-Peer Teaching Programme
Authors: Stubley T , Taylor J 
Published: May 2021

Abstract

Introduction
The time dedicated to teaching of anatomy in medical schools, as well as the importance placed upon it, is decreasing. Many students struggle with learning the vast quantity of information necessary and few medical students receive instruction on how to teach. A near-peer teaching programme was designed to allow tutors to develop vital teaching skills and provide tutees with a closer look at the more complicated aspects of the anatomy course.

Method
Sessions took place once or twice a week throughout the academic year and were subdivided into examination technique sessions, core anatomical knowledge sessions and prosection sessions. Tutors were recruited primarily from the intercalated Clinical Anatomy BSc. Tutees were provided anonymous feedback forms following each session and completed pre and post session MCQ tests. Tutors completed a feedback form following the programme’s completion.

Results
96.9% of students reported an improvement in understanding of the topic. Students reported an increase in how prepared they felt for examinations (p &lt; 0.001) as well as an improvement in MCQ scores (p &lt; 0.001). 93.8% of tutors stated the programme helped prepare them for future teaching.

Conclusions
The results of this programme strongly support the use of near-peer teaching in anatomy education, with clear benefits for tutors and students.
423 Massive Open Online Courses in Anatomy Education: A Systematic Review
Authors: Cheong J , Keenan I 
Published: May 2021

Abstract

Introduction
Massive open online courses (MOOCs) have become increasingly popular for remotely delivering education to global audiences. MOOCs can provide an online platform for participants coming from a variety of professional backgrounds and international locations. Our systematic review investigated current literature surrounding MOOCs, and identified the value of such courses with respect to anatomical and medical education.

Method
Our literature search strategy involved exploring the PubMed database for the terms ’MOOC + Anatomy’ and ‘MOOC + Medical Education’ identified 290 relevant articles. Following implementation of the PRISMA criteria, 24 articles out of 290 were selected for inclusion in our systematic review.

Results
Participants completing MOOCs in anatomical and medical education generally showed increased knowledge and skills. We found that MOOC discussion forums encourage participants’ social learning development. MOOCs have shown to address participants’ needs and expectations while supplementing traditional learning approaches. However, the majority of experimental research studies did not include pre-post testing or appropriate controls. Furthermore, high levels of participant attrition, inability to address all learning approaches were identified as limitations with respect to MOOCs.

Conclusions
Although MOOCs have shown success in providing an excellent platform for learning, it has yet to show definitive improvements when compared to traditional teaching methods.
432 What Are the Promoting and Discouraging Factors for Choosing A Career in Surgery According to Undergraduate Medical Students in A District General Hospital? A Questionnaire and Review of The Literature
Authors: Harris C 
Published: May 2021

Abstract

Introduction
The aim was to identify which factors promote and discourage undergraduate medical students, based in a district general hospital, for choosing a career in surgery. A review of the current literature on this topic was undertaken in conjunction with the questionnaire.

Method
An online structured questionnaire was sent to all undergraduate clinical medical students based in Northumbria Specialist Emergency Care Hospital (NSECH), a teaching DGH. As well as the questionnaire, a systematic review of the literature was conducted on EMBASE, MEDLINE and Google Scholar using key search terms to review factors that influenced surgical career choices.

Results
The response rate was 46% (44/95). 75% of students rated variety of work, intellectually interesting and environment as the most important factors for their future careers. Status, financial rewards, and research opportunities were least important influences for respondents’ career decision making. A systematic literature review highlights that lifestyle factors, work-life balance were particularly important, perceived prestige and financial rewards were associated surgical career choices amongst medical students.

Conclusions
Multiple factors influence medical students career decision making and it is important to identify these factors for many reasons. Further research is recommended to further explore medical students’ perceptions on promoting and discouraging factors for surgical careers.
435 A Prospective Study of Post-operative Surgical Site Infection
Authors: Shah J 
Published: May 2021

Abstract

Introduction
Organ specific surgical site infections are those that involve any part of the anatomy other than the incised body wall layer opened or manipulated during an operation. The proper understanding of bacteriology and mode of infections has surely reduced the incidence of wound infection, but it is not totally controlled.

Method
A total of 582 consecutive patient undergoing major and minor surgeries between March 2010 and October 2011 were included in the study. Detail history, physical examination, laboratory and radiological investigation according to Performa with special reference to any factor that could lead to postoperative infection – Age, sex, socioeconomic status, nutrition was recorded. Initial assessment of intra operative findings divided these cases into clean, clean contaminated, contaminated and dirty SSI.

Result
A total of 582 patients out of these, 100 have SSI, SSI rate in our hospital was found to be 17.18% including all classes of wounds. Coagulase positive staphylococci were responsible for a majority of SSIs and mixed infections were quite common. The other microorganism responsible for SSIs were E.coli, Coagulase negative staphylococci, Pseudomonas and Proteus etc.

Conclusions
The data from our study suggests a need to control modifiable risk factor responsible for development of SSI.
449 Exploring the Use of Virtual Reality in Dermatology Surgery Training
Authors: Kabbani J , Kabbani J 
Published: May 2021

Abstract

Introduction
The role of technology in surgery is continuously evolving, with the use of Virtual Reality (VR) transcending specialties for both practical and educational purposes. VR measures, analyses, and incorporates information into computer-generated environments and has been increasingly used in dermatology. We performed a literature review to assess the merits of VR for dermatological surgery training.

Method
A literature search of PubMed was conducted using the key words “surgery”, “dermatology” and “virtual”. Primary studies assessing the merits of VR for dermatological surgery training were included.

Results
Of 51 articles found, 7 discussed the application of VR in dermatological surgery. Proposed benefits include improved knowledge-retention in trainees, possibly due to the removal of time restrictions imposed with physical cases, as well as increased exposure to rarer presentations. However, concerns include cost considerations and reduced opportunities for developing communication skills. Although VR tools for practicing communication exist, their effectiveness and impact on behaviour remain undetermined.

Conclusions
The use of VR for training in other surgical specialties, alongside demonstrated benefits in the use of VR for dermatological surgery, lends merit to further assessment and incorporation of VR in dermatology training. However, clinicians should be wary of neglecting “soft skills,” such as communication.
536 Use of A Cost-Efficient Colonoscopy Simulation Model to Improve Endoscopy Skills During the COVID Pandemic
Authors: MacDonald S , Edgar B , Stokes E , McDade D , Anderson J , Macdonald A 
Published: May 2021

Abstract

Introduction
The use of endoscopic simulators as a learning aid in surgical training has been well established. This has been emphasised during the challenging times of COVID-19. However, their utility for training is countered by the high cost of the equipment, with the most basic simulators costing upwards of £50,000.

Method
A simple polypectomy simulator model was created using a drain-pipe and surgical gloves. n = 9 junior doctors were timed in their ability to remove the 3 polyps from the simulator. The exercise was repeated over 6 sessions over the course of 3 weeks. Means were compared using ANOVA.

Results
There was a mean relative reduction of 75% in overall time taken to complete the task(p &lt; 0.0001). This improvement was seen for both surgical trainees(p = 0.005) and FY1 novices(p &lt; 0.0001) and junior doctors reported feeling more confident with basic Colonoscopic skills.

Conclusions
We have demonstrated an improvement in performance times across both surgical trainees and novices. In today’s era of COVID-19, when direct training opportunities may become more scarce, simple alternatives may become vital in ensuring progression of basic surgical skills such as endoscopy. This cheap polypectomy simulator can be easily re-created across surgical units and can be used as an adjunct to traditional endoscopic training
563 Dural Tear Closure Training: A Study of a Low-Cost Model
Authors: Thomas D , Dale V , Wills-wood W , Collins I , Springall A , Boss J 
Published: May 2021

Abstract

Introduction
We developed a low cost, easily replicable model that can be used to learn dural tear techniques without posing a risk to patients, therefore, increase patient safety. The aim of this is to produce trainees that are more confident in dural tear closure, reducing the chance of post-operative CSF leak.

Method
Consultants, trainees and medical students completed a training exercise supervised by a consultant spinal surgeon. After they had completed the exercise satisfactorily, participants scored from ‘very much improved’ to ‘very much deterioration’ on a self-assessment 7-point likert scale. Qualitative questions were also asked to assess the accuracy of the model.

Results
60% stated that their skills were ‘a little improved’, and 20% were ‘very much improved’. The consultants were evenly split, with 50% stating that there was ‘no change’. However, 50% of consultants and all the trainees found skills ‘a little improved’. Overall, the model was agreed to be an accurate representation of a dural tear and that it would be useful in clinical training.

Conclusions
show that improving dural tear closure training can be achieved with our model. It is low cost, and manufacturable with equipment that clinical professionals have on hand.
592 Surgical Management of Open Tibia Fractures at A Major Trauma Centre: A Review of Cases Over A One-Year Period
Authors: Khajuria A 
Published: May 2021

Abstract

Introduction
The BOAST/BAPRAS updated the open fracture guidelines in December 2017 to replace BOAST 4 Open fracture guidelines; the changes gave clearer recommendations for timing of surgery and recommendations for reducing infection rates.

Method
Our work retrospectively evaluates the surgical management of open tibia fractures at a Major Trauma Centre (MTC), over a one-year period in light of key standards (13,14 and 15 of the standards for open fractures).

Results
The vast majority of cases (93%) had definitive internal stabilization only when immediate soft tissue coverage was achievable. 90% of cases were not managed as ‘clean cases’ following the initial debridement. 50% of cases underwent definitive closure within 72 hours. The reasons for definitive closure beyond 72hours were: patients medically unwell (20%), multiple wound debridement’s (33%) and no medical or surgical reason was clearly stated (47%).

Conclusions
The implementation of a ‘clean surgery’ protocol following surgical debridement is essential in diminishing risk of recontamination and infection. Hence, this must be the gold standard and should be clearly documented in operation notes. The extent of availability of a joint Orthoplastic theatre list provides a key limiting step in definitive bony fixation and soft tissue coverage of open tibia fractures.
602 Specialty Training Progression from Core Surgical Training: Is There Evidence from Plastic Surgery of The Importance of Location, Location, Location?
Authors: Vinnicombe Z , Little M , Johal K 
Published: May 2021

Abstract

Introduction
Obtaining a National Training Number (NTN) in Plastic Surgery is highly competitive (&lt;40 posts per year), with applicant:post ratios between 3.73 to 4.19 in 2017-2019.
Our aim was to compare deaneries for numbers successfully progressing directly from CT2 into a ST3 post in Plastic Surgery.

Method
Data for surgical trainees progressing directly from CT2 to ST3 (2017-2019) in all specialties was obtained from the GMC. The percentage of those directly progressing that obtained a Plastic Surgery NTN and the total number progressing was calculated.

Results
A total of 840 trainees obtained a NTN directly from CT2 between 2017 and 2019, 61 of whom did so in plastic surgery. Of those directly progressing, there was no significant difference between deaneries for the percentage of plastic surgery posts obtained. The highest number of trainees progressed from London deaneries (16 total (26%); 7 South, 6 NC&E, 3 NW) and the lowest number from Yorkshire and Humber (1).

Conclusions
Higher numbers of those undertaking core surgical training in London progress directly from CT2 to ST3 in Plastic Surgery. Low total numbers highlight the competitive nature of obtaining a Plastic Surgery NTN, necessitating many to undertake additional experience prior to obtaining a training number.
615 Achieving Net Zero Emission by 2050 – The Medical Education Route
Authors: Dunne H , Rizan C , Jones A , Bhutta M , Okorie M 
Published: May 2021

Abstract

Introduction
There is growing demand to reduce the environmental impact of surgery. Healthcare sustainability has recently become a mandatory GMC learning outcome for undergraduates, but expertise amongst faculty and time within the curriculum are limited. We piloted an E-module that uses surgical case studies to teach these concepts.

Method
Evidenced-based multi-media learning principles were used to develop the module. 3rd and 4th year students at Brighton and Sussex Medical School were invited to partake and complete pre- and post-module questionnaires comprising 5-point Likert scales and white-space questions. The primary outcome measures were changes in student-reported understanding of four key concepts:
Environmental impact of healthcare
Influence of climate change on health.
Principles of sustainable clinical practice.
Health co-benefits of climate change mitigation.

Results
33 students completed the E-module. Questionnaire results indicated a significant increase in understanding of all key concepts (p &lt; 0.001). Students most commonly rated improving sustainability of healthcare as ‘extremely important’. Common themes within white space responses included the importance of preventative medicine and that the module was informative, interactive, user-friendly, and engaging. The majority (81%) strongly agreed that all undergraduates should undertake this module.

Conclusions
This E-module is an effective and COVID-19-safe resource. Adapting this module for postgraduate surgical education should be explored.
641 What Is the Most Reliable Way to Secure A Surgical Drain?
Authors: Hughes B , Stallard J , Jivan S 
Published: May 2021

Abstract

Introduction
Surgical drains are used by many specialities, we aim to determine the most robust method of securing them by comparing suturing technique, material and fixation angle.

Method
A Blake’s drain was inserted into a piece of pork belly and secured using a standard ‘three half hitch’ technique with 3.0 Silk, EthilonTM and ProleneTM . For each suture type, drains were sutured in line, at 45 and 90 degrees to the course of the drain. The force needed for the suture to failure was measured and each repeated 3 times. Different suture techniques were then used to determine the strongest fixation.

Results
With the drain exiting inline the moment of failure was, on average, 1.25kg for silk, 3.5kg for EthilonTM and 4.0kg for ProleneTM. Increasing drain fixation angle required more force for the suture to fail. With EthilonTM and ProleneTM, the suture snapped before the drain slipped. Three half hitches was the strongest technique.

Conclusions
Suture material, technique and drain fixation angle had an impact on suture strength with ProleneTM outperforming Silk. We advocate using a ‘three half hitch’ technique with 3.0 ProleneTM to secure a surgical drain. It offers superior strength whilst reducing the risk of localised tissue reactions.
671 Improving the Basic Biochemical Evaluation of Acute Renal Colic – A Two Cycle Audit
Authors: Tezcan E 
Published: May 2021

Abstract

Introduction
Latest guidelines by the European Association of Urology and BAUS recommend all patients presenting with acute renal colic have basic biochemical evaluation including blood calcium, urate, white cell count, CRP, sodium, potassium, and creatinine. Patients with hypercalcaemia or hyperuricaemia are particularly at risk of developing further stones, however compliance with guidelines by AE and urology departments can vary.

Method
Retrospective audit of all acute CT urinary tract (non-contrast) scans between February-April 2020 with a confirmed ureteric stone. Patients previously investigated or re-presenting were excluded. Results were shared and education on guidelines undertaken for junior clinical staff in urology followed by re-audit between May-July 2020.

Results
The first cycle February-April identified 51 patients with acute renal colic. Overall, 47% of patients had all required blood tests performed. Urate was tested in 54.9% of patients and calcium in 58.8%. Re-audit after intervention identified 50 patients. Overall compliance with blood tests increased to 62% of patients, urate tested in 66% and calcium 76%.

Conclusions
Compliance with key screening tests for renal colic patients was generally poor in a district general hospital setting. A key causative factor identified was a lack of awareness of guidelines by junior clinicians. Education demonstrated modest improvement within a short time scale.
686 Emergencies in Plastic Surgery – The Impact of a One-Day Conference on Medical Students’ Confidence
Authors: Ngadimin C , Rai A , Ngaage L M , Dawidziuk A , Kwasnicki R M , Hettiaratchy S 
Published: May 2021

Abstract

Introduction
Plastic surgery emergencies, such as facial trauma, burns, and gunshot wounds, are commonly presenting injuries to the emergency department. However, these topics are rarely part of medical school curriculums and few educational conferences exist on these topics. Hence, we created a novel international medical student conference entitled “Emergencies in Plastic Surgery”. We then evaluated its effectiveness in improving confidence in management of plastic surgery-related emergencies.

Method
We administered pre- and post-event online questionnaires to delegates evaluating self-reported confidence for Facial Trauma, Gunshot Wounds, Burns, Tendon Repair, Splinting, and Lacerations on a 5-point Likert-scale. Responses were matched before statistical analysis.

Results
Of the 85 attendees, three quarters responded (76%, n = 65). The conference significantly increased confidence ratings in all topics (p &lt; 0.001). Prior to the conference, Lacerations had the highest confidence scores (2.36 ± 1.19) whereas Facial Trauma scored the lowest (1.79 ± 0.858). Facial Trauma had the greatest improvement in confidence (mean difference = 2.09 ± 0.974), whereas Lacerations yielded the lowest improvement (mean difference 1.21 ± 1.28). Facial Trauma also yielded the greatest mean satisfaction rating (4.68 ± 0.594).

Conclusions
The conference improved student confidence in all plastic surgery emergencies topics. More complex topics, e.g. facial trauma, yielded the greatest satisfaction and improvement in confidence.
752 Evaluating the Use of Immersive Virtual Reality Simulation in Orthopaedic Trauma Cases; A Construct Reality Study
Authors: Feeley A , Sheehan E , Merghani K 
Published: May 2021

Abstract

Introduction
Changing surgical training models as a result of reduced working hours, shorter schemes and the recent pandemic has resulted in reduced operative hours being logged by trainees. Novel and validated training methods are needed to rectify the deficit faced by surgical trainees, to maintain continued development and retention of skill throughout their training scheme.

Method
A comparative interventional study was carried out in a regional trauma unit hospital. Volunteers were stratified into novice, intermediate and expert groups based on self-reported levels of experience. Each carried out a simulated proximal femoral nail on a virtual platform following instruction on its use. Face and content validity was also assessed.

Results
The proximal femoral nail module demonstrated construct validity. Intermediate surgeons performed significantly better than novices (P=.03), with shorter procedural times (P=.013) Three of the intermediate group achieved the proficiency level set by the expert group. Time taken to completion for expert surgeons was less than intermediate group, although this did not reach significance (P=.16). Face and content validity was reported for the module.

Conclusions
The proximal femoral nail module on the Precision OS platform demonstrated good face, content, and construct validity under expert scrutiny. Further research evaluating use of virtual platforms to optimise surgical training is needed.