bluuebunny/crossref_metadata_2025_split huggingface dataset:
1306 Recommendations for the Use of Simulators in Cardiothoracic Surgical Training
Authors: Whittaker G , Salmasi Y , Asimakopoulos G , Athanasiou T 
Published: October 2021

Abstract

Aim
To systematically review the simulators that are currently available for cardiothoracic surgical procedures and the validation evidence supporting them. Additionally, to recommend several simulators for training based on analysis of results.

Method
A systematic literature search of the MEDLINE® (1946 to December 2019) and EMBASE® (1947 to December 2019) databases was performed to identify simulators for basic skills and procedures in cardiothoracic surgery. A selection of keywords and MeSH terms were used to execute the literature search. After identification of relevant articles, data were extracted and analysed.

Results
Ninety simulators were found in eighty-one articles. Simulators for basic skills (n=24) and coronary artery bypass graft (n=22) were the most commonly described, followed by miscellaneous (n=14), valve surgery (n=13), thoracic lobectomy (n=10), and mechanical circulatory support (n=7). The majority of models were either benchtop (n=42) or hybrid (n=33) modalities. Evidence of validity was demonstrated in 38 (42.2%) simulators. Five (5.6%) simulators had three or more elements of validity established and only one (1.1%) accomplished full validation.

Conclusions
Five simulators were recommended for supplemental training in cardiothoracic surgery. Low-fidelity models can provide a broad foundation for surgical skills development and high-fidelity simulators can be used for immersive training scenarios and appraisals. These should be utilised in early training, at which point the learning curve of trainees is steepest.
1393 The Impact of Using A Virtual Reality Surgical Curriculum to Train Scrub Practitioners in Complex Orthopaedic Surgery
Authors: Edwards T C , Patel A , Szyszka B , Coombs A W , Kucheria R , Cobb J P , Logishetty K 
Published: October 2021

Abstract

Background
The training scrub practitioners receive varies considerably in comparison to their surgical counterpart, although their performance is key to a proficient surgical team. For infrequent procedures that require specific and often intricate equipment such as revision total knee arthroplasty (RTKA), their training may be limited to an initial guidance session by company representatives. This study aims to evaluate the impact of using a virtual reality (VR) curriculum to train scrub practitioners in the performance of a RTKA.

Method
Ten orthopaedic scrub practitioners were enrolled into VR training across four sessions. Each VR session consisted of training where participants were guided through the assembly of equipment and steps of the surgery. In the concluding three sessions, each training session was supplemented by an assessment session in VR without guidance. The outcomes measured in VR assessment were incorrect procedural sequence, duration of surgery and efficiency of movement. The transfer of skills outside VR were assessed pre-training and post-training by the participants performance in a sequence of tasks using real equipment.

Results
All participants enhanced their surgical performance in successive assessed VR sessions reducing their operative time by 47%, assistive prompts by 75% and dominant hand motion by 28%. Improvements in VR showed effective transfer when assessed using real equipment with participants achieving superior scores post-training (11.3% versus 83.5%).

Conclusions
VR enables safe learning and provides measurable feedback of procedural steps and technical skills of complex orthopaedic surgery. VR is an effective training tool for scrub practitioners, with transfer to the real world.
1505 EASiE: ENT and Airway Simulation in Emergencies
Authors: Gurung P , Luff E , Waters C , Castelhano R 
Published: October 2021

Abstract

Aim
A literature review of undergraduate ENT teaching found that most final year medical students and junior doctors did not feel adequately prepared for clinical practice in ENT. Other surveys found junior doctors lack confidence in recognising or initiating management in patients with blocked tracheostomies. To improve this, we ran a simulation session designed to replicate airway emergencies that junior doctors should be able to manage. The aim was to improve confidence in and knowledge of basic management of airway emergencies, including tracheostomies.

Method
Groups of 4-6 final year medical students participated in 3 scenarios: 2 tracheostomy-related and 1 partially compromised airway. The students had attended a session introducing tracheostomies and the algorithms produced by the National Tracheostomy Safety Project for tracheostomy emergencies. A semi-structured debrief followed each scenario, highlighting key learning points. The students completed a pre- and post-session questionnaire, rating confidence in several domains related to the scenarios.

Results
Of 24 participants, the percentage of students who felt confident or very confident in the following domains were compared pre- and post-simulation respectively: recognising a potential airway problem (0% vs 71%); identifying an altered airway (0% vs 75%); managing a potentially compromised surgical airway (4% vs 71%); initially managing a compromised airway (8% vs 67%); and identifying when to escalate with a potential airway problem (25% vs 96%).

Conclusions
Simulation is a valuable tool that can be used to improve both knowledge and confidence in managing potential airway problems in final year medical students. This supports findings from other studies.
50 A Cross-Sectional Study Examining the Association Between MRCS Performance and Surgeons Receiving Fitness to Practice Sanctions
Authors: Ellis R , Scrimgeour D , Cleland J , Lee A , Brennan P 
Published: October 2021

Abstract

Aim
Fitness to practice (FtP) investigations by the General Medical Council (GMC) can be one of the most stressful experiences in a surgeon’s career. Demographic factors are known to alter the likelihood of GMC investigation. Despite this there are no studies assessing risk factors in surgeons for FtP sanctions. Thus, we used the newly created Intercollegiate Membership of Royal College of Surgeons (MRCS) examination database to identify risk factors for and the prevalence of GMC sanctions in early-career surgeons.

Method
FtP sanction data contained in the GMC list of registered medical practitioners (LRMP) database was linked at person-level to all UK graduates who had attempted MRCS Part A or Part B between September 2007 and January 2020. Data were anonymised by the Royal College of Surgeons of England prior to analysis.

Results
f 11,660 candidates who had attempted the MRCS within the study period only 31 (0.3%) candidates had GMC FtP sanctions within the last two years. Of these, 12 had active conditions on their registration, 7 had active undertakings and 14 had warnings. Candidate demographics were similar between cohorts and there were no significant differences between MRCS performance identified.

Conclusions
In this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.
55 Are Virtual Journal Clubs A Viable Alternative in The Covid-19 Era?
Authors: Morris J , Jenny H , Park C , Scarborough A , Antoniou V , Heylen J , Anakwe R 
Published: October 2021

Abstract

Introduction
During the COVID-19 pandemic, face to face journal clubs have been curtailed due to Governmental guidance for social distancing. We present an example of a virtual journal club set up for Orthopaedic senior house officers (SHOs) & trainees in the North West Thames (NWT) Deanery from April to August 2020.

Method
Our aims were to establish a regular online journal club for orthopaedic trainees in NWT that successfully met the objectives of the more established face to face meetings. Assessment of each session was evaluated using a post attendance survey created using an established online generator.

Results
64.4% (16/25 participants) had not attended a virtual journal club before, with 100% (33/33) reporting that they would attend another virtual journal club. 39.4% (13/33) of attendees agreed or strongly agreed that they could participate in sessions over more conventional meetings. 24.2% (8/33) of participants reported experiencing technical issues during the sessions. 90.9% (30/33) of respondents reporting the virtual model to be more convenient than standard journal clubs.

Conclusions
The potential benefits of significantly increased accessibility increased visiting expert contribution whilst still adhering to government guidelines; weighed against marginally less effective teaching nonetheless results in an overall benefit.
184 Effects of The Coronavirus Pandemic on Medical and Surgical Education: Results of An International Survey by The International Association of Student Surgical Societies (IASSS)
Authors: Kirby E , Franco H , Burger S , Shadé Breedt D , Davies J , Azam S , Weyers J , Chan K S 
Published: October 2021

Abstract

Aim
Coronavirus disease 2019 (COVID-19) presents a variety of unforeseen challenges to medical students and surgical trainees. Adaptations to the content and delivery of medical education are inevitable as institutions respond to the virus. Departments face significant restructuring, with important implications for training. Our aim was to assess the global impact of the first wave of COVID-19 on medical and surgical education.

Method
Between 12 May and 26 May 2020, an online survey was conducted and circulated to contacts of the International Association of Student Surgical Societies, including medical students and healthcare practitioners. All data were anonymous; no personal identifiable information was collected. Consent was implied by participation in the survey, which was on a voluntary basis.

Results
We collated 527 responses from 111 institutions across 26 countries. Globally, 93.5% of medical student placements were affected by the first wave of COVID-19, with examination restructuring and alternative teaching methods employed by 87.8% of medical schools. Trainee redeployment was common in both surgical (61.5%) and non-surgical (77.1%) disciplines. Surgical services were significantly affected, with reduced elective procedures in 93% of institutions. On an individual level, COVID-19 resulted in prolonged absence from clinical duties and mental health concerns at all levels of training.

Conclusions
Our data highlight drastic changes in medical and surgical education and practice as a result of the first wave of COVID-19. These changes are significant at all levels of training, both institutionally and individually. The pandemic is likely to have persistent consequences for future trainees in terms of education and career progression.
238 MRCS Performance Predicts Surgical Career Outcomes
Authors: Ellis R , Scrimgeour D , Cleland J , Lee A , Brennan P 
Published: October 2021

Abstract

Aim
Successful completion of the MRCS examination is mandatory for progression into higher surgical (registrar) training in the UK. National selection for training programmes is a highly competitive process. Despite this, the ranking of applicants does not currently include MRCS performance scores. This offers a unique opportunity to compare two independent assessments of surgical trainees to establish whether MRCS performance can predict future surgical career outcomes and competitiveness in training.

Method
All UK candidates who attempted MRCS between 2007-2020 were matched to career outcome data using the GMC list of registered medical practitioners and anonymised (n = 2910). Chi-squared tests determined associations with first attempt MRCS pass/fail outcomes. Multinomial regression models were developed to establish the predictive power of success at MRCS in determining surgical specialty and training deanery choices.

Results
There was statistically significant variability in MRCS Part A pass rates, ranging from 55.1%-76.7% between surgical specialties (P=0.001) but no significant variability in Part B pass rates (P=0.655). There was significant variability in Part A and Part B pass rates between training deaneries (P=0.010 and P=0.036 respectively). Pass rates ranged from 59.9%-77.7% for Part A and 70.1%-85.0% for Part B between training deaneries. Those in more competitive specialties and training deaneries performed better in MRCS in terms of first attempt pass rate, scores and number of attempts taken to pass.

Conclusions
MRCS performance is an early predictor of surgical career choice and competitiveness. Trainees who perform well at MRCS are more likely to enter competitive surgical specialties and training deaneries.
279 Preparing Foundation Trainees for Surgical On-Calls
Authors: Boyle M , Thu K , Mroczek T , Scicluna M , Byrne A 
Published: October 2021

Abstract

Aim
Foundation trainee feedback has highlighted low levels of confidence with the prospect of surgical on-calls. Key areas of concern are assessing and managing the acute surgical patient, identifying which patients need an operation and having the technical skills to competently assist in theatre. This lack of confidence prevents trainees engaging in an educational and rewarding rotation. We have designed and facilitated a day of robust workshops, addressing these key educational needs.

Method
Pre and post course questionnaires assessed the efficacy of teaching. Lectures on the assessment and management of acute surgical patients in general surgery, urology and trauma and orthopaedics were delivered by core surgical trainees. A named consultant oversaw quality assurance. Addressing the technical skills development need, an afternoon of surgical skills workshops covered, suturing, knot tying, laparoscopic principles, and theatre etiquette. Small groups of trainees rotated through each workshop, delivered by senior specialty trainee registrars, to ensure high fidelity training

Results
Trainees rated themselves in key areas pre and post course on a scale from 1-5. Pre course, 66% of trainees scored 3+ in “confidence in managing a surgical patient on-call”. This rose to 100% post course. Similarly; “Confidence in decision making regarding whether a patient should proceed to theatre” increased from 37.5% to 93.7%. “Suturing skills” improved from 37.5% to 100%.

Conclusions
All trainees that attended the course displayed marked improvement in their confidence and competence. We feel this course or similar should be incorporated into the foundation teaching program locally and has scope to be expanded regionally.
318 Adapting Surgical Intercalation Teaching to The Pandemic – A Novel Near-Peer Educational Model for Intercalating Medical Students
Authors: Srivastava A , Thirupathirajan V A R , Duffy E 
Published: October 2021

Abstract

Aim
The COVID-19 pandemic has reduced medical student exposure to traditional formats of surgical teaching, thereby irrefutably altering surgical education for the foreseeable future. The pandemic has compounded the preliminarily reported disconnect intercalating students experience, as well as depriving students of opportunities for surgical exposure. The aim of our study is to devise an innovative near-peer system to supplement surgical teaching and guidance for the ‘Surgical Sciences’ Intercalated BSc offered at University College London, hence promoting surgical education.

Method
Past students (preceding two cohorts) were competitively recruited, termed mentors. Each student was paired with a mentor for one-to-one guidance. Mentors and programme directors formulated surgical, module-specific, virtual tutorials (Zoom). Mentees were surveyed using predesigned Google Forms to gauge subjective utility. Likert Scales (0-10) were used for quantitative analysis and free-text fields for further commentary.

Results
Mentors and programme directors devised 8 module-specific, surgical tutorials over term 1, spaced on average at every 1.5 weeks. A statistically significant increase in confidence reported per taught module, from 5.85±1.16 to 7.85±0.93 (P &lt; 0.0001), was observed. Mentees report an overall recommendation of 93.19% that all tutorials be rerun for the upcoming cohort. 75% of mentees predict their designated mentors will be ‘very useful’ in their surgical education.

Conclusions
A novel model of near-peer education for surgical intercalation studies has been successfully established, whereby students receive valuable education and guidance from mentors with relevant surgical experiences. Students report significant utility in this programme, which can be a constant in otherwise turbulent times for surgical education.
393 Opportunities to Improve the Pan-Surgical Intercollegiate Elogbook: A National, Cross-Specialty Scoping Survey
Authors: James T , Glasbey J 
Published: October 2021

Abstract

Aim
The Pan-surgical Intercollegiate eLogbook represents the world’s largest repository of training and operative data. ASiT have recently published concerns from a nationwide survey demonstrating widespread inaccuracies in eLogbook operative case reporting. This study aimed to add to this work by identifying opportunities to improve the way eLogbook data is used and interpreted.

Method
An online, self-administered, voluntary questionnaire was created on Google Forms (Google Inc, Menlo Park, CA) to explore patterns of use of the eLogbook, and highlight areas for improvement. The survey was disseminated to surgical trainees across the UK and Ireland using specialty networks and deanery training forums.

Results
Fifty trainees across the country from all ten surgical specialties completed the questionnaire. 54% of respondents reported using the Mobile eLogbook Application to record procedural data and 62% reported doing this on the same day of the procedure. 52% reviewed their eLogbook data less frequently than monthly. Just 16% thought the current presentation of eLogbook data were ‘very useful’ or ‘useful’. 72% were happy to record more detailed procedural data. 88% were interested in anonymously comparing procedural data with peers, and four-fifths reported that hospital or regional level data would influence their application choices. 96% reported that access to trainer’s supervision data would influence planning of their daily clinical activity.

Conclusions
This survey has identified several solutions for improving engagement and utility of the Intercollegiate eLogbook. Trainees report a desire to access enhanced analysis of individual, local, regional and national operative data.
440 Training in Microbiological Sampling for Toe Amputations in Diabetic Foot Disease: A Survey of UK Vascular Trainees
Authors: Dawson J , Travers H , Wall M 
Published: October 2021

Abstract

Aim
To determine usual practice and extent of training received by United Kingdom (UK) vascular surgery trainees in microbiological sampling for toe amputations in diabetic patients.

Method
A prospective online survey was distributed via social media networks and trainee organisations. All vascular surgery trainees in the UK were invited to participate. A total of 29 responses were included in the analysis.

Results
86% of respondents have been trained in toe amputations during registrar training. 66% have not been taught which samples to send for microbiological analysis. 10% receive regular training reviews in toe amputations. There is significant variability in the types of samples sent by trainees for microbiological analysis and the majority of trainees did not know how their samples are processed in the laboratory.

Conclusions
Toe amputations appear to be a neglected aspect of training for UK vascular surgery registrars. Lack of consistency in microbiological sampling techniques may prevent optimum antimicrobial stewardship and therefore increase the risk of further complications including major amputation. Inclusion of diabetic foot sepsis as a critical condition in the new vascular surgery curriculum may help to address this issue. A national consensus needs to be reached on how microbiological samples should be taken and processed in order for trainees to be taught in a consistent manner.
448 Foundation Doctor Local Peer-Led and Organised Basic Surgical Skills in General Surgery and Plastic Surgery
Authors: Thakkar R , Lloyd N , Ghauri S 
Published: October 2021

Abstract

Aim
Foundation doctors are under pressure early in their careers to attend highly subscribed and expensive surgical courses. We assessed the feasibility of a foundation doctor led and locally organised basic surgical skills introduction.

Method
The lead foundation doctor organised a basic surgical skills introduction for foundation year doctors at Salisbury District Hospital liaising with the postgraduate centre and local surgical consultants. This training was supervised by local consultants and registrars. This teaching delivered theory and practise in suturing, knot tying and laparoscopy by local and familiar trainers. Feedback was collected using the Likert scale.

Results
12 foundation doctors attended. 100% either agreed or strongly agreed the introduction was helpful and well organised. 25% either agreed or strongly agreed feeling confident with suturing and knot tying before the teaching which increased to 92% after teaching. Only 8.3% either agreed or strongly agreed feeling confident with the principles of basic laparoscopy before teaching which increased to 83% after teaching. 100% either agreed or strongly agreed the teaching will improve their clinical practise and enhance their interest in surgery. 92% strongly agreed or agreed that the teaching improved their knowledge in basic surgical skills, and the peer led and organised structure was an effective teaching method.

Conclusions
Foundation doctor locally peer led teaching organised with supervision by local consultants is an effective method of delivering basic surgical skills with improvement especially marked in basic laparoscopy and help enhance interest in surgical training.
453 Introduction of A Novel Online Learning Platform Increases Junior Doctors Confidence Prior To Starting Trauma & Orthopaedic On-Calls
Authors: Curtis A , Foster P , Mutimer J 
Published: October 2021

Abstract

Aim
Trauma and Orthopaedic (T&O) junior doctors are expected to manage on-calls involving a high volume of patients presenting with a wide variety of complex conditions. Despite this, many junior doctors feel poorly prepared at the start of their placements with individual hospitals providing variable levels of induction. We therefore aimed to provide a free ‘Introduction to T&O on-calls’ course for junior doctors.

Method
The online platform ‘Zoom’ was used to provide 13 interactive lectures by T&O trainees and consultants over a single day in July 2020. In total, 280 UK junior doctors attended with 91.1% completing feedback. Pre- and post-course questionnaires were used to establish improved knowledge.

Results
Only 7.4% of participants either had or were aware of a local trust induction covering T&O on-calls. The course had an overall satisfaction rating of 90%, with participants showing a 15.3% improvement in on-call knowledge from pre-course to post-course (p&lt;0.05). Prior to the course only 35% of participants felt prepared to perform an on-call which increased to 77% after the course. Almost all participants (90%) agreed that similar courses in other surgical specialties (General surgery (79%), Urology (60%), Vascular surgery (60%), ENT 55%)) which are commonly cross covered by junior doctors would be hugely beneficial.

Conclusions
Our principal focus moving forward is to establish a formal national induction programme for T&O junior doctors that is recognised by the relevant T&O organisations. This will instil confidence in the junior doctors whilst achieving patient safety and excellence during busy T&O on-calls.