bluuebunny/crossref_metadata_2025_split huggingface dataset:
36 A Randomised Trial to Compare How Undergraduates Diagnose Common Ear Pathology Using A Smartphone Otoscope and Standard Otoscope in A Simulated Setting
Authors: Schuster-Bruce J , Ali A , Van M , Rogel-Salazar J , Ofo E , Shamil E 
Published: May 2021

Abstract

Introduction
Competent otoscopy is a key otolaryngology skill for a broad range of medical careers, yet undergraduate’s confidence to perform otoscopy is reported as low. This study aimed to evaluate whether a smartphone-otoscope could enhance medical undergraduates recognition of common ear pathology.

Method
52 medical students were randomised into a standard group (traditional otoscope) and an intervention group (smartphone-otoscope). Following a short didactic presentation, participants were asked to diagnose four simulated pathologies. Force response items and 5-point Likert scales loaded on an electronic platform recorded their diagnosis and their perceptions towards the otoscope.

Results
The smartphone-group (n = 20) had higher overall rates of correct diagnosis compared to control (n = 22) (84% vs 39%, p = &lt;0.001). Only the grommet station did not show a significant improvement between the two groups (100% vs 91%, p = 0.49). 90% (n = 20) of participants felt the smartphone-otoscope was preferential for their learning. The same number expressed they want to use it in future learning. The remainder were indifferent.

Conclusions
The smart-phone otoscope enabled learners to better observe and recognise middle ear pathology. This popular learning tool has the potential to accelerate the learning curve of otoscopy and therefore improve the proficiency of future doctors at recognising middle ear diseases.
102 Peer Teaching in Hip Fracture: Responding to the Medical Needs of Surgical Patients and Educational Needs of Junior Doctors
Authors: Jones N , Francis J , Parikh R , Shaath M 
Published: May 2021

Abstract

Introduction
Fractured Neck of Femur (FNOF) patients are complex. A mortality project identified topics for a peer-led teaching programme.

Method
Eight bite-sized case-based sessions were devised, to provide a framework to approach the following topics: Anaemia, delirium/dementia, ECG abnormalities, metastatic cancer, osteoporosis, renal disease, respiratory disease, and vascular complications. Attendees were asked to complete pre- and post- teaching programme questionnaires using a Likert Scale to indicate agreement with statements relating to the topic areas chosen (1=strongly disagree and 5=strongly agree).

Result
Pre-programme questionnaire: respondents were neutral (average 3.04) when asked whether topic areas were currently “well managed”. Attendees lacked confidence, indicating preparedness as neutral (average 3.35). Trainees agreed that they would benefit from teaching (average 4.56).
Post-programme questionnaire: increased confidence was reported when considering preparedness (average 4.3). Attendees felt the teaching programme was “accessible” and the “topics well-chosen”. 100% of attendees regarded the teaching as ‘excellent’ or ‘very-good’.

Conclusions
Matching patient needs to an educational programme is important.
The “bite-sized” nature of the programme paired with case-based learning increased confidence. A peer-led teaching programme is a positive response to themes emerging from morbidity and mortality reviews.
127 Standardising Access to Fracture Fixation Simulation for Core Surgical Trainees
Authors: Brown R , Curwen C , Mutimer J 
Published: May 2021

Abstract

Introduction
Simulation is increasingly being used to augment clinical experience. However, access to simulation varies geographically and national courses can be costly. The Severn School of Surgery aimed to provide a locally run, cost-neutral “Basic Principles in Fracture Fixation” course to standardise access to simulation for core surgical trainees (CSTs).

Method
The course ran from a district general hospital, accommodating lectures, case discussions, and practical stations (screw fixation, plate fixation, dynamic hip screw, and external fixation). Faculty donated their time and a devices company provided kit and dry bones. CSTs organised the course. Pre- and post-course self-rated Intercollegiate Surgical Curriculum Programme (ISCP) global competency ratings in the practical stations were recorded and usefulness of aspects of the course was recorded.

Results
32 candidates attended. Mean self-rated competency increased by at least one global rating in all practical stations (p &lt; 0.05). All aspects of the course were deemed useful (pre-course reading by 27/28, lectures by 31/32, and case discussions by 31/32). No net cost was incurred.

Conclusions
Increases in self-rated competency in surgical skills can be obtained through a cost-neutral, trainee-organised, regional skills course. Pre-course reading, lectures, case discussions, and practical sessions are all useful. This model can be used by others to standardise the simulation curriculum.
138 Sexual History, Is it Important?
Authors: Duggal S , Wanis C 
Published: May 2021

Abstract
Oral candidiasis (OC) is the most common opportunistic infection seen in patients infected with Human Immunodeficiency Virus (HIV) and remains the second AIDS-defining illness in Europe, as it has previously been reported in 11-51% of cases. We present a case of a 70-year-old male who attended the Oral and maxillofacial surgery department with refractory OC and was later diagnosed with HIV after multiple visits to various departments in hospital. Sadly, the patient declined medically and died of multi-organ failure one month following this diagnosis. On reflection, it was found that the patient suffered from the medical conditions and opportunistic infections which can be associated with HIV, but as no sexual history was ascertained this diagnosis was missed. It is prudent that we, as clinicians, take a step back and look at each patient as a whole, in order to ensure complete and holistic care. We argue that sexual history is sometimes vital in achieving a complete history of a patients’ condition, especially in cases of refractory OC where it can be a key piece in the diagnostic puzzle.
154 Enhancing Communication Between Foundation Doctors and Radiologists
Authors: Chuang Y H , Jones V , Trail M , Szewczyk-Bieda M , Nandwani G M 
Published: May 2021

Abstract

Introduction
Facilitating radiological imaging for patients is an essential task for all Foundation Year (FY) doctors. Achieving competence in this task can expedite patient management. We evaluated the confidence and skills of FYs in facilitating radiological imaging before and after introduction of formal training.

Method
Surgical FYs working at a teaching hospital were surveyed to evaluate their baseline level of competence in booking and discussing imaging with radiology colleagues. Parameters were measured on a Likert scale, including confidence in discussing requests and satisfaction of their own performance following discussions. Eight radiology consultants were surveyed to evaluate their opinions on FYs’ communication and established areas for improvement. A teaching session was then delivered to improve communication skills. Furthermore, PACCSS poster was introduced to remind the FYs of the salient information required when discussing imaging.

Results
One month after the intervention, the participants were re-surveyed. This demonstrated a statistically significant improvement in self-reported confidence from 5.3/10 to 7.3/10 (p &lt; 0.001), and in satisfaction of own performance from 5.4/10 to 7.0/10 (p &lt; 0.001).

Conclusions
We identified deficiencies in surgical FY doctors’ confidence and skills in facilitating radiological imaging. There was a demonstrable benefit with focused training. Inter-specialty communication should be introduced into under- and post-graduate educational curriculum.
171 Surgical Trainee Suggestions to Improve Surgical Training and the Surgical Recruitment Process in View of the COVID-19 Pandemic
Authors: Stoner R , Catania S 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic has had a significant impact on medical education and surgical training. The experiences of surgical trainees were sought to seek feedback on how both training and recruitment can be adapted to reflect these changes.

Method
A survey was circulated amongst surgical trainees, to ask what changes to the recruitment process and surgical training they would suggest, in view of the changes related to the COVID-19 pandemic. Circulated amongst surgical trainees in London. 25 surgical trainees from London responded. Results were analysed and tabulated.

Results
Suggestions for the recruitment process include an appreciation by the recruitment panel about reduced academic achievement, relaxation of requirements, clinically oriented interviews and extension of training. Suggestions for surgical training include resumption of educational activities, ensured surgical activities and protected theatre time, mentorship and run through training.

Conclusions
The effects on surgical training due to COVID-19 must be appreciated, and trainees’ experience and feedback should be considered when adapting training and recruitment to this.
172 The Perceived Effect of COVID-19 on Surgical Training in Malta and the UK
Authors: Catania S , Stoner R 
Published: May 2021

Abstract

Introduction
Surgical training comprises of learning in a number of environments – practical experience in hospital, educational activities, reaching core competencies and academic development. The COVID-19 pandemic has had significant effects on healthcare systems, and this likely will have impacted surgical training. This survey set out to assess the perceived effects of COVID-19 on surgical training.

Method
A survey was circulated amongst surgical trainees to assess perceived effects from the COVID-19 pandemic on their surgical training. This was circulated amongst surgical trainees in Malta and London. 32 surgical trainees from Malta and 25 from London responded. Results were analysed, tabulated and compared.

Results
Less Malta trainees were redeployed than UK (3% vs 80%), whist both had rotations postponed or cancelled (62.5% vs. 92%). Trainees felt logbook opportunities (78% vs 100%) and theatre experience (97% vs 100%) had reduced. Trainees were unsure of how this would affect their progression (56% vs 52%), and some felt recruitment criteria should be adjusted in view of the above (50% vs 68%). Overall, both groups agreed their surgical education had been negatively impacted (84% vs 100%).

Conclusions
Both UK and Malta trainees feel that surgical training has been negatively impacted during the COVID-19 pandemic.
173 Early Results of a Variable-Angle Volar Locking Plate for Distal Radius Fractures: A Bi-Centre Study
Authors: Elerian S , Singh T , Jagodzinski N A , Norris R , Tan S , Power D , Jones J , Rajaratnam V 
Published: May 2021

Abstract

Introduction
This study examines the clinical, functional and radiological outcomes of distal radius fracture fixation with the Aptus® (Medartis, Pennsylvania) locking plate in order to determine its efficacy and to identify notable findings related to treatment variations.

Method
This is a retrospective bi-centre study collecting patient details from a District General Hospital and a Regional Hand Unit. We assessed 61 consecutive patients with distal radius fractures (AO grade A = 19, B = 9, C = 33) fixed using Aptus® plate with a minimum of six months follow-up. Outcome measures included the DASH score, wrist range of movement and grip strength, and complications. Radiographs were reviewed to assess restoration of anatomy and union.

Results
All but two fractures united within six weeks. Mean ranges of movement were only mildly restricted compared to the normal wrist (flexion/extension = 102°; radial/ulna deviation = 53°; pronation/supination = 169°). Mean postoperative grip strength was 23.8kg which was comparable to the contralateral side at 31.5kg. The mean DASH score was 18.2. Seven patients had screws misplaced outside the distal radius although three of these remained asymptomatic.

Conclusions
Variable-angle locking systems benefit from flexibility of implant positioning and may allow enhanced inter-fragmentary reduction for accurate fixation of intra-articular fractures.
213 A Novel, Cost-Effective and Convenient Model for Simulating Facial Wound Repair
Authors: Rowe A , Rapaport B , Al-Najjar Y , Chaudhry B , Leow J , Thomas S 
Published: May 2021

Abstract

Introduction
We describe the use of a novel synthetic simulation pad for learning complex facial wound management including local flaps. The simulation pad is a cost effective and convenient model of facial wounds. We have compared the use of animal tissue to the simulation pad in the context of a workshop for surgical trainees and collected feedback from delegates.

Methods
Feedback was collected from 14 of 16 attending delegates.

Results
It was clear from feedback that animal tissue is not an ideal model of facial wounds with 71% of delegates stating that they did not consider it to be high-fidelity. The synthetic pad was rated more favourably with 100% of delegates reporting that it was a valuable exercise and well designed for local flaps.

Conclusions
It is imperative that training opportunities are high quality and useful to clinical practice. Techniques learnt in the context of a course or workshop are more valuable where targeted practice may occur following learning. The use of a synthetic pad is more amenable to continued practice where it may be taken home following a workshop. Feedback from this event suggests a well-designed synthetic pad is more useful than animal tissue in learning local flaps.
222 Simulation Training in Aesthetic Medicine; A Safe, Effective and Ethically Sound Modality to Teach Basic and Advanced Aesthetic Interventions
Authors: Chalhoub X , Ghanem A 
Published: May 2021

Abstract

Introduction
The role of high-fidelity prosthetic simulation models for Botulinum Toxin Type A (BoNT-A) and cross-linked Hyaluronic Acid dermal fillers (HA) was evaluated and its efficacy and safety discussed in addition to its ethical and cost-effective advantages.

Method
The experiment group (N = 26) included a high-fidelity simulation silicone head to inject as part of dexterity training prior to injecting live adult voluntary models. The control group (N = 8) had only live adult voluntary models for the practical session. Pre-test and post-test of self- assessment of procedure competence and confidence to perform the procedure unaided was evaluated using a modified reflective CEX.

Results
The average competency and confidence pre-test for score for students was (mean±SD) 7.2±4.6 and 2.9±2.9 respectively. The post-test scores rose to 15.8± 2.5 and 7.8±1.5. The improved competency and confidence score were statistically significant (p &lt; 0.05). There was no statistically significant difference of pre-test or post-test scores between the experimental and control group.

Conclusions
High fidelity synthetic simulation models allow novice practitioners to improve pre-procedure counselling, technical skills, management plan and follow up as well as confidence to perform the procedure effectively. We therefore recommend this method as a first-line training model in aesthetic medicine.
326 Student Perceptions of Neurosurgery: Evaluating the Role of Undergraduate Neuroscience Societies
Authors: Aw K L , Lee S H , McLarnon M , Raveendran D , O'Callaghan C , Mullan G , Fearon M , Samuel S , Sekar V , Rogan P 
Published: May 2021

Abstract

Introduction
Many institutions lack an organized system of informal network for medical students wishing to explore neurosurgery. We sought to evaluate the role of extracurricular neurosurgical events in influencing student perceptions of neurosurgery.

Method
Participants for this study were recruited from a neurosurgical careers seminar and practical workshop. Responses were collected prospectively using a multi-method strategy consisting of closed and open-ended questions. Additionally, semi-structured interviews were conducted to gain a deeper insight of students’ evaluation of these events and their perceptions of neurosurgery.

Results
A total of 124 students attended our extracurricular neurosurgery events. These events showed benefits in clinical knowledge and career planning. Students perceived the practical workshops to be useful in improving their basic surgical skills. Semi-structured interviews revealed that students felt their opportunities in exploring clinical neurosciences to be limited, which was seen as contributing towards the wider culture of neurophobia.

Conclusions
Undergraduate neuroscience societies provide useful educational platforms for students interested in neurosurgery, even in regions lacking institutional neuroscience networks. To help mitigate the wider culture of neurophobia, undergraduate neuroscience societies should focus on non-academic aspects of neurosurgery that are more personal and engaging, in an effort to spark interest in those who have had little exposure to the specialty.
354 Differential Attainment in Surgical Training
Authors: Vinnicombe Z , Little M , Super J 
Published: May 2021

Abstract

Introduction
Differential attainment (DA), according to the General Medical Council (GMC), is the gap between attainment levels in different groups. Attainment measures should cover aspects that include academic performance and career progression. Two such areas in surgical training are the MRCS examinations and ARCPs, both of which are required for progression in a career in surgery.
Our aim was to investigation whether socio-economic background was a significant factor for progression in surgical training.

Method
Data from the GMC for Core Surgical Trainees (CSTs) taking the MRCS examination between 2016 and 2019 and CST ARCP outcomes between 2017 and 2019 were obtained. Socio-economic background was assessed using the Index of Multiple Deprivation (IMD). ARCP and MRCS outcomes were assessed against IMD.

Results
Trainees from IMD Q1&2 (most deprived) had a significantly higher (p &lt; 0.01) mean number of attempts (1.86) to pass MRCS examinations than trainees from IMD Q4&5 (least deprived) (1.54). IMD Q1&2 were significantly more likely to obtain unsatisfactory outcomes (24.4%) than trainees from IMD Q4&5 (14.2%) (p &lt; 0.05).

Conclusions
There is clear evidence that differential attainment exists within Core Surgical Training. The reasons for this are likely to be complex and more work is needed to further investigate the relationship.
374 Simulation and the Surgeon during COVID-19: The Double 2s Surgical Emergencies Course
Authors: Bhojwani D , McNutt A 
Published: May 2021

Abstract
Educational opportunities for surgeons have been limited by COVID-19. This is due to reductions in elective operating, clinic cancellations and redeployment of doctors to medical wards. Surgical education has evolved to address anxieties from staff about missing out on valuable skills and experience. Although there has been a big emphasis on virtual learning, in-person simulation remains highly relevant.
The Double 2s MDT Surgical Emergencies Course was piloted amidst the pandemic at UHBW Foundation Trust. Places were restricted in view of social distancing (n = 13). Foundation doctors and nurses engaged in two simulation sessions based around acutely deteriorating surgical patients. Feedback was collected anonymously via an online google form.
All participants agreed that the course was pertinent to their clinical practice. 77 and 100% learners felt that their confidence had improved in assessing and managing surgical emergencies respectively.
The feedback shows that simulation can and should be employed alongside virtual learning to maintain the integrity of surgical education. Whilst the situation may eventually return to ‘business as normal’, the Double 2s course is appropriate to run again during winter pressures which may have similar implications for surgical training. It could also be adapted for medical students and higher surgical trainees.
376 Factors Affecting Female Medical Student Interest in Surgery - A Nationwide Cross-Sectional Survey
Authors: Tran T T , Dolfini L , Oremakinde O , Rasul S , Zahra S A , Harky A , Pandey S 
Published: May 2021

Abstract

Introduction
We aim to elucidate female student interest in Surgery and factors that are deterring students from considering a surgical career. With this information, we can evaluate if there are changes that can be made within medical education.

Method
A cross-sectional online survey was distributed via LimeSurvey to medical students across 33 UK medical schools. Our survey assessed student interest in a surgical career, personal experience on clinical placements, and what attracts or dissuades students from a surgical career.

Results
211 student responses were collected. 57% of students indicated an interest in Surgery. 55% of female and 63% of male students expressed surgical interest. 65.7% of second-year students indicated surgical interest, compared to 54.3% of students in final year; a 17.35% decrease. When asked, 88% of students believe there is disproportionate female to male surgeons.

Conclusions
Although our survey revealed that there is a healthy interest in Surgery, the number of women considering Surgery continues to dwindle throughout training, leading to massive discrepancy. It is paramount that there are both male and female mentors for students to visualise that there are no limitations for women in the field of Surgery.
378 The Future Potential of Artificial Intelligence in Upper Gastrointestinal Endoscopy, A Scoping review
Authors: Burke E , Awan F , Balfe P 
Published: May 2021

Abstract

Introduction
The use of Artificial Intelligence (AI) in medicine is accelerating. Recently there have been significant advancements made in its role in upper GI endoscopy.

Aim
To assess current research questions exploring the use of AI in diagnosing upper GI pathology at endoscopy.

Method
A scoping review of studies published on PubMed over the last 5 years using the search string: (((artificial intelligence) OR AI)) AND (Gastroscopy OR OGD OR EGD OR oesophagus OR esophagus OR stomach OR Gastric) was conducted.
Inclusion criteria: retrospective and prospective studies, published in the English language. Data extracted: country of origin for the research, clinical question, demographics, form of AI and study design.

Results
Search run on 5thof February 2020 yielded 2542 results. Articles meeting inclusion criteria numbered 25. Research originated in Japan (32%), Europe (24%), China (20%), South Korea (8%), other (16%). Clinical questions being explored included: use of AI for detecting gastric cancer, assessing depth of gastric cancer invasion, detecting early neoplasia in Barrett’s Oesophagus, real time gastric polyp detection and H.Pylori infection status.

Conclusions
AI use in upper GI endoscopy is being evaluated at an increasing rate. Surgeons must be ready to gain a working knowledge of this technology to safely interpret its results.