bluuebunny/crossref_metadata_2025_split huggingface dataset:
1314 Ad-Hoc Suturing Course Teaching: A Valuable Tool for A New Starter
Authors: Labib A , Salfity L , Dhillon A , Saour S 
Published: October 2021

Abstract

Aim
The study aims to assess effectiveness of a three-hour suturing skills course for healthcare professionals at a tertiary hospital in London. Intended outcomes were improvement in confidence and proficiency at simple interrupted sutures.

Method
Four suturing sessions were delivered over five months to healthcare workers new to the clinical setting. The session included lecture, video, and practical skills. Participants completed a pre- and post-course survey to measure confidence levels in suturing using Likert scale. Participants performed simple interrupted sutures for 10 minutes in a pre- and post-course assessment. Performance was assessed using a suturing proficiency proforma. Pre- and post-course data was compared to assess improvement.

Results
Fifty participants attended the course. 93% had previous suturing teaching. Pre-course confidence in simple interrupted suture was 3.1 (SD = 1.2) and post course was 4.8 (SD = 0.2). One tailed T score was 14.7, and the difference was significant (p &lt; 0.05). Pre- and post-course assessment demonstrated improvement in the following parameters and participant proportions: handling of the needle driver (50%, n = 25), adequate placement of needle driver (68%, n = 34), appropriate needle angle entering skin (60%, n = 30), following needle curve (36%, n = 18), non-touch technique (64%, n = 32), surgical knot tying (56%, n = 28). Average number of sutures completed in 10 minutes increased by 1.9 times.

Conclusions
The majority of participants had previously been taught suturing in other settings; however, data demonstrated improvement in confidence and performance. Ad-hoc suturing skill teaching is a valuable tool to increase confidence of healthcare workers at early stages in their careers.
1492 The Age of Trainees When Joining the Specialist List – What Are the Differences Across Specialties?
Authors: Douglas J , Magennis P , Begley A 
Published: October 2021

Abstract

Introduction
Those wishing to pursue a career in surgery will be aware of stereotypes that exist within each specialty, including how long it takes to attain a certificate of completion of training (CCT). These perceptions are often historic, and whilst may be based on elements of truth, are rarely backed by robust data. Oral & maxillofacial surgery (OMFS) for example is plagued by the stigma of necessitating a second degree which gives the assumption the age of being appointed a consultant is somewhat above average. We aim to dispel (or prove, depending on one’s predisposition) such myths by analysing the age of surgeons when appointed to the General Medical Council’s specialist list.

Method
Information on the age of entry onto the surgical specialist lists between 1997 and 2018 was obtained from the General Medical Council (GMC). Data was suitably statistically analysed.

Results
19,135 surgeons joined surgical specialist lists during the study period. General and trauma and orthopaedic surgery accounted for 60% of all surgeons (n = 11,444). The age on joining surgical specialist lists ranged from 27–83 years, with a mean of 41.4 years. Neurosurgeons most frequently joined the specialist list in the youngest age bracket. OMF surgeons, along with their cardiothoracic and vascular colleagues, are joint eldest by 1.3 years.

Conclusions
Since the creation of the specialist list, training has seen several upheavals. This data shows that despite each specialty’s specific requirements and individuals’ varying paths, there is little difference in the age when the consultant destination is reached.
1504 Mandatory Reflection as a Learning Tool
Authors: Payton O , Spurrier E , Stapley S 
Published: October 2021

Abstract

Introduction
Reflection has become a compulsory part of medical training and forms the basis of most trainee portfolios.

Method
We sent an electronic questionnaire to doctors from a range of specialties at various stages of training and asked how often they were involved in reflection, whether this was mandatory, and whether they found this useful.

Results
We received 608 responses, 66% from doctors in training. 90% stated that reflection was mandatory for training. 396 had a pre-set number of reflections they had to meet in a set timeframe. 26% of respondents admitted using formulaic responses in the “majority of occasions” or “always”. 27% admitted to copying and pasting from previous reflections. 20% altered their story to make it relevant to the message they wished to convey. 85% found voluntary reflection useful to some degree.

Conclusions
Although reflection plays it part as a learning aid, making this mandatory, with a set number of reflections seems to detract from its value. There is a risk that this educational tool becomes an exercise in creative writing.
1520 Decoding Neurophobia – Insights from an Undergraduate Neuroanatomy Course
Authors: Bhate R , Colman J , Fowler T , Hayley J , Kallam N , Mak T L A , Matthews F , Norton E , Richardson D 
Published: October 2021

Abstract

Introduction
Neurophobia is a common multifaceted issue amongst students studying medical sciences at an undergraduate level associated with difficulty in understanding neuroscience topics and ongoing negative perceptions of clinical neurosciences. We sought to examine whether neurophobia was present even amongst students who participated in an extracurricular neuroanatomy teaching course.

Method
Prior to the beginning of a twelve-week online neuroanatomy course, delegates were asked to complete a short questionnaire examining perceptions of neurophobia and specialities of interest. This was repeated after the course. This course was open to all undergraduate students in the UK and covered material beyond the remits of the undergraduate curriculum.

Results
From the 166 signups, 98 students completed the pre-course questionnaire. As expected, the majority of students (n = 83) taking part did not identify as neurophobic, describing the subject area as ‘interesting’, ‘enjoyable’ and ‘challenging’. Students who identified as neurophobic described neuroanatomy as ‘complex’ or ‘overwhelming’. Some students (n = 12) continued to describe themselves as neurophobic at the end of the course, despite this 7 of those students continue to consider a future career in a neuro-related speciality.

Conclusions
The fact that students with Neurophobia attended this extra-curricular course speaks volumes of how perception and self-motivation of a student are important for learning a subject. All students who participated in this course recognised the complexity and interesting nature of neuroanatomy. This experience highlights the challenge of medical educators to provide teaching experiences that are stimulating and enjoyable, but not overwhelming.
1536 Neuroanatomy, Not Just for Budding Neurosurgeons. Motivations for Participating in An Extra-Curricular Neuroanatomy Course for Undergraduates
Authors: Bhate R , Colman J , Fowler T , Hayley J , Kallam N , Mak T L A , Matthews F , Norton E , Richardson D 
Published: October 2021

Abstract

Introduction
Extra-curricular activities form an important part of undergraduate education as they give students the opportunity to explore subjects of interest. There is significant demand within the undergraduate population for further teaching in neuro-related specialities. The aim of this online twelve-week course was to provide neuroanatomy teaching in greater breadth and detail than possible in the undergraduate curriculum. We sought to gauge motivations for involvement.

Method
Delegates (n = 166) from six UK universities were asked to complete a short questionnaire examining motivations and future career plans prior to the course beginning, only those who consented were involved further in the analysis (n = 98).

Results
Motivations for involvement were predominantly to develop a greater understanding of neuroanatomy (63.3%), to support career plans (13.3%) or to support preparation for an examination or competition (8.2%). The majority (56.1%) had no particular speciality in mind. For those who did, a range of specialities including neurosurgery (24.5%), neurology (8.2%) was given.

Conclusions
There is clear interest within the undergraduate population for more specialised extra-curricular activities in addition to conventional experiences such as conferences. Online courses run over multiple weeks provide further scope for depth and exploration of subjects in further detail. In this course, the majority of delegates did not have a particular speciality in mind, demonstrating neuroanatomy to be a popular subject regardless of potential career plans. For students looking to pursue a career in neuro-related specialities, courses are perceived as important opportunities to support future career development.
1552 'The Modified Cappuccini Audit Tool: Patient Safety in the Operating Theatre'
Authors: Lee G , Clough O , McLean El , Campioni-Norman D 
Published: October 2021

Abstract

Aim
To assess our trust over a period of two weeks with regard to safe supervision of surgical and anaesthetic trainees within the operating theatre using the Cappuccini audit tool.

Method
Between 7th of December 2020 and 18th December 2020 the anaesthetic and surgical team were approached and if there was a trainee present, they were asked a set of questions as follows:
If the supervisor is present in theatre no further action would be taken. If the supervisor was not present the volunteer would attempt to contact the supervisor by the method given by the trainee, and they were asked several questions:

Results
146 trainees were identified during our period. Of these the supervisor was present in 93% of cases. Of those not present 90% were contactable by phone, the other 10% were contactable by the trainee themselves. All trainees were happy to answer the questions was explained and all consultants were happy to be contacted. The average time to attend when not present was 2 minutes and 36 seconds.

Conclusions
We have shown the Cappuccini audit tool to be effective in determining safe supervision and found it in general to be well received within surgery and anaesthetics. We found our trust to have safe supervision in the operating theatre.
1650 Is There a Place for Medical Students at Organ Retrieval? 4 Years’ Experience at a Single Centre
Authors: Duck E , Schofield E 
Published: October 2021

Abstract

Aim
Medical students at a hospital with a national organ retrieval service (NORS) had the unique opportunity to attend organ retrieval. This retrospective survey investigated how attendance affected students’ desire to pursue a career in surgery, and what they learnt from the experience.

Method
Clinical medical students were invited to sign-up to shifts with the regional NORS team. If notified of a potential organ donation event the NORS co-ordinator would inform the medical student, who would then join the retrieval team and travel with them to the donation site. An electronic survey was later distributed to students, whether or not the donation proceeded. This survey collected both quantitative and qualitative information about the students’ experiences.

Results
51 responses were collected from students who attended proceeding organ donations between January 2015 and October 2019. 100% of students found it a useful learning experience and would recommend it to their peers. 98% were able to scrub in for the retrieval procedure. Common learning points were improved understanding of the process of organ retrieval (n = 34), and anatomy (n = 15). Following experience of organ retrieval 59% reported being more likely to pursue a career in transplant surgery and 69% reported being more likely to pursue any surgical career.

Conclusions
Medical students should be included in organ retrieval, as it not only benefits their learning, but also increases interest in surgical careers. Given that only two out of the sixteen UK NORS teams involve medical students currently, there is scope for much greater adoption of student retrieval rotas.
1653 How Do Trainees Prepare for Operating and Improve Theatre Learning Experiences?
Authors: Dunstan M , Fawns T 
Published: October 2021

Abstract

Introduction
Reforms to surgical training in the last three decades have threatened to reduce trainees’ operative experience. In 2012 ASiT recommended that trainees “take a proactive role in utilising all training opportunities” and that they “should be well prepared”. Published quantitative studies into surgical preparation involve mental practice and simulation and make assumptions that these are the most appropriate preparatory techniques. No qualitative studies have been published that explore how trainees prepare, to put this evidence base in context. This study aimed to investigate what trainees do to prepare for operating, their opinions on preparation for surgery, and how preparation may improve training experiences.

Method
Twelve General Surgical trainees consented to semi-structured interviews at a London District General Hospital. Interviews were recorded, transcribed and thematic analysis was undertaken.

Results
Interviewees described how preparation involves complex interactions between learning resources, their mental processes, emotions, the actions, and attitudes of other members of the theatre team, and situational and organisational barriers. These affected the quality of preparation and training experiences. Significant barriers to preparation were identified as a lack of learning resources and time to prepare. Techniques for preparation were mainly learnt informally through the ‘hidden curriculum’ and were lacking from the formal curriculum. Trainees felt that raising awareness of preparatory processes may enhance learning experiences.

Conclusions
An awareness of the factors that affect preparation and actions to mitigate barriers to preparation may help trainees to gain more from training opportunities, in the context of threats to training and the Covid-19 pandemic.
1668 Buying Your Way into A Run-Through Surgical Training Post: The Way Forward?
Authors: Raja H , Ebrahim S 
Published: October 2021

Abstract

Introduction
Competition for core surgical training (CST) applications has increased significantly over the last few years. This has been largely attributable to the introduction of limited run-through surgical posts which avoids the bottleneck at ST3 applications. We sought to assess how financial factors may affect current or potential future surgical trainees in their pursuit for run-through posts.

Method
A 10-point questionnaire was designed to assess various financial considerations for surgical trainees applying to the 2021 CST cycle who had the sole goal of securing a run-through post. Results were analysed using Chi-squared test.

Results
Of the 40 respondents, 95% were foundation doctors and 5% were core trainees. There was a significant association between willingness to achieve full marks in the CST interview and attending an interview course and obtaining 1-1 coaching sessions (p &lt; 0.05). Familial income was not found to be a significant barrier to spending money on interview courses and coaching sessions (p &lt; 0.05).

Conclusions
Applicants are willing to pay a significant premium to secure a run-through surgical post. Further research is required to fully understand the reasons behind this phenomenon and the impact on those from widening participation backgrounds.
1691 Survey of Patient Attitudes Towards Face-To-Face and Telemedicine Teaching in the COVID-19 Era
Authors: Coady L , Charturvedi A , Fearon N , Heneghan H , Carrington E 
Published: October 2021

Abstract

Background
COVID-19 has profoundly impacted the healthcare education environment and telemedicine has been used to augment face-to-face learning and support social-distancing. There is little evidence which examines how patients feel about participating in teaching with this technology.

Method
A prospective survey of 229 surgical inpatients/outpatients was conducted at a university hospital between August–September 2020. The survey consisted of 31 questions (7-point Likert scales, quantitative items, and free-text answers) to explore: general attitudes towards teaching, attitudes towards COVID-19, perceptions of face-to-face teaching and perceptions of telemedicine teaching. Relationships between demographics and areas of interest were analysed qualitatively and quantitatively.

Results
Patients reported a positive attitude towards both face-to-face (mean 5.5 [1.1SD]) and telemedicine teaching (5.4 [1.2]) however there was a preference for the face-to-face approach (mean difference [MD]=.16, p = 0.14). Face-to-face teaching was found to be less bothersome (MD=.32, p=.002) and more rewarding (MD.33, p&lt;.001). Older patients were more likely to report both teaching techniques as embarrassing (face-to-face r=.16, p=.048; telemedicine r=.15, p=.036) or as an infringement on their privacy (face-to-face r=.13, p=.048; telemedicine r=.17, p=.017). Qualitative analyses revealed four themes of the patient experience: apprentice role of students, communication skills, transient need for telemedicine during COVID-19 and privacy concerns.

Conclusions
Despite reporting a favourable impression of telemedicine teaching, patients prefer traditional face-to-face styles as they find telemedicine more bothersome and less rewarding. Educators should take this into consideration during planning of teaching during the pandemic.
1695 Undergraduate Cardiothoracic Surgery: Pumping Up Knowledge and Inspiration with High-Fidelity Simulation
Authors: Hirniak J , Hussein F , Seyedzenouzi G , Adil S , Vaghela M , Liu G , Asif A , Churchill T , Zargaran A 
Published: October 2021

Abstract

Introduction
Alongside declining ST3 applications, cardiothoracic surgery (CTS) is underrepresented in the medical curriculum with 90% of medical students reporting no exposure to the specialty in medical school placements. This may result in clinicians having difficulties recognising emergency presentations, with subsequent referrals made inappropriately.

Method
A simulation course involving teaching around common CTS conditions and procedures was delivered by CTS trainees to undergraduate medical students (n = 50). This involved both theory and high-fidelity simulations of coronary anastomoses using cardiac surgical equipment on porcine hearts and ureters. Delegates were given pre and post-test questionnaires, and another at six-weeks to test knowledge retention. Results were statistically analysed using paired and independent sample t-tests.

Results
Delegates demonstrated significant improvements in post-test knowledge of 56% (p&lt;0.01), and sustained improvement of 51% (p&lt;0.01) six-weeks later compared to baseline. 64% of delegates reported an increased interest in pursuing CTS as a career; 40% reported improved confidence performing a coronary anastomosis.

Conclusions
Immediate and long-term knowledge retention of key CTS concepts and ability to assess common CTS pathological scenarios were demonstrated in this study. CTS simulation therefore represents an effective mechanism by which key concepts can be taught to undergraduate medical students, whilst enhancing interest in pursuing CTS as a career. As an educational adjunct, simulation can help bridge the gap between taught theory and applied practice, with the potential to empower future doctors to make more informed referrals and management decisions.
1697 Undergraduate Otolaryngology: Enhancing Interest and Education with Hands-on Simulation
Authors: Hirniak J , Jain A , Van M , Kokotkin I , Vaghela M , Churchill T , Zargaran A 
Published: October 2021

Abstract

Introduction
With cancelled student placements due to the COVID-19 pandemic, there is a shift towards non-patient-facing methods to deliver medical education. The aim was to design, deliver and evaluate an ENT course for undergraduate medical students.

Method
A three-part simulation course on common and emergency ENT conditions was delivered by ENT trainees to undergraduate medical students (n = 50). It involved theoretical and hands-on experience with otoscopy on head models; nasoendoscopy and epistaxis management with upper airway head models and nasal packing kits; and management of compromised airways using critical airway models, airway adjuncts, intubation and cricothyroidotomy kits. Delegates were given pre- and post-course questionnaires, with another at six-weeks to test knowledge retention. Results were statistically analysed using paired and independent sample t-tests.

Results
A statistically significant improvement in post-test knowledge of 55% (p&lt;0.01) was observed. Delegates also demonstrated a sustained improvement of 51% (p&lt;0.01) six-weeks later compared to baseline knowledge. 76% and 80% reported improved confidence managing epistaxis and performing intubation respectively; 46% reported increased interest in pursuing ENT as a potential career.

Conclusions
This study demonstrated statistically significant and sustained improvements in knowledge about common and emergency ENT concepts. ENT simulation therefore represents an efficacious mechanism for teaching key ENT concepts and improving confidence in undergraduate medical students, whilst improving interest in pursuing ENT as a career. Additionally, simulation is an invaluable educational adjunct that may foster more realistic, impactful, and safer educational experiences for medical students whilst exposure to patients is minimised due to the current pandemic.
175 Sternal Closure with Single Compared to Double or Figure-Of-8 Wires in Obese Patients Post Cardiac Surgery: A Systematic Review and Meta-Analysis
Authors: Shafi Ahmed Mohamed Abdel , Abuelgasim Eyad , Abuelgasim Biyaser , Iddawela Sashini , Harky Amer 
Published: October 2021

Abstract

Aim
Sternal instability and wound infections are a major cause of morbidity following cardiac surgery, which is further amplified in high-risk patients that include diabetics and patients with high BMI. We compare the different outcomes of different sternal wire closure techniques following median sternotomy for cardiac surgery in obese patients

Method
A comprehensive electronic literature search was undertaken according to PRISMA guidelines from inception to July 2020 to identify all published data comparing single wire sternal closure to either double wire or figure-of-8 techniques following median sternotomy for cardiac surgery in obese patients, defined as a BMI ≥ 30.

Results
Eight studies met the final inclusion criteria; single wire versus double wire sternal closure (n = 2) and single wire versus figure-of-8 wire closure (n = 6). Higher rate of sternal instability was noted in single wire vs double wire closure (22/150 (14.7%) patients vs 6/150 (4%) patients, p = 0.003, OR 0.25 [95% CI 0.10-0.63]). Similarly, sternal instability was higher in single wire vs figure-of-8 wire closure technique (33/2422 (1.3%) vs 11/8035 (0.1%), p = 0.04 OR 0.30 [95% CI, 0.09-0.96]) respectively.

Conclusions
There is benefit in the use of either double or figure-of-8 sternal wire closure techniques over single wire closure in terms of sternal instability. However, as the studies were limited, larger scale comparative studies are required to provide a solid evidence base for choosing the optimal sternal closure technique in this high-risk group of patients.