bluuebunny/crossref_metadata_2025_split huggingface dataset:
1007 Flipping the Radiology – Teaching ‘Normal Radiological Anatomy’ to UK Medical Students
Authors: Vaghela M , Khera G 
Published: August 2024

Abstract

Aim
Our undergraduate medical education series ‘Normal Radiological Anatomy’ aimed to improve confidence and competence in medical students interpreting plain-film and cross-sectional imaging. This is in contrast to the traditional curriculum, where mostly only pathology and relevant landmarks are identified and discussed.

Method
Four extracurricular, hybrid in-person/virtual, voluntary, lectures covering chest/vascular, abdomen, musculoskeletal, and neuroanatomy were delivered through a UK University Surgical Society and offered to all medical students. After the lectures, the students were surveyed with 7 questions.

Results
A total of 72 students attended at least one lecture. However, only feedback forms from individuals who attended all four lectures and gave feedback on all the lectures were considered. With our inclusion criteria, 48 individuals (67% of total attendees) were considered. Before attending the series, the mean confidence level in interpreting scans was 2.6/5. After attending the series, it was reported to be 4.8/5. The series was praised for its detailed demonstration of normal anatomy in scans; showing students rarely taught/discussed vessels/structures in imaging such as the great cerebral vein of Galen and the adrenal glands.

Conclusions
In contrast to conventional radiological education where students are taught to identify pathology in imaging, it may be more productive to teach students how to recognise normal anatomy on scans, as demonstrated in our series. This approach not only drastically increased student confidence when approaching pathological imaging but potentially helped students identify more pathology on scans as they are more familiar with the appearance of normal anatomy in imaging.
1024 Improving Patient Education and Implementation of Early Mobilisation Following Hip or Knee Replacement Surgery
Authors: Hussain N , Yadati S , Laity A , Murphy Lonergan R 
Published: August 2024

Abstract

Aim
Early mobilisation within the enhanced recovery after surgery (ERAS) pathway has been proven to reduce the risk of postoperative complications following orthopaedic surgery. Currently there is suboptimal compliance with NICE guidance on early mobilisation. This QIP is aimed to improve awareness on the importance of early mobilisation within a 24-hour period post-surgery as well as increase the incidence of mobilisation post intervention.

Method
We interviewed 17 inpatients following total hip or knee replacement surgery on their understanding of the importance of early mobilisation after surgery and whether they had been encouraged to do so by their ward teams. Following analysis, we created and distributed patient-centred information leaflets and posters around orthopaedic units in Chelsea and Westminster hospital, with information regarding the benefits of mobilisation along with the complications avoided.

Results
We measured patient knowledge on early mobilisation via electronic survey following distribution of posters and leaflets on the ward. We also assessed if patients operated on following our intervention were mobilising within 24 hours. We demonstrated increased patient knowledge on the benefits of early mobilisation and an absolute increase in patients mobilising within 24 hours.

Conclusions
Further cycles would be beneficial to determine true statistical significance of this intervention.
1156 Women in Surgery: Perceptions, Actions and Experiences
Authors: Shankar M 
Published: August 2024

Abstract

Aim
Women represent roughly 58% of medical school cohorts however only 28% eventually pursue higher training in surgery in the United Kingdom. This study aimed to explore the perceptions, experiences, and actions of women towards surgical specialties.

Method
An electronic survey was distributed to surgeons, trainees, and medical students who identified as female across the United Kingdom for a one-time submission per responder. The link was kept active for 72 hours. 237 complete responses were recorded and statistically analysed.

Results
A total of 112 participants (47.2%) felt that pay inequity based on gender was the biggest deterrent to a career in surgery. Orthopaedic/Trauma Surgery was reported as the most sexist surgical specialty with 36.2% of the responders. The most common action preferred to deal with sexism in the workplace was to demand an apology (40.9%). Overall, family and career conflicts, gender bias, and lack of motivating factors (female role models, mentors) were perceived barriers for women to pursue surgical careers.

Conclusions
These findings highlight the challenges perceived by women to pursue surgical careers. Women who feel biased against are less inclined to choose surgical specialties. Changes must be made to be more inclusive. This study may help guide transformative adaptations within surgical departments.
136 Epidemiology and 5-Year Outcome of Operated Cases of Intracranial Meningioma in a Tertiary Care Centre in Nepal in the Last 10 Years
Authors: Shrestha S , Karmacharya D , Shrestha P 
Published: August 2024

Abstract

Aim
To know the epidemiology and 5-year outcome of operated cases of intracranial meningioma in a tertiary care centre in Nepal in the last 10 years.

Method
This is a retrospective study from the time period of 10 years, from 2010 to 2020 in the Neurosurgery department of Upendra Devkota Memorial National Institute of Neurological and Allied Sciences. The inclusion criteria for the study consist of all the patients who underwent an operation with proven histopathological findings of meningioma. The Glasgow Outcome Score was noted for the 5-year outcome.

Results
A total of 239 patients were operated over the span of 10 years. The mean age of presentation was 47 years. The female-to-male ratio was found to be 2.1:1. The most common site of meningioma was found to be convexity meningioma followed by parafalcine meningioma and sphenoid wing meningioma. The most common histopathological finding was a transitional meningioma, WHO Grade I, followed by fibrous and atypical meningioma. Out of 239 cases, 68 patients had not yet reached 5 years post-operative period. Outcome after 5 years postoperative period, 140 patients (81.87%) had good recovery, 4 patients (2.34%) had moderate disability, 2 patients (1.17%) had a severe disability, 1 patient (0.58%) were in a vegetative state and 24 patients (14.04%) had died. Among all the patients who were operated on, mortality was found to be 10.04%.

Conclusions
Intracranial meningiomas are slow-growing extraaxial tumours, usually benign, most commonly located along convexities, parafalcine, parasagittal and sphenoid ridges. Most are cured if completely removed, which is not always possible.
238 Management of Extravasation Injuries Referred to the Plastic Surgery Department in a Regional Centre
Authors: Evans J , Ahmed O 
Published: August 2024

Abstract

Aim
To assess the volume and outcome of extravasation injuries referred to the plastic surgery department in a regional centre, and to devise and implement a protocol to improve outcomes.

Method
A retrospective review was undertaken of extravasation injuries referred to the plastic surgery department between August 2021 and November 2022. Data collected included time of injury and subsequent referral, drug type and volume, seniority of reviewer and subsequent outcomes including whether patients required surgery. A total of 18 patients were included in this study.

Results
None of the patients had documented first aid from their home teams. 5 of the 18 patients (28%) required surgery (debridement + skin grafting+/- BTM).

Conclusions
Delays in referral to plastic surgery and the lack of first aid from the referring teams may result in poorer outcomes from extravasation injuries. A guideline should be accessible for all clinicians to facilitate early referral and appropriate first aid measures.
745 Improving Time to ERCP for Acute Gallstone Cholangitis Admissions at a District General Hospital: A Closed Loop Audit
Authors: Boyce L 
Published: August 2024

Abstract

Background
NICE guidelines recommend prompt endoscopic retrograde cholangiopancreatography (ERCP) within 72 hours for adults with acute gallstone cholangitis, especially in moderate-to-severe cases. We audited our management of obstructive gallstone disease to enhance timely access to ERCP.

Method
We conducted a closed loop audit at a UK district general hospital, assessing time to ERCP for patients with acute gallstone cholangitis. Severity was graded using the 2018 Tokyo Guidelines. Data was collected over a 5-month period (01/05/2023 to 01/10/2023), analysed and presented to the surgical multi-disciplinary team. Additional referral pathways to 3 nearby tertiary care centre for ERCP were established. Post-intervention admissions were re-audited over a second 5-month period (01/01/2023 to 01/06/2023) to assess the effect of the new referral pathways.

Results
Forty-one patients underwent ERCP for acute gallstone cholangitis. Pre-intervention, median time to ERCP overall was 10 days (5–24), 8 days (5–19) for moderate-to-severe cases, and 28 days (9–46) for mild cases. Post-intervention, median time to ERCP overall was 6 days (4–9), 6 days (6–8) for moderate-to-severe cases, and 4 days (4–25) for mild cases. Median length of stay pre- and post-intervention was 8 (6–13) and 7 days (4–10), respectively.

Conclusions
By establishing referral pathways to tertiary care centres, we successfully reduced time to ERCP for local patients with moderate-to-severe cases. This change contributed to shorter waiting times for ERCP in mild cases and decreased overall length of stay. Collaborative efforts between district general hospitals and tertiary centres improve outcomes in the management of acute gallstone cholangitis.
998 Reducing Medical Student Anxiety and Stress by Providing Guidance on Specialty Training and Self-Assessment Portfolios Early on Within Their Medical School Careers
Authors: Patel R D , Lonergan R M , Bartholomew B 
Published: August 2024

Abstract

Aim
With CST applications becoming increasingly competitive and relying on a strong portfolio, third year is the perfect time to teach medical students how to maximise points. It gives them ample time to prepare and structure their projects with a clear goal in mind. However, they are often unaware of where to begin causing avoidable stress and subsequent regret. Our aim is to explore medical students’ knowledge and awareness of specialty training portfolios as well as to provide guidance on specialty training and self-assessment portfolios through a near-peer talk and to evaluate usefulness of this talk for third year students.

Method
We conducted data collection via an anonymous survey, to establish baseline understanding of CST and other specialty training pathways, as well as interest in learning more. We hosted an optional lecture for third year students on specialty training portfolios by a core surgical trainee and gathered post-session feedback on understanding of specialty pathways and applications. We specifically asked how confident students felt they could organise a portfolio.

Results
Post-session, confidence levels increased while stress related to CST application decreased. A predominant theme was the usefulness of this talk early in the undergraduate programme, so students felt they had clear goals, aims and time to develop their portfolios.

Conclusions
Students feel unclear and anxious about specialty training. A clear understanding of specialty recruitment and postgraduate portfolio empowers students to work towards their career goals in a structured and manageable way. Early dissemination of information on CST applications reduces anxiety and improves confidence.
1270 Enhancing Mobility During Mealtimes on an Orthopaedic Ward: A Collaborative Intervention Approach
Authors: Al-Azzawi H , Keehan R , Jervis C , Fern S Archer , Rajab A , Ein S Abu , Akbar S , Smith A 
Published: August 2024

Abstract

Aim
This quality improvement project aimed to enhance patient mobility by engaging nursing staff in identifying barriers and implementing strategies to increase number of patients sitting out of bed during mealtimes, on a trauma and orthopaedics ward.

Method
Data collection occurred over three weeks (Monday to Friday) to assess patient mobility during mealtimes. Subsequently, the collected data was presented to nursing assistant, staff nurses, the ward sister, and the matron. Collaborative discussions led to the implementation of four key interventions: empowering all staff to engage in mobilisation, reprioritising night staff tasks to include getting patients out of bed, establishing a dedicated mobilisation time of 0730-0800, and communication of these interventions daily during the nursing safety brief. Following the intervention, another week of data collection was conducted.

Results
Initially, only 53% of patients were sitting out of bed during mealtimes. Post-intervention, a significant improvement was observed, with 75% of patients sitting out of bed during mealtimes.

Conclusions
The implementation of targeted interventions led to a significant improvement in patient mobility during mealtimes. By incorporating dedicated time for mobilisation and modifying workflow priorities, the healthcare team successfully increased the number of pts sitting out of bed for mealtimes. These interventions highlight the significance of empowering staff to make their own decisions on how best to achieve shared goals. Such interventions, embedded within routine care practices, have the potential to enhance patient mobility and overall well-being in orthopaedic settings.
350 Adding Education Fellows to Surgical PTWR Improves Medical Student Learning
Authors: Clay W , Lau K , Kimyongur S , Skinner H , Ravi K 
Published: August 2024

Abstract

Aim
To assess if there is any improvement in student evaluation of surgical PTWR when a surgical education fellow is facilitating.

Method
Medical students from two medical schools on surgical placement in a district general hospital were encouraged to attend one surgical post-take ward round during their allocated Surgical Assessment Unit week. The students ranged from their first to final clinical placement. Students were then asked to complete a questionnaire, detailing their thoughts and feelings about their learning needs, objectives, and overall understanding of the cases they saw on the round. There was also space for free text. The students were later invited to join another surgical PTWR with one or more surgical education fellows present in a non-clinical capacity to facilitate the students’ learning by discussing the clinical scenarios in depth. The students were then given the opportunity to fill out a second identical questionnaire and the results were compared.

Results
22 students completed the initial questionnaire, and 23 students completed the post-intervention questionnaire. The results showed that 59.1% students agreed or strongly agreed their learning needs were met and addressed initially, rising to 95.6% on the fellow-facilitated round with 4.3% answering neither agree nor disagree. No students selected disagree/strongly disagree to this question.

Conclusions
The surgical post take ward round is already a generally useful learning tool for medical students on their surgical placements, but the addition of an education fellow in a non-clinical capacity can improve students’ experience, learning and understanding of common post-take surgical pathologies.
421 Surgical Bedside Teaching at St Helier Hospital – a Quality Improvement Project
Authors: Norris C , Al-Jasim A , Lewis T 
Published: August 2024

Abstract

Aim
To assess the impact of bedside sessions on medical students’ confidence in clinical assessment. It aims to assess strengths and weaknesses and guide further interventions.

Method
It employed a mixed-methods approach using both quantitative and qualitative measures in anonymised surveys. The intervention that was introduced was a ‘learning objective ticket’, whereby learning objectives were distributed and discussed prior to the session.

Results
There were 22 responses in the first cycle of the evaluation. Quantitative data revealed that the mean confidence in history taking was 3.55(+/- 0.59) before the session, and 4.32(+/-0.56) after the session (P&lt;0.001).There was also a significantly significant difference in mean confidence levels in examination skills (p&lt;0.001) with confidence going from 3.14(+/-0.56), to 4.45(+/-0.51). Qualitative data highlighted areas of improvement such as clearer learning objectives, greater alignment with assessments and better adherence to time constraints.
There were 18 responses to the survey in the second cycle of this evaluation. Quantitative results showed that 88% of students ‘strongly agreed’ that the learning objectives were clear, 88% of students ’strongly agreed’ learning objectives were relevant, and 72.2% ‘strongly agreed’ that they had met their learning objectives. 12 out of 18 responders (66.7%) ‘strongly agreed’ that the timings of the session were adhered to.

Conclusions
Overall bedside teaching sessions are a valuable tool in undergraduate surgical education. Their impact can be further advanced by linking with learning objective as per constructivist alignment theory. Applying closer alignment with formal assessment could further improve these sessions.
708 Innovating Low-Cost Automated Progress Tracking System (APS) for Laparoscopic Cholecystectomy Simulation (LaChSi) Models in the Lower Middle-Income Countries (LMICs) and Its Application for the Global HPB Surgery in Resource-Limited Settings
Authors: Karki B B , Sharma S , Thapa B , Neupane P , Phuyal S , Shrestha S , Katuwal S , Satyal S , Loubani M 
Published: August 2024

Abstract

Aim
Global HPB surgery aims to provide safe, timely, accessible surgical care and to address the healthcare disparities emphasising equity & sustainability in care delivery for the Hepato-Pancreatico-Biliary (HPB) disease on a global scale, which can be achieved through comprehensive simulation-based surgical training in resource-limited settings. The aim is to develop a low-cost Laparoscopic Cholecystectomy Simulation (LaChSi) model and automated Progress Tracking System (APS) and to ensure a realistic and accurate representation of the laparoscopic cholecystectomy (LC) procedure.

Method
A silicon model replica of the biliary tree fabricated with wires traversing the biliary tree. These wires are connected to a printed circuit board (PCB) at the model's base, linked to a microcontroller and a computer which will track the skills progress of the trainee. Any erroneous manipulation or damage to the bile duct triggers identification, resulting in a negative score for the surgeon and highlights on the computer screen. This facilitates the evaluation of trainee surgeon skills while concurrently enhancing their surgical skills.

Results
The successful adaptation and validation of the APS for laparoscopic appendicectomy models have demonstrated its effectiveness and the suitability of its application for LC. The development of these low-cost LaChSi models will aid in enriching the global HPB workforce, in resource-limited settings.

Conclusions
There is an unmet need for the development of a Low-Cost simulation model in LMICs and these models can provide a safe and standardised method for HPB simulation training before operating on real patients addressing the core value of Global HPB surgery.
896 Near-Peer Teaching (NPT) to Enhance Surgical Education in the Medical Curriculum: A Review of the Current Literature and Recommendations for the Future
Authors: Lee K B C , Rojanathagoon T , Suvarna R , Choi Y S , Chang F 
Published: August 2024

Abstract

Aim
There is increasing evidence of insufficient surgical education in the medical curriculum and a growing sentiment amongst medical students of poor confidence in the operating room (OR). Near-Peer Teaching (NPT) has emerged as a common pedagogical solution utilising cognitive congruence to counter this, whereby senior medical students and recent graduates are recruited as near-peer tutors. We aim to review the successes and areas for improvement in the current literature.

Method
A comprehensive literature search was performed on EMBASE, PubMed and MedLine.

Results
Pre-post questionnaire comparison from a NPT-led surgical skills course reported significantly increased self-perceived confidence in performing some of 8 surgical domains. Providing basic surgical skills in conjunction with 'Flipped Classroom' yielded significantly higher confidence in performing all sutures and knot-ties assessed. Another workshop had medical students achieve double the number of sutures and improved suturing technique post-session. Increased confidence in surgical skills and OR were additionally achieved through a NPT-led OR simulating environment. NPT-led surgical and clinical anatomy courses equipped students with higher confidence and comfort assisting in the OR. Commonly, the informal, perceived 'low-risk' kinaesthetic environment is described to ease feelings of anxiety and be conducive to surgical education. NPT furthermore reported benefits for instructors pertaining to self-efficacy, teaching skills, surgical confidence, and knowledge consolidation.

Conclusions
NPT enhances surgical career interests and improves outcomes of surgical education for both tutors and tutees, when delivered in addition to surgical teachings in the curriculum. The design of NPT and training of tutors however, ought to be supervised by a senior surgical staff.
1062 Out of Theatre Training (OTT) for Vascular Surgery
Authors: Elkawafi M , Alnatsheh W , Alshiek A , Greaves N 
Published: August 2024

Abstract

Introduction
We recognise the challenges faced by Pre-registrar Doctors in acquiring vascular technical skills in theatre . anastomosis and patching are performed with clamped arteries and margins for errors are slim . To bridge the gap between patient safety and training, we introduced Out of Theatre Training ( OTT) in our units. we provide one-to-one training with stress-free and patient-safe environment with consistent feedback and continuous practice . This was started as a pilot in the vascular department, and we aim to provide it to the whole hospital surgical cohort.

Aim
Improve training for pre-registrar Doctors in vascular techniques and evaluate the efficacy of OTT in our unit.

Method
Each trainee was trained using with at least one session on both patch and anastomosis . following this we provide each trainee with personal suturing equipment, grafts, and patches to use in their own time to practice. They send pictures of their work for feedback. OTT was evaluated using pre and post survey to collect both subjective and objective data

Results
7 pre-registrar doctors involved in the pilot, 3 CST,4 F2. trainees evaluated this as an excellent training opportunity. Each participant performed at least 2 anastomosis/patches with 1 on their own. Each trainee acquired at least 2 DOPS in their portfolio. Trainees found themselves more confident in performing the procedure in theatre following this . Further granular data was collected.

Conclusions
We would like to coin (OTT) as a leading method in training in a patient safe, stress-free, trainee focused environment. We encourage other specialities to follow this method.