bluuebunny/crossref_metadata_2025_split huggingface dataset:
357 A Case-Control Study to Evaluate the Impact of Pet Cat or Dog Ownership on Medical Students’ Psychosocial Wellbeing
Authors: Wong R , Co M 
Published: August 2023

Abstract

Aim
This study aims to evaluate the impact of pet dog or cat ownership on medical students’ stress response and academic performance during the COVID-19 pandemic.

Method
This is a prospective case-control study. A validated questionnaire, COVID-19 Student Stress Questionnaire (CSSQ), was distributed to all final year medical students studying at University of Hong Kong in July 2021. Stress responses and academic performance between pet and non-pet owners were compared.

Results
A total of 110 medical students participated in the study, with non-pet owners accounting for 81 students (control group), and 29 students being pet-owners (case group). The baseline demographic characteristics were comparable between both groups. Non-pet owners demonstrated higher levels of stress compared to pet-owners, with 49.4% perceiving academic study experiencing being “very” or “extremely” stressful compared to 24.1% seen in pet owners (p = 0.0278).
13 (11.8%) students failed in the final examination in the medical school requiring supplementary examination. Of which, 1 (7.7%) were pet-owner while 12 (92.3%) were non-pet owner. However, statistically significant correlation cannot be demonstrated (p = 0.1778).

Conclusions
Pet ownership is associated with reduced stress levels among medical students during COVID-19 pandemic.
482 Is Collaboration the Key to Strength in Unity for Surgical Education?
Authors: Baskaran R , Vyas R , Naguib A 
Published: August 2023

Abstract

Aim
With the everchanging landscape of surgery, there is a paucity of surgical education courses focused on medical school finals examination. We examined the effectiveness of an eight-part specialty-doctor-delivered collaborative online teaching.

Method
The largest surgical education collaboration, SurgEazy, was organized between eight national/international organizations (NSTS, BIMA, NANSIG, ANTS, INCISION UK, WEDNS, BURST Urology). Finals-specific online teaching sessions were organized and delivered via zoom spanning eight surgical specialties. All sessions were delivered by session specialty-specific surgical trainees ranging from FY2 to ST3. 10-point Likert scales were used to measure the outcomes of sessions.

Results
A total of 433 students attended the eight sessions. All sessions demonstrated an increase in knowledge (8 ± 1.48), interest in pursuing surgery as a career (8 ± 2.17), commitment (8 ± 2.06), confidence (8 ± 1.60), and clarification of discrepancies in knowledge (8 ± 1.64). It also saw a decrease in concerns and worries (8 ± 1.89), and anxiety (8 ± 2.30). The majority of the students felt that the collaborative nature of the series increased its value (8 ± 1.79), their likelihood to attend (8 ± 2.13), and their awareness of all organizations (79.94%).

Conclusions
While online teaching has its merits of accessibility and convenience, collaborations have been shown to increase the overall merit of surgical education. Conducting such specialty-doctor-delivered focused collaborative online teaching is proven to be effective and should be considered by organizations in the future to increase the value, reach, attendance, and overall awareness of both the series and individual organizations.
605 Whose Operation Is It Anyway? Is There Consensus on Supervision Codes Use for General Surgical Procedures?
Authors: Cohen H , Simson R , Bamford R 
Published: August 2023

Abstract

Aim
Operative numbers are critical in applications to Core and Higher Surgical training, ARCP and CCT requirements. However, instructions for the use of supervision codes on the surgical eLogbook and ISCP are ambiguous. This study seeks to determine if there is a consensus for supervision coding for common general surgical operations.

Method
A survey of 10 operative vignettes was distributed to doctors who used the eLogbook. Participants were asked to indicate if they would code the operation Assisted (A) or Supervised Trainer Scrubbed (STS) from the vignette provided.

Results
The survey received 258 responses from doctors across all grades. In one appendicectomy vignette describing involvement at each key step but no dissection, 55% coded it as Assisted and 40% STS. For a laparoscopic cholecystectomy vignette which described dissecting the gallbladder off the liver and closing the ports, 59% coded it as Assisted and 37% STS. By including port insertion in this vignette 25% coded it as assisted and 72% as STS. Only 20% agreed with the statement “I find it easy to understand what supervision code I should record in my logbook”.

Conclusions
This study shows little consensus on supervision codes for general surgical operations and considerable ambiguity in the system. The description of the codes on eLogbook is not fit for purpose with minimal supporting guidance on ISCP. Clearer guidelines are required to enable trainees to use consistent coding to ensure validity in the use of indicative numbers in applications and as a marker of progress.
623 How Much Time Do Surgeons Spend Operating?
Authors: Fu K , Abdelrahman M , Walmsley J , Chan D 
Published: August 2023

Abstract

Aim
There is significant variation in the amount of time that surgeons spend performing elective surgery worldwide. The aim of this study was to assess this degree of variation.

Method
An anonymised survey was sent via email to members of The Upper Gastrointestinal Surgeons (TUGS). The questionnaire consisted of demographic details, scope of practice, experience, the average number of days spent performing elective surgery per week and what they would prefer.

Results
206 surgeons (174 males; most of whom were aged 35-64 years and were trained surgeons) from 46 countries completed the survey with the majority working as general surgeons with an upper gastrointestinal interest in the public sector. Worldwide, the median number of days that surgeons spend performing elective surgery in the public sector is 2 days per week. Surgeons in the UK spent the least amount of time performing elective surgery compared with surgeons in the rest of Europe, North America, Asia and Africa (1 day vs. 3, 2 and 2 days respectively, p&lt;0.05). All surgeons preferred to spend at least 3 days performing elective surgery per week.

Conclusions
Surgeons in the UK spend the least amount of time operating electively. The reasons for this is multifactorial and should be explored further. The results of this study could improve public expectations of surgeons in different countries and inform trainee surgeons on ideal opportunities for training.
701 Designing a Transition Programme: From Higher Surgical Training to Consultant Practice
Authors: Kamran Siddiqui Z , Jayasuriya R , Lewis C , Tomlinson J 
Published: August 2023

Abstract

Background
Higher surgical training (HST) in the UK focuses on delivery of clinical knowledge to pass FRCS exams, technical skills to fulfil CCT requirements, and clinical preparedness for a day-one consultants.

Aim
To identify specific professional capabilities deficient in HST which may inform new training objectives to aid transition between HST and T&O consultant practice.

Study Design
PRISMA Scoping Review. Review of existing courses and interviews with course directors. Semi-structured interviews with newly appointed consultants (&lt; 5 years) exploring non-clinical attributes necessary for new consultants. Interactive questionnaire with senior trainers and with post-FRCS trainees exploring timeframe for current trainees to gain non-clinical experience compared to the ideal timing of developing these skills.

Results
PRISMA-ScR papers identified n = 434, screened n = 276, eligible n = 105, included n = 50, of which surgical = 7, T&O = 0; demonstrating limited literature characterising the gap in preparedness during this specific surgical transition-point.
Specialities with dedicated courses include paediatrics and ophthalmology; programmes reviewed demonstrated a wide array of topics.
Interviews identified strong themes of lack of understanding of NHS structure, job planning, procuring specialist equipment, handling complaints and human factors.
The interactive survey undertaken by both senior trainers and post-FRCS trainees demonstrated a similar trend with a clear shift towards pre-FRCS delivery of skills.

Conclusions
Differences in trainees’ perceived needs and those identified by consultants pose a potential challenge in HST. Across all groups involved, deficiencies were identified in acquiring non-clinical skills and knowledge. This mixed methods approach identified key topics to cover in transition to consultant course to improve challenges during transition.
768 Exploring the Use of the HoloLens2 as a Tool in a Clinical Skills OSCE
Authors: Moore A , Moorjani U , Karunaratne D , Dasigan K , Bartholomew B 
Published: August 2023

Abstract

Aim
We explored the impact of examiners using mixed-reality headset (HoloLens2) on student performance/wellbeing, examination logistics, marking accuracy and examiner availability during a formative clinical skills OSCE.

Method
24 final-year medical students from Singapore were tested on clinical skills including catheterisation, suturing and arterial blood gas sampling. The first station had two in-person examiners, the second had an examiner using the HoloLens2 to live-stream footage to a remote examiner, the third had an examiner using the headset to view a virtual mark scheme. Quantitative and qualitative data were obtained using questionnaires and semi-structured debriefs.

Results
Qualitative data was analysed thematically, with impacts on examination implementation, student/examiner wellbeing and marking ability emerging as key themes that were discussed in depth. 83% of students denied any impact of the HoloLens2 on their performance and 75% denied experiencing any distractions. However, correctable technical challenges were highlighted by 75% of examiners, such as difficulty visualising finer details of suturing remotely. Despite this, all examiners felt this was an acceptable mode of examination and would improve their availability to examine.

Conclusions
This evaluation served as a useful pilot of how the HoloLens2 may be used for remote examination and virtual marking in OSCEs. Examiners and students highlighted the value of this technology on examiner availability, student wellbeing and potential use for external examiners to monitor each station remotely. The main limitations lie with technological issues impacting on implementation, making this currently unsuitable for high-stakes assessment. However, it poses significant advantages for formative assessment in medical education.
950 Optimising Remote Near-Peer Teaching for Undergraduate Clinical Orthopaedic Skills - a Series of Quality Improvement
Authors: McColm C , Williamson T , Kay R , Brennan J , Martinson E 
Published: August 2023

Abstract

Aim
Undergraduate medical education has changed significantly following the COVID-19 pandemic, necessitating the adaption of medical education to an online environment. The aim of this quality improvement project was to develop and refine a series of online orthopaedic teaching sessions to supplement history and examination teaching within the undergraduate curriculum.

Method
Near peer tutorials, led by final year students, were delivered to year 4 students at the University of Edinburgh Medical School. The series of interactive tutorials ran three times throughout the academic year. Qualitative and quantitative feedback was collected, and the tutorial content adapted and improved for future sessions. Attendees ranked their confidence to deal with orthopaedic pathology pre and post session on a Likert scale to quantify the value of these sessions.

Results
Attendees ranked their confidence in dealing with orthopaedic pathologies on a 1-10 Likert scale to quantify the effectiveness of the teaching sessions. Cycle 1 for the history and examination tutorials demonstrated a +2.75 (p = &lt;0.001) and +3.15 (p = &lt;0.001) mean improvement in overall student perceived ability. By cycle 3 this was increased to 2.64 (p = &lt;0.001) for the history tutorial and +3.5 (p = 0.027) for the examination tutorial.

Conclusions
We have demonstrated that traditionally practical skills including history taking and orthopaedic examinations can be successfully implemented in a virtual environment. Online teaching methods can be utilised with great success within undergraduate trauma and orthopaedic teaching. Ensuring session interactivity, limiting session duration, and providing students with live feedback can greatly improve student satisfaction and thus improve the learning experience.
1209 Comparison of Competition in Recruitment into Surgical and Non-Surgical Specialties
Authors: Ridgley J , Vaidya A 
Published: August 2023

Abstract

Aim
Despite notoriety for strenuous training with significant out of hours commitments, surgical specialties maintain a reputation for competitive entry with rigorous portfolio requirements. This study aimed to compare recruitment data between surgical and non-surgical specialties to examine whether surgical specialties are more competitive for entry.

Method
Recruitment data from 2022 published by Health Education England was collated. Specialties included were those recruiting for registrar level training post (ST3/ST4 depending on specialty). Fill rates and competition ratios for all surgical specialties (with an ST3 entry-point) were compared with all non-surgical specialties for which there was data. Statistical analysis was completed using the Mann-Whitney U test.

Results
Median fill rates were 94.99% (IQR 23.81%) for non-surgical specialties and 100% (IQR 0%) for surgical specialties (p &lt; 0.05). Median competition ratios were 3.17 (IQR 2.86) for non-surgical specialties and 3.92 (IQR 1.58) for surgical specialties (p &lt; 0.05). Highest competition ratio overall was in immunology (46), with cardiothoracics having the highest surgical competitions ratio (23.5). Only genitourinary medicine and diagnostic neuropathology had a competition ratio &lt;1.

Conclusions
All specialties at registrar level training had high fill rates and competition ratios, however this varied greatly between specialties perhaps due to lifestyle factors and exposure as students. Surgical sub-specialties demonstrated significantly higher competition ratios and fill rates, suggesting that despite discussion around quality of life and burnout in recent years, surgery continues to be an attractive career. It would be interesting to compare the rates of those leaving training posts with recruitment data.
748 Views of Theatre Staff Regarding Reusable Gowns and Sustainability
Authors: Wheeley E , Jenkins R , Curtis R , Narayanan D , Murray C , Barthelmes L 
Published: August 2023

Abstract

Aim
The three Colleges of Surgeons declared a climate emergency. Reusable gowns are suggested to improve sustainability in theatres.

Method
Reusable gowns were made available to explore the interest of staff in using them. Staff were encouraged to answer a questionnaire about their attitude towards sustainability, their view on the impact of using reusable gowns, and whether they would be prepared to approach a colleague wearing a single use gown for a non-clinical reason (feeling cold).

Results
30 staff members agreed with global warming being important to them, with 4 staff members being indifferent. The same proportion agreed with theatres being an important area of net zero opportunities. 10 staff members consider changes in theatres to only play a minor role in relation to the magnitude of global warming.
26 of 34 colleagues would voluntarily wear reusable gowns, 8 would prefer single-use gowns given a choice.
Replying to the scenario of a staff member not being scrubbed up wearing a single-use gown feeling cold 7 would do the same, 9 would disapprove and raise this to the staff member, 8 would disapprove but not raise this, 3 would disapprove and raise this if there was a hospital policy in place to challenge 'it is ok to ask'.

Conclusions
Most staff (30/34) recognise opportunities in theatre to become carbon neutral. A considerable proportion (26/34) would use reusable gowns if available. We have started work on a logo for a code of conduct of respectful conversations regarding wasteful behaviour (e.g. wearing disposable gowns for non-clinical reasons).
1117 The NHS in Crisis; Assessment of the Impact of Litigation Trends Over 20 Years in General Surgery
Authors: Wallace-King S , Musbahi A , Coates R , Mofidi R 
Published: August 2023

Abstract

Introduction
A rising proportion of the National Health Service (NHS) annual budget is being spent on medico-legal costs, with over 1.6% of total UK healthcare spending on litigation in the year 2018/19. This is a risk to both patient care and public opinion of the NHS and as per business definitions the system is in crisis. This paper aims to assess the scale of the litigation crisis to fuel further work into mitigating it to improve value for patients and staff alike.

Method
Data was obtained from NHS resolution for claims relating to General Surgery between January 2000 and December 2020 to include the following: number of claims, cost of settled claims with and without damages paid, age/sex of patients, and primary injuries/causes.

Results
Between 2000 and 2020, 17,542 claims were made against General Surgical units in England with an increase in claims per year. Successfully closed claims cost the NHS £1.3 billion. The three most common causes for claims were intra-operative problems, failure/delay of treatment and failure/delay of diagnosis.

Conclusions
The NHS is threatened by a litigation crisis, with case volume and cost rising out of proportion to surgical workload and inflation. The most common causes for claims are known complications discussed as part of a standard consenting process, indicating that current practice may fail to achieve adequate patient understanding of surgical risk. More research is required to improve the current consenting process and identify demographics that may increase an individual’s propensity to make a claim.
1149 Bringing Recycling to the Operating Department - a Sustainability Project in a DGH in London
Authors: Cho G , Yun J W 
Published: August 2023

Abstract

Aim
The Lancet Commissions report of 2015 suggested that tackling climate change could be the greatest global health opportunity of the 21st century. Both the Royal College of Surgeons of England and the Royal College of Anaesthetists have committed to sustainability task forces and have published guidance on improving care through small, sustainable practices including recycling waste.

Method
We conducted a theatre staff survey on SurveyMonkey in an operating department in an acute district general hospital without any recycling facilities on the attitudes towards recycling, and how this could be implemented.

Results
We received 103 responses, including a broad spectrum of the multi-disciplinary team including surgeons, anaesthetists, scrub nurses, operating department practitioners and healthcare assistants. Results showed that little to no recycling occurred (59%), 48% of respondents were not familiar with which material can be recycled, and 96% were agreeable to improving access to recycling in theatres. Two main areas identified as barriers to recycling were inadequate access to recycling bins and inadequate information on what can and what cannot be recycled. In terms of implementation, 75% of respondents indicated that posters around the department would be most useful in raising awareness and providing information on recyclable materials.

Conclusions
Currently, we are in conversation with the Trust and the waste management company to identify a list of recyclable materials and to incorporate recycling bins as part of the waste management pathway.
836 Aetiology and Management Outcomes of Adult Mechanical Bowel Obstruction in Nigeria: A Systematic Review and Meta-analysis
Authors: Falola A , Dada O , Ndong A , Akande D 
Published: August 2023

Abstract

Aim
Adult mechanical bowel obstruction (AMBO) has been previously reported to be majorly caused by hernias in developing countries. In Nigeria, however, there has been a recent change in pattern with adhesions now being the leading cause. The changing pattern of the causes, clinical features, mode of management and factors influencing the outcome of adult patients managed for bowel obstruction in Nigeria necessitated this review.

Method
Relevant keywords relating to AMBO were used to conduct a search on PubMed, Google Scholar and AJOL. The search returned 452 articles which were subjected to title, abstract and full text screening, according to the inclusion and exclusion criteria. 10 articles met the inclusion criteria and were included in the final qualitative synthesis.

Results
The total sample size across the 10 studies was 1033. Adhesions, hernias and intra-abdominal tumours, which are responsible for 46.25%, 26.31% and 12.23% of cases respectively, were the major causes of AMBO. 65.6% of cases were managed operatively and 34.4% were managed conservatively. The meta-analysis revealed high morbidity and mortality rates of 31% (95% CI:17, 44) and 11% (95% CI: 6, 15), respectively, among adult patients managed for mechanical bowel obstruction in Nigeria.

Conclusions
Adhesion, which results majorly from appendicectomy is the most common cause of AMBO in Nigeria. This is unlike former reports where hernia was the most common cause. Morbidity results majorly from wound infection, recurrent adhesions and post-operative enterocutaneous fistula. The mortality rate is similar to reports from various West African studies, and it is significantly influenced by surgical intervention time.
984 Comparing Modalities for the Detection of Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis
Authors: Lastoria D Ab 
Published: August 2023

Abstract

Aim
Papillary thyroid carcinoma (PTC) is the most common cancer of the thyroid gland (Lin, 2007). Cancer cells can metastasise to the cervical lymph nodes (LNs), including the central and lateral group of LNs (Yu et al, 2020). Lymph node metastasis is an important indicator of PTC prognosis, leading to a high recurrence rate and low survival (Yu et al, 2020). Identification of LN metastasis is key for improving surgical outcomes in patients with PTC. The aim of this systematic review and meta-analysis was to compare imaging modalities for the detection of LN metastasis in PTC.

Method
A total of 2756 records were identified and screened following database, conference proceedings and currently registered studies search. Data from 15 case series was extracted. A random-effects meta-analysis of sensitivity and specificity of ultrasound (US), CT and MRI for the detection of LN metastasis in PTC was performed. A sub-group analysis of central and lateral LNs was also performed.

Results
Sensitivity for the detection of LN metastasis was the highest for MRI (69.7%, 95% CI: 45.1%-89.9%), followed by CT (63.3%, 95% CI: 44.1%-80.7%), and US (57.1%, 95% CI: 44.1%-69.7%). Specificity was highest for MRI (85.5%, 95% CI: 78.6%-91.3%), followed by US (81.2%, 95% CI: 74.7%-87.9%), and CT (80.2%, 95% CI: 67.2%-90.8%).

Conclusions
This meta-analysis suggests MRI should be used for the detection of LN metastasis in PTC, given it demonstrated the highest sensitivity and specificity. Accurate identification can lead to the implementation of tailored surgical and chemoradiotherapeutic treatment approaches, improving patient outcomes.