bluuebunny/crossref_metadata_2025_split huggingface dataset:
618 A Registrar - Delivered Urology Experience Improves Medical Student Knowledge of the Subject and Increases Interest in a Surgical Career
Authors: Nelson A , McCann K 
Published: November 2022

Abstract

Introduction
Exposure to Urology is thought to vary considerably between medical schools, leading to a lack of competence by foundation doctors in basic urological skills and knowledge, and perhaps low interest in a urological / surgical career. In our hospital students had no dedicated Urology placement until 2020.

Method
A weeklong Urology placement was designed for 3rd year students. This comprised tutorials on topics set out by the university curriculum, a catheter insertion simulation session, and regular theatre and ward rounds. Most students also had the opportunity to insert a catheter on the ward / theatre. Students were encouraged to complete The National Catheter Education Programme, an online course providing a point for CST applications. This placement is registrar delivered, giving a more accurate idea of what a surgical career involves. Student feedback was obtained on the first and last days to ascertain self-rated confidence on a Likert-type scale regarding urological key topics, as well as career intentions.

Results
Self – rated knowledge on the 5 identified topics at the start of the week was most likely to be “Poor,” and by the end “Good” or “Very good.” By the end of the week most students indicated they were much more likely to pursue a career in surgery, although the same response was not seen as strongly for the subspeciality of Urology.

Conclusions
The placement continues to run and develop based on feedback. We look forward with interest to the publication of LEARN (uroLogical tEAching in bRitish medical schools Nationally) — a multicentre audit – to further inform this project.
771 Surgical Training for International Doctors in the United Kingdom: How Do We Improve?
Authors: Uddin A , Vinoo A , Abualsaud S , Eldolify M , Jha G , Korde V , Kuttuva S , Win MM , Pratap H , Sahni D , Subbiah P , Glenn S 
Published: November 2022

Abstract

Aim
The number of international medical graduates (IMGs) in the various surgical specialties in the United Kingdom (UK) has been growing recently. Owing to the differences in the undergraduate medical training between the UK and other countries, it can be very challenging for IMGs to establish themselves in the competitive surgical training programs in the UK. With that in mind, some International Core Surgical Trainees founded the Surgical Society of International Doctors (SSID) as an initiative to connect, support and promote aspiring international surgeons in the UK.

Method
SSID was formed by recruiting other committee members with similar backgrounds and interests as leads for education, research, networking, and regional representatives. The society currently has 13 active members, a website - www.surgicalsid.com and an active social media presence. Monthly committee meetings and WhatsApp group chats are used to organise and run various society activities.

Results
The two projects undertaken so far are:

Conclusions
Our society is expanding with increasing members and growing interest from medical colleagues, and rising followers on the website and social media. We plan to expand our reach with more events, conferences, research collaborations and opportunities for international doctors.
774 Operative Experience Targets in General Surgery Training: A Systematic Review
Authors: Toale C , O'Byrne A , Morris M , O Kavanagh D 
Published: November 2022

Abstract

Aim
Operative experience targets are well established as a proxy measure for operative competence in surgical training across jurisdictions. The aim of this study was to examine the validity evidence of operative experience targets in surgical training as an assessment tool.

Method
A systematic review of the PubMed, EMBASE, Web of Science and Cochrane library databases was conducted in accordance with the PRISMA guidelines. The educational impact of included studies was evaluated using a modified Kirkpatrick model.

Results
Of 3,672 records identified on database searching, 11 papers were ultimately included in a narrative synthesis. Two studies reported a positive relationship between operative experience and self-reported confidence only (Kirkpatrick level 2a). Six studies documented improvements in assessed trainee performance associated with experience (Kirkpatrick level 2b). No study documented trainee behavioural change, or changes in organisational practice, related to experience targets (Kirkpatrick level 3 and 4a). No studies have identified an association between trainees reaching mandated experience targets and improved clinical outcomes.

Conclusions
Definitive evidence comparing either clinical or assessment outcomes for trainees who have reached pre-defined experience targets compared to those who have not is lacking. A number of studies have recorded competent trainee performance in key index procedures only after reaching experience thresholds greatly in excess of currently mandated targets in Ireland and the United Kingdom. This review supports the move away from these targets toward objective assessor-mediated measures of trainee competence.
778 Portfolio for Core Surgical Training: International Doctors’ Experience
Authors: Uddin A , Pratap H , Jha G , Vinoo A , Subbiah P , Sahni D , Win MM , Kuttuva S , Korde V , Eldolify M , Abualsaud S 
Published: November 2022

Abstract

Introduction
As the number of international medical graduates (IMG) applying for Core Surgical Training (CST) is growing, the understanding of the portfolio and application system is crucial to succeeding in this competitive application process. We conducted a webinar to grow the awareness of the system, especially amongst doctors still in the process of moving to the UK for surgical training.

Method
The webinar was part of an online teaching series for IMG doctors run by the SSID society. It was conducted in two separate two-hour sessions using a virtual conferencing tool in September and October 2021. Alongside, it was streamed on Facebook live to grow the reach. The advertising was done via flyers on social media and various WhatsApp groups. Each webinar was delivered by an IMG doctor in CST in the UK where they shared their personal experiences. Feedback was collected after each webinar using an online form generating tool and analysed on Excel. The certificate of attendance was distributed via E-mail.

Results
The webinar was viewed by 1200 on Facebook Live. Feedback was received from 66 attendees. 96.96% agreed that the webinar improved their understanding of the portfolio and 94.45% agreed they learned about ways to improve their portfolio. 89.39% agreed that they would change their practice after attending this webinar.

Conclusions
Simple online webinars can improve the understanding of the portfolio requirements for CST amongst IMG doctors. Subsequently, this could allow for early portfolio preparation opportunities, improve application self-assessment scores, and reduce the years needed to get a successful training number.
833 Is the Undergraduate Medical Curriculum Aligned to and Is It Facilitating Medical Students to Learn the Ear, Nose and Throat Content in the New UK Medical Licensing Assessment? a Study of One UK Medical School
Authors: Summerbell A 
Published: November 2022

Abstract

Aim
Every medical student in the United Kingdom (UK) must pass a new Medical Licensing Assessment (MLA) from 2024/25 before graduating. This includes Ear, Nose and Throat (ENT) content: ‘Conditions’, ‘Patient presentations’ and ‘Practical skills and procedures. Research shows the provision of UK undergraduate ENT training is controversial. This research aimed to determine whether a UK medical school curriculum is aligned to the ENT content in the UK MLA, and if it is facilitating students to learn it.

Method
A mixed methods approach examined one UK medical school curriculum in relation to the ENT content in the UK MLA. A document analysis reviewed the learning set for ENT. A survey collected the final year medical student cohort's recall and perceptions of their ENT learning. Data was analysed using descriptive statistics.

Results
The curriculum documents met 6/10 ENT ‘Conditions’, 6/18 ‘Patient presentations’ and 3/5 ‘Practical skills and procedures. There were 17 (13.1%) survey responses; most students generally recalled learning the ENT content during the curriculum. The teaching activities most commonly used to learn the ENT content generally helped most students to learn it; the activities least commonly used generally helped the fewest students.

Conclusions
The curriculum is largely aligned and facilitates medical students to learn the ENT content in the UK MLA. The results contribute to the existing literature, with further research needed to determine the degree of student learning. Learning outcomes should be added to the curriculum documents for unmet content with learning redirected to the most helpful teaching activities for curriculum optimisation.
888 Utility of a Virtual Mock Interview Course to Prepare Trainees on UK Core Surgical Training Interviews – a Cross-Sectional Study
Authors: Wise K , Ebrahim S , Raja H 
Published: November 2022

Abstract

Aim
To assess the usefulness of a virtual mock interview course to prepare trainees for UK Core Surgical Training (CST) interviews.

Method
Junior doctors interested in applying for CST attended a one-day interview course delivered by highly ranked surgical trainees. All attendees were invited to complete pre- and post-interview course questionnaires to assess usefulness in improving the confidence and preparedness for interviews.

Results
A total of 60 trainees attended the course with an 87% (52/60) response rate to both pre- and post-course surveys. Most trainees were FY2 doctors (50%) applying to CST for the first time (78%). Before the course, 60% of attendees reported feeling “not so confident” for their upcoming interview; 38% of participants felt “somewhat confident” whilst 2% reported feeling “very confident.” 100% of doctors found the pre-mock interview presentations “very useful” or “extremely useful”. Matched data revealed an improvement in attendees’ overall confidence (p&lt;0.0001), with 98% reporting they felt “somewhat” or “very confident” and 2% reporting feeling “extremely confident” about upcoming interviews.

Conclusions
We demonstrate evidence of a successful CST virtual mock interview course that significantly aids preparation and improves confidence for junior doctors.
966 The Surgical Handbook: Enhancing Surgical Education for Medical Students and Foundation Doctors
Authors: Vincent E , Thenabadu S , Yiu C , Ayeni A , Osa-Iduma A , Mishra V 
Published: November 2022

Abstract

Aim
In recent years, the GKT School of Medical Education has introduced a new curriculum resulting in a shift from a single surgical block to an integrated approach. After recognising the potential challenges that the lack of standardisation across various hospitals may cause, we created the Surgical Handbook to supplement learning, improve confidence in approaching surgical patients and prepare students for the United Kingdom Foundation Programme (UKFP).

Method
We sought authorisation for the Surgical Handbook from the GKT medical education faculty, assembled a team and conducted further background research. The National Undergraduate Curriculum by the Royal College of Surgeons of England was an excellent resource in the design of the Surgical Handbook. The handbook underwent multiple cycles of review by senior medical education faculty before its final digital and physical distribution for students.

Results
The Surgical Handbook has resulted in a sustained positive impact on surgical education for GKT students, with feedback highlighting it as an excellent additional resource for placements, exams, and the Foundation Programme.

Conclusions
Most doctors in the United Kingdom will undertake a surgical rotation as part of the Foundation Programme. Preparation for this role is essential and linked to the quality of undergraduate surgical education. Nevertheless, the importance of surgical teaching within the undergraduate curriculum remains a topic of debate. Our Surgical Handbook addresses this issue, and we are in the process of collaborating with other medical schools across the United Kingdom and beyond.
1027 Urology Teaching - Improving Hesitancy by Live-Streaming!
Authors: Shkoukani ZW 
Published: November 2022

Abstract
The covid-19 pandemic and associated social distancing restrictions had a significant impact on medical education and clinical learning opportunities for not only medical students, but for all those involved in the healthcare system. Given that up to 15% of general practitioner appointments and more than 25% of acute surgical referrals are urology related, adequate teaching is pertinent to ensure medical staff have the confidence and competence to manage urological concerns in a clinical setting. This quality improvement project aimed to design and develop an international educational series of virtual teaching sessions by the collaboration of senior urological trainees from various trusts across the United Kingdom.
We designed a once-weekly urology teaching series that targeted all healthcare workers (medical students, junior doctors, nurses, ANPs, PAs…etc). The series continued for 12 consecutive weeks, with each session discussing a different aspect of clinical urology and delivered by different senior urology trainees with varying experiences across the UK. Pre-session surveys and post-session feedback were collected to evaluate levels of confidence in said topics before and after session delivery.
Session attendance averaged 250 individuals per session, of multiple healthcare backgrounds and from varying countries across the world (UK, Asia, Middle East, Australia, New Zealand…etc). Overall confidence improved on average from 2/5 to 4/5 across all 12 sessions. An average of 4.5/5 agreed that the content of the sessions was beneficial, and 4.5/5 would recommend future sessions to colleagues.
Virtual learning can thus be a useful tool to aid in improving medical education, even on an international level.
84 An Analysis into the Prevalence of Work-Related Musculoskeletal Disorders Affecting Surgeons: A Systematic Review
Authors: Daruwalla AC , Patel B 
Published: November 2022

Abstract

Aim
This review sought to answer 3 primary questions- (1) What is the global career prevalence rate of work-related musculoskeletal disorders (WRMSDs) among the surgeon population? (2) What is the prevalence rate of WRMSDs between surgical specialties? and (3) Which anatomical locations are most affected in surgeons with WRMSDs?

Method
A qualitative systematic review of publications was conducted across 4 medical indices, 3 clinical trial registries, and 2 specialised search engines for relevant records published from inception until the 31st of December 2020. The JBI checklist and ROBINS-I tool were used for quality and risk assessment among included studies.

Results
In total, 56 articles met the inclusion criteria set for this review. This gave a pooled total of 13,628 surgeons. From this population, the calculated career prevalence rate of WRMSDs was found to be 71.1%, and the specialties with the highest incidences of WRMSDs were- Dermatology surgery (90.1%), Obstetrics and Gynaecology surgery (81.4%), and Vascular surgery (80.0%). When analysing body regions most frequently affected by WRMSDs, 91.3% of injuries were reported above the waist. More specifically, the most frequently reported injuries were to the back (30.4%), neck (26.2%), and shoulders (16.0%).

Conclusions
Overall, this review found high career prevalence rates of WRMSDs across all analysed surgical specialties. Furthermore, these injuries were most frequently reported in the upper limb and torso of the surgeon. With these findings, it is hoped future interventional studies would aim to target specific ergonomic deficits in specialties at high risk of developing WRMSDs.
110 What Is the Evidence From in Vivo Studies That Mesenchymal Stem Cell Derived Extracellular Vesicles Can Facilitate Tendon and Ligament Repair?
Authors: Lu V , Tennyson M , Zhang J , Khan W 
Published: November 2022

Abstract

Aim
Tendon and ligament injury pose an increasingly large burden to society. With surgical repair and grafting susceptible to failure, tissue engineering provides novel avenues for treatment. This systematic review explores evidence whether mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) can facilitate tendon and ligament repair in animal models.

Method
A systematic search was performed on PubMed, Web of Science, Cochrane Library, Embase. Risk of bias was assessed using Systematic Review Centre for Laboratory animal Experimentation (SYRCLE). Studies administering EVs isolated from human or animal derived MSCs into in vivo models of tendon/ligament injury were included. In vitro, ex vivo, in silico studies were excluded. Data on isolation and characterisation of MSCs and EVs, and in vivo findings in animal models were extracted.

Results
Eleven case-control studies were included for analysis. Six studies utilised bone marrow derived MSCs. All studies characterised MSCs via flow cytometry, which expressed CD44 and CD90, and isolated EVs via ultracentrifugation (average diameter 125nm). Five studies utilised histological scoring systems, all of which reported a lower score with EV treatment, suggesting improved healing ability. Four studies reported increased anti-inflammatory cytokine expression (IL-10, TGF-β1); three studies reported decreased endogenous M1/M2 macrophage ratio with EV treatment. Eight studies reported increased maximum stiffness, breaking load, tensile strength in EV-treated tendons.

Conclusions
MSC-EVs are effective therapeutic agents for tendon/ligament pathologies, attenuating the initial inflammatory response, accelerating tendon matrix regeneration, however evidence linking biomechanical alterations to functional improvement was weak. Future randomised controlled trials are needed to definitely demonstrate MSC-EVs superiority in tendon/ligament injury management.
111 Adipose Tissue-Derived Mesenchymal Stem Cells as a Potential Restorative Treatment for Cartilage Defects: A PRISMA Review and Meta-Analysis
Authors: Meng H , Lu V , Khan W 
Published: November 2022

Abstract

Aim
Joint damage through trauma or degeneration causes cartilage defects, leading to osteoarthritis (OA). Current therapies relieve symptoms or replaces damaged joint, which is costly and fraught with complications. Mesenchymal stem cells (MSCs) have immunomodulatory properties and low immunogenicity, making them a novel avenue for research for OA treatment. This systematic review investigates whether adipose derived MSC (AMSCs) can treat cartilage defects.

Method
A systematic search was performed on MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science. Clinical, imaging, functional outcomes were extracted from nineteen included studies. Inclusion criteria was studies conducted on human populations that compared effects of AMSCs on cartilage regeneration to non-exposed controls. Studies conducted on animals, ex vivo studies, in vitro studies were excluded.

Results
Nine studies reported improved Visual Analogue Scale (VAS) scores (mean difference -3.30; 95% CI:-3.72,-2.89; p&lt;0.001). Eight studies reported improved Knee injury and Osteoarthritis Outcome Score (KOOS) in five subscales. Pooled analysis of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in seven studies revealed an improvement (mean difference -25.52; 95% CI:-30.93,-20.10; p&lt;0.001). Cartilage regeneration was assessed using Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. All studies reported improved regeneration, with a pooled end-point score of 68.12 (95% CI:62.18–74.05; p&lt;0.001).

Conclusions
AMSCs are effective therapeutic agents for cartilage defects. We recommend researchers to determine roles of biochemical components that facilitate AMSC-mediated cartilage repair. Establishing the most efficient methods for MSC extraction, culture, delivery, and performing studies with long follow-up times enable future research to provide evidence needed to bring AMSC-based therapies into the market.
167 Efficacy of Minimally Invasive Surgery on Hallux Valgus – a Systematic Review and Meta-Analysis
Authors: Lisacek-Kiosoglous A , Georgiou A , Antoniou S , Ristanis S 
Published: November 2022

Abstract

Aim
The aim of this study is to evaluate the effect of minimally invasive surgery over open surgery for hallux valgus with respect to surgical outcomes and patient reported outcomes.

Method
Medline Complete, PubMed, Cochrane Library, Scopus, SAGE Journals and gray literature were searched. Primary outcomes focused on hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle. Secondary Outcomes included the American Foot & Ankle Society Score (AOFAS), as well as Pain on a Visual Analogue Scale(VAS), patient satisfaction, complications, SF-36 questionnaire and Manchester Oxford Foot Questionnaire (MOXFQ).

Results & Conclusions
8 randomized trials and 7 cohort studies were identified (n=907). Radiological outcomes between similar techniques were found to have no significant difference pre-post operatively at final follow up. Visual analogue scale scores were found to be significantly lower in the MIS groups compared to open techniques (MICA v Scarf) in the short term at Day 1 (P&lt;0.00001) MD= -1.96 95% CI: -2.28, -1.65; I2 = 0%; Week 2 (P=0.001) MD= -1.40; 95% CI: -2.26, -0.54; and Week 6 (P=0.005) MD= -1.50; 95% CI: -2.55, -0.45. There was no statistical difference at 6 months (P=0.46) MD= -0.16; 95% CI: -0.59, 0.27; I2 = 0%; or final follow up (6 m to &gt;24m) (P=0.94) MD= -0.02; 95% CI: -0.44, 0.41; I2 = 0%.). There were no statistically important differences between post-operative AOFAS scores across comparisons, whereas AOFAS mean difference was found to be significantly higher in Open Scarf vs MICA (P = 0.003); MD=-5.54; 95% CI: -9.19, -1.88. I2 = 0%.