bluuebunny/crossref_metadata_2025_split huggingface dataset:
364 Systematic Review of Simulation-Based Training Tools in Plastic Surgery
Authors: Rehman S , Jasionowska S , Aydin A , Dasgupta P , Salibi A , Cavale N 
Published: November 2022

Abstract

Aim
The recent shift from traditional surgical teaching to the incorporation of simulation training in plastic surgery has resulted in the development of a variety of simulation models and tools. We aim to identify all currently available simulators and tools for plastic surgery, assess their validity and establish their effectiveness.

Method
MEDLINE and Embase were searched for articles which validate simulation models in plastic surgery. Each study was screened in accordance with the Messick validity framework, and a rating was given for each section. In order to determine the effectiveness of each study, the McGaghie model of translational outcomes was used.

Results
On screening 2104 articles, 71 were identified to discuss validity and effectiveness. Only one study was found to achieve a high score in all validity parameters and no studies achieved an effectiveness level &gt;2.

Conclusions
With the increasing amount of simulation training tools, there must be more validity studies conducted using updated validity frameworks. In addition, there should be an increased emphasis of the relationship between these simulators and patient outcomes/surgical technique in the operating theatre in order to determine translational outcomes. More training tools evaluating both technical and nontechnical surgical skills are recommended.
635 Validation of Virtual Reality Training for Femoral Nail Procedures in Orthopaedic Surgery: A Systematic Review
Authors: Sharma M , Khanal P , Patel N , Patel A 
Published: November 2022

Abstract

Aim
To evaluate the effectiveness and shortcomings of virtual reality (VR) simulators to teach and assess femoral nail procedures.

Method
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm was used to screen and select studies from four databases: Embase (via Ovid), PubMed, Web of Science and Scopus. In total, fifty titles were identified. Of these, four studies met the eligibility criteria and underwent narrative analyses.

Results
The studies consisted of 86 participants and measured 17 outcomes associated with procedural learning. Three studies showed that VR simulation trained cognitive and psychomotor skills relevant to the real procedure (construct validity) and one study showed that these skills were transferrable to another simulation model (transfer validity). In addition, two studies employed questionnaires to investigate the visual realism (face validity) and technical accuracy (content validity) of the VR simulators, receiving positive feedback for both components. The main limitation pervading all simulators was the minimality of haptic feedback when interacting with the virtual instruments and environment.

Conclusions
This systematic review demonstrates that VR simulators may be a viable tool for trainees to safely learn and practise femoral nail procedures outside the theatre. However, there remains scope for design and technological enhancements to further improve their effectiveness. To facilitate this continued development, we are presently conducting a large-scale validation study for the DePuy Synthes (Johnson and Johnson) Trochanteric Femoral Nail Advanced VR system, comprising participants from two London, UK, Hospital Trusts.
772 Perspectives on Simulation as an Assessment Tool in Surgical Training: A Qualitative Study of Key Stakeholders
Authors: Toale C , Morris M , O Kavanagh D 
Published: November 2022

Abstract

Aim
The perspectives of the wider surgical community toward simulation-based assessment (SBA) in training is a gap in the literature. This study aims to generate a conceptual framework regarding the acceptable use of SBA in surgical training, through the perceptions and experiences of a broad range of stakeholders.

Method
A sequential transformative qualitative methods approach employing constructivist grounded theory was used. Ten semi-structured interviews were conducted representatives from identified key stakeholder groups; executive management, risk management, a practicing surgeon, an anaesthesiologist, a theatre-nursing representative, a representative from simulation, a patient, a medical student, a junior surgical trainee and a senior surgical trainee. interview transcripts underwent content analysis using NVIVO software (NVIVO 12, QSR International).

Results
Four themes emerged: the ‘need’ for SBA, the concept of a ‘minimum standard’, the ‘optimum design’ of an SBA framework, and ‘fairness’. SBA is a potential solution to challenges in the current training environment. It emerged that it should not replace trainer judgement but could ensure that trainees meet a minimum operative competency standard. SBA should be used to identify underperforming trainees early in training, to provide remediation. The application of SBA in high stakes settings such as trainee selection, autonomy granting, and end-of training certification has perceived benefits over current assessment methods.

Conclusions
This study generates a conceptual framework regarding the acceptable use of simulation as an assessment tool in surgical training, including perspectives from a broad range of stakeholders. Findings can inform the development of simulation-based assessment curricula in surgical training.
977 Breaking Out of Tradition: Designing Escape Rooms as Novel Simulation
Authors: Badenoch T , Benton K , Jacobs E , Law S , Ahmed M , Curtis A , Everett S , Hunter I , Bamford R 
Published: November 2022

Abstract

Aim
The emerging field of gamification, the addition of game play elements to non-game settings, is widely used in business and is increasingly being used in education. Successful methods have included live leader boards and a web-based game solving a protein folding conundrum.

Method
We designed an escape room (ER), incorporating gaming elements, focussing on communication in a surgical environment. A cross over study was delivered to 4th year medical students, comparing traditional simulation. The ER included logic puzzles, hidden clues, padlocked boxes, and surgical skills appropriate to their level. Self-reported engagement and teamwork were recorded, as was observed teamwork and communication skills.

Results
Self-reported engagement was very high for the students compared to more traditional simulation, including better understanding of effective communication strategies. The ER group were less likely to self-identify learning points but structured debrief mitigated this difference.

Conclusions
Gamification techniques can be integrated with good engagement and educational outcomes and should be considered as an adjunct to existing simulation strategy.
72 Medical Students’ Opinion on Academic Surgery as a Career and Access to Opportunities in Surgical Research
Authors: Kathiravelupillai A , Fanning SJ , Robinson A , Jaunoo S 
Published: November 2022

Abstract

Introduction
The clinical academic training pathway in the United Kingdom is offering an increasing number of surgically themed roles. The understanding of research and available academic opportunities amongst applicants is variable. The aim of this study was to capture the understanding and exposure to clinical academia in surgery amongst UK medical students. Methods: We surveyed 100 medical students prior to them attending the inaugural Academic Surgery Virtual Conference based at Brighton and Sussex Medical school. Participants were sent a google survey via email the day prior to attending the conference to be completed anonymously.

Results
52 students completed the pre-conference survey; 55.8% were female, 42.3% male, 1.9% preferred not to disclose gender. Mean ages for females were 21.4 and for males 23.5. An even distribution of students from different year groups responded, from 4 deaneries encompassing different UK medical schools. All participants had an additional degree with a BSc being the most common (n=36, 69.2%). Overall, 61.5% (n=38) of students expressed an interest in an academic surgical career. Only 52.7% (n=30) had previous experience in research, and 36.5% (n=19) knew how to get involved in surgical research. The majority of students had not received any teaching in medical school on academic surgery (n=38, 73.1%).

Conclusion
This survey has identified that amongst a cohort of medical students interested in academic surgery, few had research experience or knew how to get involved in surgical research. Medical schools should provide earlier education on clinical academic pathways to meet the rising demand for clinical academics in surgery.
270 The Innate Aptitude's Effect on the Surgical Task Performance
Authors: El Boghdady M , Ewalds-Kvist BM 
Published: November 2022

Abstract

Aim
Surgery is a craft profession requiring individuals with specific innate aptitudes for manipulative skills, visuospatial and psychomotor abilities. The selection process of surgical trainees excludes aptitude testing for the psychomotor and manual manipulative skills of candidates for required abilities. We scrutinize the effect of innate aptitudes in surgery and its skill-training by systematically reviewing its significance on the surgical task performance.

Method
A systematic review was performed by PRISMA guidelines. A search on PubMed/Medline for English language articles was performed from January 2001 to January 2021. Search terms were ‘aptitude for surgery’, ‘innate aptitude and surgical skills’, ‘manipulative abilities and surgery’ and ‘psychomotor skills and surgery’. The quality of quantitatively researched citations was assessed by MERSQI scores.

Results
The results yielded 1142 studies and 21 met the inclusion criteria and 6 high-quality citations rejected our 3-null hypothesis, and all medical students cannot reach proficiency in skills necessary for a career in surgery. Playing video games and/or musical instruments do not promote surgery skill; yet a valid test with predictive value for novices aspiring for a surgical career is helpful. MERSQI mean score was 11.07 (SD= .98; range 9.25 to 12.75).

Conclusions
Visuospatial aptitude, rate of skill acquisition and quality of surgical performance predicted baseline surgical ability. Additionally, visuospatial aptitude along with psychomotor skills and perceptual talent, furthered laparoscopic simulator performance. The selection process for candidates suitable for a career in surgery requests a simulated surgical environment, where the candidates’ skills also in forms of non-technical aptitudes are assessable.
363 A Comparative Analysis of Night-Time General Surgical Training
Authors: Aseem R , Khan N , Bowbrick G 
Published: November 2022

Abstract

Aim
The aim of surgical training is to ensure trainees acquire competencies to perform as a Day 1 Consultant. The last decade has seen the introduction of European Working Time Directive, NELA guidelines and the revised Junior Doctor Contract. All of these, as well as the COVID 19 pandemic, have caused concerns regarding training. Our aim was to examine any changes to night-time on call activity during this time.

Method
We retrospectively analysed prospectively collected data from 2011, 2018, and 2021, in a busy District General Hospital. The data collection period was 31 days, looking at night-time (8pm to 8am) operative experience, supervision, and non-operative activity. A regression analysis was conducted to compare outcomes. A qualitative survey was used to assess attitudes and confidence.

Results
On average, trainees spent 11% of their time operating independently, 2% operating supervised, 11% attending trauma-calls and 73% clerking/non-educational activities. There was a significant difference between the hours spent on operative versus non-operative activity (P 0.00046) with no differences over the years. Junior trainees did not feel confident operating at night and only 33% of all trainees found night-time training effective.

Conclusions
Nightshifts comprise a substantial proportion of potential training opportunities and managing the unselected emergency take is one of the Capabilities in Practice. Effective solutions must be implemented to help improve night-time surgical experience and confidence in order for this time to be effective for training of both operative and non-operative competency attainment.
386 A Comparison of Academic Output of Welsh Plastic Surgery Trainees Pre- and Mid-COVID-19 Pandemic
Authors: McGregor C , Sin-Hidge C , Wilson-Jones N 
Published: November 2022

Abstract

Aim
The COVID-19 pandemic has affected doctors worldwide, with 1.5 million surgeries being postponed or cancelled in England and Wales during 2020. Surgeons in competitive specialties requiring active research portfolios may have used this time to strengthen their academic work. This cross-sectional study provides insight into the academic output of Welsh plastic surgery trainees during the COVID-19 pandemic, which could be used to highlight contributing factors to benefit future training.

Method
A cross-sectional study was distributed to all Welsh burns and plastic surgery trainees from specialty trainee levels 3–8. Data was obtained comparing publications achieved, abstracts submitted, and projects undertaken pre-pandemic, March 1st to 31st August 2019 and mid-pandemic, March 1st to 31st August 2020.

Results
Of the 12 Welsh plastic surgery trainees, 75% participated in this survey, with representation from all years of training. Mid-pandemic, an average of 3 publications were achieved per trainee when compared with 1.4 pre-pandemic. 78% submitted abstracts during both periods, increasing from 1.5 to 2.44 mid-pandemic. Although the average number of projects undertaken pre- and mid-pandemic was 3.2 and 3.1 respectively, the number of trainees undertaking projects increased by 22% to 100%. Most commonly, this was attributed to an increase in capacity.

Conclusions
Our study demonstrated that overall, academic output increased significantly during the COVID-19 pandemic. Unsurprisingly, this sudden decrease in surgical activity led to trainees in this highly competitive specialty employing their time towards research. Further studies investigating the factors enabling trainees to increase their academic productivity would be beneficial as routine surgical activity resumes.
422 Assessment of an Articulating Laparoscopic Needle Holder (FlexDex™) Compared to a Conventional Rigid Needle Holder in 2-Dimension Vision Amongst Novices: A Randomised Controlled Study
Authors: Farzaneh SB , Motahariasl N , Motahariasl S , Kokotkin I , Sousi S , Zargaran A , Zargaran D , Patel B 
Published: November 2022

Abstract

Aim
This study aims to compare novice performance of advanced bimanual laparoscopic skills using an articulating laparoscopic device (FlexDex™) compared to a standard rigid needle holder amongst surgical novices in 2-dimension (2D) visualisation.

Method
In this prospective randomised trial, novices (n=40) without laparoscopic experience were recruited and randomised into two groups, which used either traditional rigid needle holders or the FlexDex™. Both groups performed 10 repetitions of a validated assessment task. Times taken and error rates were recorded, and results were evaluated based on completion times, error rates, and learning curves.

Results
The intervention group that used the FlexDex™ completed 10 attempts of the standardised laparoscopic task slower than the control group that used traditional rigid needle holder (415 seconds vs 267 seconds taken for the first three attempts and 283 seconds vs 187 seconds taken for the last three attempts, respectively). The difference in average time for the first three and last three attempts reached statistical significance (P &lt; 0.001). Furthermore, the intervention group demonstrated a higher error rate when compared to the control group (9.2 vs 6.3 errors per individual).

Conclusions
When compared to the FlexDex™, the traditional rigid needle holder was observed to be superior in task performance speed, leading to shorter completion times and quicker learning effect, as well as fewer errors.
452 A National Survey of UK Foundation Trainee's Perceptions of Surgical Skills in the Foundation Training Programme
Authors: Gnanalingham S , Limbachia D 
Published: November 2022

Abstract

Aim
Attention to surgical skills development of UK foundation trainees within the UK foundation training programme appears to be neglected. This study aimed to ascertain junior doctors’ perceptions of surgical skills within the foundation training programme, irrespective of their future career intentions.

Method
An online survey generated using SurveyMonkey was distributed to all 18 UK foundation training schools. This survey assessed foundation trainees’ surgical skills experience in medical school, current career intentions, confidence at basic surgical skills and perceptions of the level of surgical skills training within the foundation programme.

Results
A total of 245 responses were collected. Career intentions amongst foundation trainee respondents was evenly distributed with 39.6% aiming for a career in surgery, 41.6% opting for a non-surgical career and 18.8% of participants were undecided on their future career path.
Trainees felt that they did not have adequate exposure to surgical skills (4.5, Likert scale 1–10) and did not have adequate exposure to specialty specific skills within the foundation training programme (3.3, Likert scale 1–10). On average, 75% of participants believed further exposure to surgical skills training would be beneficial to their professional development. Furthermore, 67% believed that surgical skills should be incorporated in the core competencies for the foundation training programme.

Conclusions
Our study shows that foundation trainees feel that there is a lack of adequate exposure to surgical skills within the foundation programme. Foundation trainees feel change is required to help improve competency in basic surgical skills and as an extension increase interest in a surgical career.
478 Enhancing Technology Interface in the Dissection Room (DR)
Authors: Balfour J , Banziger C , Burr P , Quigley C , Chisholm F 
Published: November 2022

Abstract

Aim
Anatomy teaching increasingly utilises technology alongside dissection to improve anatomy teaching. Student use of the touchscreen computers in dissection sessions at the University of St. Andrews was infrequent, with students lacking confidence in touchscreen use. The aim of this QI project was to improve medical student confidence and increase the use of touchscreen computers in the DR during dissection sessions.

Method
A data-collection tool was designed and tested. It included 4 Likert-style and one blank space question. 111 baseline responses from 3rd-year medical students were collected over 1 week in November 2021. Documentation was optimised for touchscreen usage. Cycle 2 was collected from the same cohort, with 83 responses. The second intervention introduced styluses. Cycle 3, with 85 responses, was collected.

Results
Question 1 examined awareness of touchscreen function. Positive responses (agree and strongly agree) increased from 76.5% to 95.2%, then 97.7% after interventions 1 and 2 respectively. Positive responses for question 2, examining confidence, improved from 53.2% to 88.0%, then 96.5%. Positive responses to question 3, examining the frequency of touchscreen use, improved from 49.6% to 91.6% then 92.9%. Positive responses for question 4, examining how useful touchscreens were for student learning, improved from 70.3% to 94.0%, then 97.7%. Blank space questions demonstrated positive opinions of changes made in the dissection room.

Conclusions
The significant and sustained increase in positive responses regarding student confidence, touchscreen use and the usefulness of touchscreens as an adjunct to dissection in the DR demonstrated significant improvement in the use of the facilities and student educational experience.
538 Peer MRCS Teaching Among Surgical Trainees in the East Midlands Deanery, UK
Authors: Charuvila S , Olaitan O , Srinivasan A , Mepani V , Putt O , See A , Dhingra M 
Published: November 2022

Abstract

Background
During the covid-19 pandemic, the East Midlands South Deanery ran virtual peer-MRCS OSCE teaching. We analysed two surveys to understand the impact of peer-MRCS teaching on surgical trainees in this region.

Method
One survey was completed by peer-MRCS teachers who delivered sessions in 2020–2021. The second survey was completed by prospective MRCS OSCE candidates. Responses were anonymised.

Results
7 / 8 peer teachers and 13/17 prospective learners completed the surveys. 6/7 peer-teachers had previous experience and prior teacher-training ranged from day courses to university degrees. All peer-teachers felt that peer-MRCS teaching enabled them to refresh their anatomy knowledge. 0/7 peer-teachers preferred to deliver practical-skills teaching.
Passion for teaching was identified as a motivating factor by all peer teachers. This was further supported by the general consensus (5/7) for peer teachers preferring feedback that is focused on self-development rather than conveying appreciation. Majority (12/13) of peer learners also preferred to give feedback focused on teacher development and felt they were more likely (7/13) to provide accurate feedback for peer-sessions when compared to formal teaching sessions run by the deanery.
Majority of participating prospective MRCS OSCE candidates (12/13) expressed an interest in peer-MRCS teaching. Low stress environment and cost effectiveness were the top reasons why prospective peer learners preferred virtual peer MRCS teaching.

Conclusions
Overall peer-MRCS teaching in this cohort suggests advantages to both peer-teachers and learners with the potential to improve teaching skills and clinical knowledge among surgical trainees.
563 Help! I’m Starting Surgery: An Educational QI Project to Improve the Surgical Induction Process and FY1's Confidence in Starting Surgery at Bolton Hospital
Authors: Spurring E 
Published: November 2022

Abstract

Introduction
The surgical induction process for FY1's at Bolton consisted of 280-pages of pre-reading and a series of short talks delivered on their first day. Foundation doctors were surveyed (n=20) and only 25% were satisfied/very satisfied with this process.

Aim
To improve satisfaction ratings and junior doctor's confidence in surgical skills required to be a competent surgical FY1 through a series of PDSA cycles.

Method
PDSA Cycle 1: Creation of the survival guide. PDSA cycle 2: Pre-reading was condensed into the survival guide and a 12-week teaching programme was introduced. PDSA cycle 3: The induction agenda was updated, and a tour of the department was added. PDSA cycle 4: Introduction of a Q&A session with a previous surgical junior.

Results
Through the above cycles (PDSA Cycle 1–5) satisfaction ratings improved from 25% to 41%, 28%, 83% and 85% respectively. Junior doctors’ confidence increased on average from 41% to over 90% in each cycle. These skills included: requesting scans, consenting for endoscopy, prescribing, assessing unwell patients, clerking, and managing and explaining post-operative complications.

Conclusions
Following the creation of the survival guide, eradication of extensive pre-reading and the above PDSA cycles, satisfaction ratings improved and FY1's confidence in surgical skills increased. The findings of PSDA cycle 2 could be attributed to the pandemic as induction took place on Microsoft teams rather than face-to-face. To ensure future sustainability, the guide and induction process should be updated and analysed every rotation.