Non-consultant hospital doctors in Ireland; A survey of satisfaction in training
Authors: W. Fahmy, W. Tawfick, H. Khokhar, R. Kumar, B. Azeem
Journal: International Journal of Surgery (2015)

s / International Journal of Surgery 23 (2015) S15eS134 S106 0828: NON-CONSULTANT HOSPITAL DOCTORS IN IRELAND; A SURVEY OF SATISFACTION IN TRAINING W. Fahmy , W. Tawfick , H. Khokhar , R. Kumar , B. Azeem . Connolly Hospital Blanchardstown, Ireland; Galway University Hospital and National University of Ireland, Ireland Aim: Assessing Irish NCHDs satisfaction, at different training levels, regarding the quality of training. Methods: A questionnaire was sent to NCHDs in four major hospital (Dublin, Cork, Galway and Drogheda) assessing NCHD's satisfaction during training year 2013e2014. (SPSS) Results: 678 emails were sent with 117(17.25%) response rate. 74 (63.2%) males and 43(36.8%) females responded .49.6% (n 1⁄4 58) were Irish graduates.15.4% were interns, 33.3% SHOs, 0.9% lecturers, 30.8% registrars and 19.7% SPRs.57.3%(n 1⁄4 67) were on a formal training scheme. 56.1%(32/57) Interns and SHOs either disagreed or strongly disagreed that their training helped improve the acquisition of higher skills, compared to 22.2%(8/36) registrars and 13%(3/23) SPRs (p 1⁄4 0.001). 52.6%(30/57) Interns and SHOs either disagreed or strongly disagreed that their training helped improve their research skills acquisition, compared to 36.1%(13/36) registrars and 30.4%(7/23) SPRs (p 1⁄4 0.271). 22.8%(13/57) Interns and SHOs either agreed or strongly agreed that implementation of European Working Time Directive (EWTD) negatively impacted on their training, compared to 38.8% (14/36) registrars and 26%(6/23) SPRs (p 1⁄4 0.008). Majority of NCHDs (62%, n1⁄431/50 non-training and 73.1%, n 1⁄4 49/67 training scheme) preferred to change current training model (p 1⁄4 0.200). Conclusion: Interns and SHOs were apprehensive that their training was not helping improve their clinical and research skills. Registrars and SPRs felt that EWTD was negatively aff5cting training. 0874: THE EFFECTIVENESS OF NEW LAPAROSCOPIC TASKS TO ACQUIRE SKILLS IN THREE DIMENSIONAL LAPAROSCOPY A. Morawala , B. Alaraimi , B. Patel . Queen Mary University of London, UK; Barts Health NHS Trust, UK Aim: To establish validity of novel 3-D models using McGill inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) criteria for training of laparoscopic skills in 3D. Methods: Total 23 subjects [18 non-competent (novices, intermediates) and 5 experts] followed the training flow comprises of three sets of repetitions of an improved FLS tasks (Peg transfers, Ligating Endoloop, Intracorporeal suture, Pattern-cutting) and an additional new task (Creating Zig-zag loop). The tasks were performed under 3D and 2D visual modalities. Overall performances (Total scores, total errors) were measured. Student’s t test used to compare the data. Results: Each group performed significantly better in 3D. Statistically significant differences found between skilled and non-skilled groups’ overall performances (p1⁄4 < 0.05) in both visual modalities. Using Likert scale (1e5) candidates favoured (face validity) the use of models in 3D (4.3). Conclusion: We have effectively established the face and construct validity of novel models for both visual modalities. Hence, models can be successfully used for simulation training in both visual modalities. 3D vision allows remarkable improvement in performance and error rates. 0875: OBSTRUCTION OR OBSTRUCTIVE-ARE WE CAUSING MORE HARM THAN GOOD? AUDIT THE USE OF THE ABDOMINAL XRAY (AXR) IN PATIENTS PRESENTING WITH AN ACUTE ABDOMEN Y.R. Rahman, N. Muhammad. Alexandra Hospital Redditch, UK Aim: AXR is the most commonly ordered radiograph for patients presenting with an acute abdomen1, however is of low diagnostic yield. A previous audit in 2011 showed 43% of patients were unnecessarily exposed. Our aims was to determine whether AXR use is in keeping with Royal College of Radiology2 (RCR) standards and whether unnecessary radiation exposure has reduced. Methods: Retrospective study of patients presenting with an acute abdomen to AE safeguarding the future of the NHS. Junior Doctors, thus play a key role. 0884: INTRAVENOUS FLUID PRESCRIBING IN ACUTE GENERAL SURGICAL PATIENTS WITHIN FIRST 24 HOURS OF ADMISSION AT THE ROYAL BRIGHTON AND SUSSEX HOSPITAL C. Murkin, R. Sinha, M. Khusheh. Royal Brighton and Sussex Hospital, UK Aim: To evaluate the accuracy of intravenous fluid prescribing in acute surgical patients at a busy teaching hospital. Methods: Data was retrospectively collected from 27 general surgical inpatients who received intravenous fluids for either maintenance or replacement within the first 24 hours of admission. Standards were set by pre-existing guidelines from the National Institute of Clinical Excellence (CG174). Results: Of the 15 patient’s requiring fluid maintenance alone 60% (n 1⁄4 9) received greater than the maximum advised fluid requirement (average 638 ml) based on individual weight. 26.6% (n 1⁄4 4) received less than the advised minimal fluid requirement (average 933 ml). 13.3% were prescribed the appropriate volume of fluid. 10 patients required fluid replacement alone and 100% appropriately received crystalloids with daily urea and electrolyte monitoring. No (n 1⁄4 27) patients received the recommended quantities of glucose, potassium, chloride or sodium. Conclusion: A large proportion of acute general surgical patients are receiving inadequate quantities of glucose and electrolytes as well as volumes of fluid. Patients are potentially at risk of fluid overload, starvation ketosis and electrolyte imbalance. In response to these findings we recommend early access to patients weight, inclusion of NICE guidelines in the surgical clerking proforma and further local education. 0905: REPRESENTATION OF SURGEONS AS FOUNDATION TRAINING PROGRAMME DIRECTOR’S IN THE UNITED KINGDOM T. Hubbard, E. Martinou, S. Vig. Croydon University Hospital, UK Aim: The Foundation Training Programme Director (FTPD) oversees the junior Doctor when most will decide their career speciality and has a strong role in inspiring and assisting future surgical trainees in career progression. In this study we aimed to assess the representation of surgeons as FTPDs in the UK. Methods: A list of Deanery’s in the UK FTPD’s was made from deanery website, e-mail or telephone call (n 1⁄4 21). Deanery’s not supplying a list were excluded (n 1⁄4 4). FTPD speciality was determined by internet search or telephone call. Definition of ‘surgeons’ included all sub specialties of general surgery, Urology, Vascular, ENT, Plastics, Paediatric, Orthopaedics. Results: The quality of data received from each deanery was of varying quality. Overall in the data we received (FTPD n 1⁄4 278) 41% were Physicians, 16.5% of FTPD’s were surgeons. Other specialties represented were Anaesthetics (13%), ED (11%), Obstetrics and Gynaecology and Paediatrics (5%) The proportion of FTPD’s that were surgeons varied widely between Deanery’s from 36% (East Anglia) to 0% (West Midlands). Conclusion: Surgeons are the second most represented specialty in the role of FTPD. There is large variation between deanery’s in specialty