Real-world use of workplace based assessments in surgical training: A UK nationwide cross-sectional exploration of trainee perspectives and consensus recommendations from the Association of Surgeons in Training

Abstract Background The COVID-19 pandemic has resulted in dynamic changes to healthcare delivery. Surgery as a specialty has been significantly affected and with that the delivery of surgical training. Method This national, collaborative, cross sectional study comprising 13 surgical trainee associations distributed a pan surgical specialty survey on the COVID-19 impact on surgical training over a 4-week period (11th May - 8th June 2020). The survey was voluntary and open to medical students and surgical trainees of all specialties and training grades. All aspects of training were qualitatively assessed. This study was reported according to STROBE guidelines. Results 810 completed responses were analysed. (M401: F 390) with representation from all deaneries and training grades. 41% of respondents (n = 301) were redeployed with 74% (n = 223) redeployed > 4 weeks. Complete loss of training was reported in elective operating (69.5% n = 474), outpatient activity (67.3%, n = 457), Elective endoscopy (69.5% n = 246) with > 50% reduction in training time reported in emergency operating (48%, n = 326) and completion of work-based assessments (WBA) (46%, n = 309). 81% (n = 551) reported course cancellations and departmental and regional teaching programmes were cancelled without rescheduling in 58% and 60% of cases respectively. A perceived lack of Elective operative exposure and completions of WBA’s were the primary reported factor affecting potential training progression. Overall, > 50% of trainees (n = 377) felt they would not meet the competencies required for that training period. Conclusion This study has demonstrated a perceived negative impact on numerous aspects of surgical training affecting all training specialties and grades.

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Characterization and Treatment Goals of Patients on Long-Acting Injectable vs Oral Antipsychotics: Results from a Patient/Caregiver/Psychiatrist Survey

CNS Spectrums ◽

10.1017/s109285292000245x ◽

2021 ◽

Vol 26 (2) ◽

pp. 154-154

Author(s):

Heather M. Fitzgerald ◽

Jason Shepherd ◽

Hollie Bailey ◽

Mia Berry ◽

Jack Wright ◽

...

Keyword(s):

Real World ◽

Sufficient Evidence ◽

Treatment Goals ◽

Full Time ◽

Medication Regimen ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Course Of Illness ◽

Current Medication ◽

Long Acting

AbstractBackgroundPatient preferences in schizophrenia (SCZ), including identification of key goals and outcomes for treatment and relative importance of certain treatment goals to patients, have been assessed by several studies. However, there continues to be a lack of sufficient evidence on US patient attitudes and perceptions towards treatment goals and pharmacotherapy options in SCZ, especially taking into context long-acting injectable antipsychotics (LAIs) in this disease area. This lack of evidence is further pronounced in caregivers of individuals with SCZ. The objective of this analysis was to characterize patients with SCZ on LAIs vs patients on oral antipsychotics (OAPs) and evaluate the treatment goals of patients in each group.MethodsThis was a real-world, cross-sectional survey of US psychiatrists, patients =18 years old with a diagnosis of SCZ, and caregivers. Data was collected using the Disease Specific Programme (DSP) methodology, which has been previously published. Psychiatrists (n=120) completed detailed record forms for next 8 consecutive outpatients and 2 inpatients matching inclusion criteria, including non-interventional clinical and subjective assessments. The same patients and their caregivers, if present, were invited by their psychiatrist to voluntarily complete a separate survey.ResultsOf 1135 patients on treatment where the physician provided survey data; 251 were on an LAI, and 884 were on an OAP. Mean (SD) time to SCZ diagnosis for those on an LAI was 10.3 (12.0) years vs 7.8 (10.5) years for those on OAPs. More patients in the LAI vs OAP group were being treated as an inpatient (27.1% vs 15.7%, respectively; p<0.0001). Patients on an LAI reported being on their current medication regimen for less time (mean 1.7 years) vs those on OAPs (mean 2.5 years) (p=0.0093). More patients on LAIs were unemployed due to disability vs those on OAPs (56.1% vs 39.5%, respectively), and less patients on LAIs were able to work part-time or full-time (21.1% or 4.1%) vs those on OAPs (23.2% or 11.4%). More patients on an LAI had a caregiver vs those on OAPs (37.3% vs 26.1%, respectively; p=0.0011). Regarding the most important treatment goals reported by patients, both groups reported similar preferences for decrease in disease symptoms (62% on LAI vs 65% on OAPs) and thinking more clearly (53% on LAI vs 46% on OAPs); however, a numerically higher proportion of LAI patients reported that the current medication helped decrease hospitalizations due to relapse vs those on OAPs (38% vs 32%, respectively).DiscussionGiven the characteristics of patients participating in this real-world survey, those on LAIs exhibited qualities which indicate a higher severity of illness vs those on OAPs. Results suggest that treatment with LAIs is still mainly being provided to patients later in the disease course and/or who have adherence problems, despite a growing body of evidence of utility in younger patients earlier in the course of illness.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. and Lundbeck LLC

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Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-021966 ◽

2018 ◽

Vol 8 (9) ◽

pp. e021966 ◽

Cited By ~ 10

Author(s):

Federica Dellafiore ◽

Cristina Arrigoni ◽

Francesco Pittella ◽

Gianluca Conte ◽

Arianna Magon ◽

...

Keyword(s):

Heart Failure ◽

Gender Differences ◽

Chronic Heart Failure ◽

Real World ◽

Self Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Caregiver Relationship

AimThe aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF).Methods and resultsA monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%.ConclusionThis study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.

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Drug treatment patterns and work productivity in chronic kidney disease patients with anemia in China: Cross sectional analysis of real-world data

Kidney Research and Clinical Practice ◽

10.23876/j.krcp.20.020 ◽

2020 ◽

Vol 39 (3) ◽

pp. 318-333

Author(s):

Heleen van Haalen ◽

James Sloand ◽

Rebecca Moon ◽

Eirini Palaka ◽

Gary Milligan ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Drug Treatment ◽

Real World ◽

Work Productivity ◽

Treatment Patterns ◽

Real World Data ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education

Wellcome Open Research ◽

10.12688/wellcomeopenres.15580.1 ◽

2019 ◽

Vol 4 ◽

pp. 187

Author(s):

William Dean ◽

Stephen Gichuhi ◽

John Buchan ◽

Ibrahim Matende ◽

Ronnie Graham ◽

...

Keyword(s):

Surgical Training ◽

Southern Africa ◽

Surgical Education ◽

Training Programme ◽

Sub Saharan Africa ◽

African Region ◽

Cross Sectional Survey ◽

Small Incision Cataract Surgery ◽

Cross Sectional ◽

Recent Graduates

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as ‘somewhat satisfied’ or ‘very satisfied’ by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

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Accelerometric Gait Analysis Devices in Children—Will They Accept Them? Results From the AVAPed Study

Frontiers in Pediatrics ◽

10.3389/fped.2020.574443 ◽

2021 ◽

Vol 8 ◽

Author(s):

Isabella Wiedmann ◽

Marcello Grassi ◽

Ibrahim Duran ◽

Ricardo Lavrador ◽

Evelyn Alberg ◽

...

Keyword(s):

Gait Analysis ◽

Real World ◽

Gait Speed ◽

Daily Living ◽

Walking Speed ◽

Pediatric Population ◽

Rehabilitation Medicine ◽

Cross Sectional ◽

Laboratory Conditions ◽

Significant Difference

Aims: To assess children's acceptance to wear a 3D-accelerometer which is attached to the waist under real-world conditions, and also to compare gait speed during supervised testing with the non-supervised gait speed in every-day life.Methods: In a controlled observational, cross sectional study thirty subjects with cerebral palsy (CP), with level I&II of the Gross Motor Function Classification System (GMFCS) and 30 healthy control children (Ctrl), aged 3–12 years, were asked to perform a 1-min-walking test (1 mwt) under laboratory conditions, and to wear an accelerometric device for a 1-week wearing home measurement (1 WHM). Acceptance was measured via wearing time, and by a questionnaire in which subjects rated restrictions in their daily living and wearing comfort. In addition, validity of 3D-accelerometric gait speed was checked through gold standard assessment of gait speed with a mobile perambulator.Results: Wearing time amounted to 10.3 (SD 3.4) hours per day, which was comparable between groups (T = 1.10, P = 0.3). Mode for wearing comfort [CP 1, Range (1,4), Ctrl 1, Range (1,6)] and restriction of daily living [CP 1, Range (1,3), Ctrl 1, Range (1,4)] was comparable between groups. Under laboratory conditions, Ctrl walked faster in the 1 mwt than CP (Ctrl 1.72 ± 0.29 m/s, CP 1.48 ± 0.41 m/s, P = 0.018). Similarly, a statistically significant difference was found when comparing real-world walking speed and laboratory walking speed (CP: 1 mwt 1.48 ± 0.41 m/s, 1 WHM 0.89 ± 0.09 m/s, P = 0.012; Ctrl: 1mwt 1.72 ± 0.29, 1 WHM 0.97 ± 0.06, P < 0.001).Conclusion: 3D-accelerometry is well-enough accepted in a pediatric population of patients with CP and a Ctrl group to allow valid assessments. Assessment outside the laboratory environment yields information about real world activity that was not captured by routine clinical tests. This suggests that assessment of habitual activities by wearable devices reflects the functioning of children in their home environment. This novel information constitutes an important goal for rehabilitation medicine. The study is registered at the German Register of Clinical Trials with the title “Acceptance and Validity of 3D Accelerometric Gait Analysis in Pediatric Patients” (AVAPed; DRKS00011919).

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Treatment patterns in patients with acute myeloid leukemia in the United States: a cross-sectional, real-world survey

Current Medical Research and Opinion ◽

10.1080/03007995.2019.1578152 ◽

2019 ◽

Vol 35 (5) ◽

pp. 927-935 ◽

Cited By ~ 3

Author(s):

Bruno C. Medeiros ◽

Bhavik J. Pandya ◽

Anna Hadfield ◽

James Pike ◽

Samuel Wilson ◽

...

Keyword(s):

United States ◽

Acute Myeloid Leukemia ◽

Real World ◽

Myeloid Leukemia ◽

The United States ◽

Treatment Patterns ◽

Cross Sectional ◽

World Survey ◽

Acute Myeloid

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Competences for Solving Complex Problems: A Cross-Sectional Survey on Higher Education for Sustainability Learning and Transdisciplinarity

Sustainability ◽

10.3390/su12156016 ◽

2020 ◽

Vol 12 (15) ◽

pp. 6016 ◽

Cited By ~ 1

Author(s):

Filippina Risopoulos-Pichler ◽

Fedor Daghofer ◽

Gerald Steiner

Keyword(s):

Higher Education ◽

Sustainable Development ◽

Continuing Education ◽

Real World ◽

Academic Disciplines ◽

Education For Sustainability ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Human Environment ◽

Complex Problems

Successfully coping with complex, real-world challenges, such as those related to sustainable development and the resilience of coupled human–environment systems, calls increasingly for adapted forms of education and extended competences. Hence, we argue that, beyond knowledge and expertise in professional domains, additionally, personal, systemic, creative, and sociocultural competences are required to meet such challenges. Herefor, institutions of higher and continuing education play a crucial role. In this paper, universities as institutions of higher education are critically considered in relation to delivering education for sustainable development by raising awareness and providing the necessary competences to cope with complex problems such as sustainable development through effective forms of higher and continuing education as well as training. Research on attitudes and perceptions regarding sustainable development and the perceived need for comprehensive competences required to deal with such complex problems is still lacking. Our study provides a first attempt to elucidate core aspects of these attitudes, perceptions, and competences aiming to contribute to future, more tailored education approaches. We discuss the outcomes of a survey on sustainability in teaching and learning conducted at four Austrian universities. The analyzed sample comprised 3200 students as the recipients of, and 498 lecturers as the providers of, sustainability education in various academic disciplines at four distinct Austrian universities. Applying a questionnaire-based investigation of self-reported sustainability-related perceptions, attitudes, and competences and conducting factor analysis and cluster analysis, five sustainability types were identified that revealed a type of specific core awareness of sustainability and the perception of required competences related to sustainable development. The results presented are positioned to build a basis for further investigation that goes beyond the self-reported assessments to enable a comparison with sustainability-related, real-world problem-solving performance.

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