scholarly journals 536 Use of A Cost-Efficient Colonoscopy Simulation Model to Improve Endoscopy Skills During the COVID Pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S MacDonald ◽  
B Edgar ◽  
E Stokes ◽  
D McDade ◽  
J Anderson ◽  
...  
Keyword(s):  
Relative Reduction ◽  
Junior Doctors ◽  
Drain Pipe ◽  
Surgical Gloves ◽  
Direct Training ◽  
Surgical Trainees ◽  
Surgical Units ◽  
Cost Efficient ◽  
Performance Times ◽  
Training Opportunities

Abstract Introduction The use of endoscopic simulators as a learning aid in surgical training has been well established. This has been emphasised during the challenging times of COVID-19. However, their utility for training is countered by the high cost of the equipment, with the most basic simulators costing upwards of £50,000. Method A simple polypectomy simulator model was created using a drain-pipe and surgical gloves. n = 9 junior doctors were timed in their ability to remove the 3 polyps from the simulator. The exercise was repeated over 6 sessions over the course of 3 weeks. Means were compared using ANOVA. Results There was a mean relative reduction of 75% in overall time taken to complete the task(p < 0.0001). This improvement was seen for both surgical trainees(p = 0.005) and FY1 novices(p < 0.0001) and junior doctors reported feeling more confident with basic Colonoscopic skills. Conclusions We have demonstrated an improvement in performance times across both surgical trainees and novices. In today’s era of COVID-19, when direct training opportunities may become more scarce, simple alternatives may become vital in ensuring progression of basic surgical skills such as endoscopy. This cheap polypectomy simulator can be easily re-created across surgical units and can be used as an adjunct to traditional endoscopic training

scholarly journals SP10.2.1 Use of a cost-efficient Colonoscopy simulation model to improve endoscopy skills

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ben Edgar ◽  
Scott MacDonald ◽  
Emily Stokes ◽  
David McDade ◽  
Anderson John ◽  
...  
Keyword(s):  
Relative Reduction ◽  
Junior Doctors ◽  
Drain Pipe ◽  
Direct Training ◽  
Surgical Trainees ◽  
Surgical Units ◽  
Efficient Alternative ◽  
Cost Efficient ◽  
Training Opportunities ◽  
Made In

Abstract Aims The use of endoscopic simulators as a learning aid in surgical training has been well established, particularly in those with less experience. In the challenging time of COVID-19, when endoscopic procedures are at a minimum, this can become more valuable. However, their utility for training is countered by the high cost of equipment. We demonstrate a cost-efficient alternative to traditional endoscopy simultators, which can be easily made in any centre. Methods A polypectomy simulator model was created using a drain-pipe and surgical gloves. Junior doctors were timed in their ability to remove the 3 polyps from within the simulator. The exercise was repeated over 6 sessions over the course of 3 weeks. Means were compared using ANOVA. Results There was a mean relative reduction of 75% in overall time taken to complete the task (p < 0.0001). This improvement was seen for both surgical trainees with previous endoscopy experience (p = 0.005) and FY1 novices (p < 0.0001). Conclusions In our group, we have seen improvement in performance across both surgical trainees and novices. In today's era of COVID-19, when direct training opportunities may become more scarce, simple alternatives may become vital in ensuring progression of basic surgical skills such as endoscopy. This cheap polypectomy simulator can be easily re-created across surgical units and can be used as an adjunct to traditional endoscopic training.

Consultant Attitudes to 'St' Higher Surgical Trainees

2012 ◽  
Vol 94 (10) ◽  
pp. 1-334
Author(s):  
A Rashid ◽  
N Al-Hadithy ◽  
D Rossouw ◽  
S Mellor
Keyword(s):  
Surgical Training ◽  
Selection Process ◽  
Career Progression ◽  
Junior Doctors ◽  
Short Term ◽  
Medical Careers ◽  
Surgical Trainees ◽  
Higher Surgical Training ◽  
Training Programmes ◽  
Training Opportunities

The Modernising Medical Careers 2005 report on SHO training concluded that there was a need to minimise the SHO years that had, until then, involved short-term posts, poor training opportunities and indifferent career progression. In response to this, 'run-through training' was introduced in August 2007. However, numerous problems were highlighted with this system, including lack of confidence in the selection process, concern about how to counsel failing trainees, concerns about staffing the wards at the junior level if all trainees were to have realistic anticipation of promotion and difficulty reconfiguring hospital services to support high-quality training. Consequently, run-through training was uncoupled at CT2 and ST3, reverting back to a system of competitive entry into higher surgical training. Nevertheless, junior doctors in new core training posts could still potentially progress to higher surgical training programmes with as little as nine months of experience in their chosen subspecialty.

scholarly journals 1674 Training Opportunities and Safe Staffing Levels – Loop Closure Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Teklay ◽  
D Dhillon ◽  
N Aslam-Pervez
Keyword(s):  
Royal Infirmary ◽  
Junior Doctors ◽  
Orthopaedic Department ◽  
Staffing Levels ◽  
Surgical Trainees ◽  
Retrospective Audit ◽  
Before And After ◽  
Service Coverage ◽  
The Cost ◽  
Training Opportunities

Abstract Aim It is not uncommon to find rota gaps at junior doctors’ level across many NHS Trusts within United Kingdom – especially in district general hospitals. In the trauma and orthopaedic department at Huddersfield Royal Infirmary, there were significant rota gaps that frequently relied on locum doctors to provide adequate service coverage. The aim of the audit was to determine whether rota gaps had any impact on safe staffing levels, training of core surgical trainees (CSTs) and costs to the department. Method Retrospective audit - assess daily staffing levels as per rota for three weeks before and after implementation of recommended better utilisation of the department’s Advanced Clinical Practitioners (ACPs) to cover trauma wards. The audit took place over October 2018 – December 2018. Results There were safe staffing levels daily in both audits. Audit 1 demonstrated locum doctors were required to cover 36.6% of ward duties and 42.9% of oncall shifts – costing the department £25, 190. Following implementation of recommendation, where ACPs were rostered to cover trauma, audit 2 reduced the requirements of locum doctors for coverage of ward duties and oncalls to 23.7% and 33.3%, respectively. Protected theatre allocation of CSTs remained less than 1 day/week. The cost of locum doctors in audit 2 was reduced to £17, 050. Conclusions Through better utilisation of the department’s ACPs to cover trauma wards, we managed to significantly reduce cost of locum doctors by £8, 140 over a three-week period. We believe CST theatre allocation will also improve from this intervention.

The Lost Generation: Impact of the 56-hour EWTD on Current Surgical Training

2010 ◽  
Vol 92 (3) ◽  
pp. 102-106 ◽  
Author(s):  
CR Chalmers ◽  
S Joshi ◽  
PG Bentley ◽  
NH Boyle
Keyword(s):  
Shift Work ◽  
Surgical Training ◽  
New Deal ◽  
Working Hours ◽  
Lost Generation ◽  
Surgical Trainees ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
The New Deal

The reform of specialist surgical training – the New Deal (1991), the Calman report (1993) and the implementation of the European Working Time Directive (EWTD, 1998) – has resulted in shorter training periods with reduced working hours. The Calman reform aimed to improve and structure training with regular assessment and supervision whereas the New Deal and the EWTD have concentrated predominantly on a reduction in hours. The adoption of full or partial shift work to provide surgical cover at night compliant to a 56-hour working week, as stipulated by phase one of the EWTD, has resulted in daytime hospital attendance for surgical trainees of an average three days per week despite almost universal acknowledgement of the limited training opportunities available at night.

scholarly journals Clinical audit on possible causes of hospital initiated clinic cancellations and recommendation to improve the service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S324-S324
Author(s):  
Tanzida Haque ◽  
Mosab Mohammed Jodat Ibrahim ◽  
Bapu Ravindranath
Keyword(s):  
Inner City ◽  
Clinical Audit ◽  
Significant Loss ◽  
Junior Doctors ◽  
Time Period ◽  
Cancellation Rate ◽  
The World ◽  
Patient Appointment ◽  
Training Opportunities ◽  
Changeover Period

AimsThe aim of this audit is to explore the possible causes of clinic cancellation in an inner city CMHT and the recommendation to reduce the burden.BackgroundCancellations of planned appointments have been a major and long-standing problem for healthcare organisations across the world. It represents a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for trainees. Re-scheduling appointment is one of the major issues of inconvenience to the patients. It also increases workload for the patient appointment team.MethodData have been collected retrospectively from patient appointment booking team regarding clinic cancellation with causes of cancellation recorded in the system (01/07/2019–30/09/2019). The investigators have investigated if the cancellation has been made when it was absolutely necessary to cancel the clinic (Unavailability of doctors due to leave/on calls) and if patients have been informed at least 8 weeks prior to the appointed clinic as per trust protocol.ResultTotal number of 193 clinics were booked at the CMHT from July 2019 – September 2019. About 54% clinics were cancelled during the time period. The Clinic Cancellation rate was higher in September (68%) and was lowest in August (30.30%). As the month of July is the changeover period for trainees, the number of clinics booked during August was relatively less than normal. 72% clinics were cancelled by junior doctors and 28% clinics were cancelled by consultants at the CMHT. The major cause of clinic cancellation was unavailability of the junior doctors due to on call (31.58%) which was not communicated to the patient appointment booking team. Due to annual leave, 25% clinics were cancelled and 21% clinics were cancelled due to study leave. In both cases it is evident that, lack of communication between clinicians and patient appointment team are primarily responsible for hospital-initiated clinic cancellations. As per Patient Appointment booking team, around 50% cases, patients were informed 8 weeks in advance before cancelling the clinics.ConclusionThis is evident from this audit that the number of hospital-initiated clinic cancellations can be reduced by improving communication between Patient Appointment booking service, Medical staffing department and clinicians. The findings of the audit have been shared locally with CMHT managers, clinicians and with the patient appointment booking team.

scholarly journals TP8.2.10 Impact of COVID-19 on General Surgery Training in a University Hospital with Ring Fenced Elective Centre

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tanzeela Gala ◽  
Quratul Ain ◽  
Chekwas Obasi ◽  
Hajar Rashid ◽  
Sarkhell Radha ◽  
...  
Keyword(s):  
General Surgery ◽  
Normal Activity ◽  
University Hospital ◽  
Surgical Trainees ◽  
Higher Surgical Training ◽  
Theatre Utilisation ◽  
The Impact ◽  
Second Wave ◽  
Training Opportunities ◽  
General Surgery Training

Abstract Aim Higher Surgical training was decimated by the COVID-19 pandemic with cessation of elective care. Trainees raised concerns that the elective restart and need for higher theatre activity to clear backlogs would impact on training opportunities. This study evaluated the resumption of training associated with a ring-fenced elective centre (EC). Methods The EC was established in July 2020 and three time periods were determined: pre-COVID (10/19-2/20), 1st wave of COVID (3/20-7/20) and post EC go-live (8/20-12/20). Data was collated from the E-Logbooks of General Surgery Registrars. Results The normal all-speciality pre COVID theatre-activity averaged 1052 cases/month. During the first wave elective activity decreased to 254 cases/month (24% of normal activity). Within 5 weeks of establishment of the EC, theatre activity was near normal despite a reduced number of theatres (with higher theatre utilisation). Pre COVID, trainees accessed 22.9 cases per month which then dropped to 7.7 cases during the first wave of COVID. Post the go live of the EC, trainees were able to operate on 20 cases per month almost back to normal training levels. Prior to the impact of the second wave, each trainee had developed a deficit of 90 cases during the 5 months pause. Conclusion The ring-fenced elective centre has protected training opportunities for higher surgical trainees. However, the pause in training requires a targeted training recovery plan to overcome the deficit secondary to the first and subsequent waves of COVID to ensure that the JCST target of 1200 cases can be met for CCT.

scholarly journals Consenting Operative Orthopaedic Trauma Patients: Challenges and Solutions

ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Amin Kheiran ◽  
Purnajyoti Banerjee ◽  
Philip Stott
Keyword(s):  
Phase 1 ◽  
Operative Procedure ◽  
Trauma Surgery ◽  
National Standards ◽  
Junior Doctors ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Phase 2 ◽  
Consent Forms ◽  
Surgical Trainees

Guidelines exist to obtain informed consent before any operative procedure. We completed an audit cycle starting with retrospective review of 50 orthopaedic trauma procedures (Phase 1 over three months to determine the quality of consenting documentation). The results were conveyed and adequate training of the staff was arranged according to guidelines from BOA, DoH, and GMC. Compliance in filling consent forms was then prospectively assessed on 50 consecutive trauma surgeries over further three months (Phase 2). Use of abbreviations was significantly reduced (P=0.03) in Phase 2 (none) compared to 10 (20%) in Phase 1 with odds ratio of 0.04. Initially, allocation of patient’s copy was dispensed in three (6% in Phase 1) cases compared to 100% in Phase 2, when appropriate. Senior doctors (registrars or consultant) filled most consent forms. However, 7 (14%) consent forms in Phase 1 and eleven (22%) in Phase 2 were signed by Core Surgical Trainees year 2, which reflects the difference in seniority amongst junior doctors. The requirement for blood transfusion was addressed in 40% of cases where relevant and 100% cases in Phase 2. Consenting patients for trauma surgery improved in Phase 2. Regular audit is essential to maintain expected national standards.

Where is General Paediatric Surgery Going? An Analysis of General Paediatric Surgery in South Wales, 1997–2006

2012 ◽  
Vol 94 (1) ◽  
pp. 1-4
Author(s):  
WD Beasley ◽  
R Surana
Keyword(s):  
Paediatric Surgery ◽  
General Hospitals ◽  
Surgical Services ◽  
Medical Careers ◽  
South Wales ◽  
Surgical Trainees ◽  
Surgical Units ◽  
European Working ◽  
General Surgeons ◽  
Working Practices

Traditionally, general paediatric surgery (GPS) has been delivered by general surgeons, often in district general hospitals (DGHs). Changes to higher training in general surgery as a result of Calmanisation, the European Working Time Regulations and Modernising Medical Careers has meant that fewer general surgical higher trainees are being exposed to GPS Together with changes in paediatric anaesthesia working practices and guidelines, the future delivery of GPS services in DGHs is in jeopardy. The burden on specialist paediatric surgical units (SPSUs) will increase with implications for the training of paediatric surgical trainees. Evidence from England has shown that there has been a shift of paediatric surgical services from DGHs to SPSUs.

PTU-016 The lack of ercp training opportunities for surgical trainees

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A65.1-A65
Author(s):  
HL Adams ◽  
SS Jaunoo
Keyword(s):  
Surgical Trainees ◽  
Training Opportunities

scholarly journals EP.TU.40Tendon Repair Training: An Alternative Approach

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Parisa Moori ◽  
Shafiq Rahman
Keyword(s):  
Tendon Repair ◽  
Outer Core ◽  
Surgical Skill ◽  
Tissue Handling ◽  
Surgical Trainees ◽  
Alternative Approach ◽  
Reproducible Method ◽  
Set Up ◽  
Training Opportunities ◽  
Repair Techniques

Abstract Aims The COVID-19 pandemic has seen reduced training opportunities for surgical trainees. Tendon repair is an important surgical skill for all core surgical trainees. It is particularly essential for those training within Plastic and Orthopaedic surgery. Tendon repair simulation often involves the use of expensive materials or animal tissues, posing ethical predicament. Here we aimed to devise a simple and reproducible method for tendon repair simulation. Methods Our tendon simulation model is an inexpensive and easily set up arrangement consisting of edible strawberry laces. Results The tendon simulator gives reasonable replication of a tendon, with the laces depicting an inner and outer core of a severed tendon. In addition the materials are easy to acquire, handle, dispose of and are free from ethical limitations. Conclusions Surgical trainees will be able to practice varying tendon repair techniques on this model, applying basic surgical principles such as instrument and tissue handling and develop their expertise.

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