scholarly journals SP2.2.18UK Surgical Training in the Independent Sector During COVID-19 – A Snapshot Survey

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Valdone Kolaityte ◽  
Charlotte El-Sayed ◽  
Josh Burke

Abstract Aims In response to the COVID-19 pandemic and the cancellation of elective surgery, the Independent sector (IS) has been utilised to provide COVID-light sites. On average operative log book numbers have been reduced by 50% due to a reduction in operative exposure. The Four Educational Bodies continue to support training within the independent sector. This study aimed to qualitatively assess access and barriers to UK surgical training in the Independent Sector. Methods A snap-shot online survey was distributed to ASIT members of all training specialities and grades between 21/10/2020-11/11/2020 . Data measures included participant demographics, frequency of access, participation in training opportunities including outpatient clinic, theatre lists and endoscopy and any barriers encountered. A mixture of Likert scale and short answer questions were utilised. Results 249 complete responses representing all grades and specialities were included in the final analysis (34.29% CST and 56.3% HST). 35.7% of trainees reported access to the IS. 22.9% had access to at least one operating list whilst 70.3% had none. Access to outpatient clinics and endoscopy was negligible. 75% of trainees ‘strongly agreed’ that when access was achievable, it was beneficial to their training. Multiple barriers were identified including Human Resource requirements and local service provision. Conclusions Within the sample, access to the IS has been poor. There is wide variation in barriers to access across the 4 nations and IS providers. Trainees and Trainers should maximise training opportunities in the IS. Where barriers exist, they should be reported to local Training Programme Directors.

2014 ◽  
Vol 10 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Dulani Mendis ◽  
Calum Paton

Purpose – Previously published studies about trainee perceptions of clinical leadership, although small in number, have not assessed the opinions of senior registrars nor established their awareness of the relevant leadership frameworks. The paper aims to discuss these issues. Design/methodology/approach – Survey questions and interview questions were designed and a comparison of the relevant literature was performed. An online survey was sent via e-mail to a potential of 2,126 registrar trainees within the deanery and a series of semi-structured interviews (analysed via a content analysis) were conducted amongst voluntary subjects. Findings – The response rate for the questionnaire was 247/2,126 (11.6 per cent). Respondents recognised the importance of leadership (90.4 per cent), professionalism (99.6 per cent) and promoted team-working (89.8 per cent). In total, 94.3 per cent of respondents have had ideas for improvement in their workplace; however, only 27.9 per cent have had their ideas for change implemented. Of the 85.5 per cent of trainees who are not aware of the leadership frameworks, 89.1 per cent performed leadership activities either daily or sometimes. The priorities of registrars did appear to differ between the junior and senior grades. Originality/value – Registrar trainees have a desire to engage and a perceived ability to contribute to service improvement; however, a lack of encouragement, awareness and limited training opportunities serve to hamper the development of clinical leadership potential. This study presents itself as a pilot and will hopefully prompt a larger deanery study to gain a thorough assessment of all trainee perceptions, in order to improve the training programme and ultimately create a generation of consultants equipped to engage in clinical leadership throughout their lifelong career in the National Health Service.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J O'Callaghan ◽  
S Lochab ◽  
P Stanier ◽  
D Woods

Abstract Introduction The COVID pandemic had led to the cancellation of elective Orthopaedics in the NHS. The aim of this study was to investigate the effect of the independent sector on orthopaedic training and the effect of the COVID pandemic on training locally. Method A retrospective review of trauma and elective operations was made between April and September of 2019 and 2020 to compare the effects of COVID on training opportunities and the additional capacity provided by the private sector. Results The impact of COVID on Surgical training at GWH has been no decrease in trauma operating experience, but a 53% decrease in elective operating experience and a 74% decrease in joint replacement operative experience during an equivalent six-month period. Use of the independent hospital has enabled 6% of the total elective surgery experience, and 11% of the joint replacement surgery experience. Discussion The private sector has provided additional capacity but a productivity of 66 cases from 48 half day lists is low (1.4 cases per list) has proved disappointing. There has been a low impact on elective training. The challenges have been faced on the elective side as trauma cases have remained consistent during the pandemic. Conclusions Use of the alliance between the private sector and NHS as a resource to provide additional training opportunities needs to be developed further in the future with incentivised guidance. Orthopaedic training will inevitably adapt to the challenges presented for the next generations of surgeons.


2018 ◽  
Vol 21 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jitoko Kelepi Cama ◽  
Sonal Singh Nagra

Post-graduate surgical training at the Fiji National University (FNU), previously known as the Fiji School of Medicine) has recently been updated by incorporating elements from the Royal Australasian College of Surgeons (RACS) training curriculum. The revised curriculum maintains strong contextual relevance to the needs and pathologies of the Pacific Island nations.  This paper outlines why the FNU surgical postgraduate training programme should be applauded as a successful programme in the training of surgeons for the region.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Christian Asher ◽  
Ibrahim Ibrahim ◽  
Eyfrossini Katsarma

Abstract Introduction COVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills. Methods Enrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion. Results 5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020. Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent. Conclusions The COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Riad ◽  
S Knight ◽  
E Harrison

Abstract Background Malnutrition is a state linked to worse postoperative outcomes, and cancer patients are particularly vulnerable due to cachexia. We aimed to explore the effect of malnutrition on 30-day mortality following gastric and colorectal cancer surgery. Method GlobalSurg3 was multicentre international cohort study which collected data from consecutive patients undergoing emergency or elective surgery for gastric and colorectal cancer. Malnutrition was defined using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Multilevel variable regression approaches determined the relationship between malnutrition and early postoperative outcomes. Results 6438 patients were included in the final analysis (1184 gastric cancer; 5254 colorectal cancer). Severe malnutrition was common across all income-strata, affecting 1 in 4 patients overall, with a higher burden in low and lower-middle income countries (64%). In patients undergoing elective surgery (n = 5709), severe malnutrition was independently associated with increased mortality (aOR = 1.62 (1.07-2.48, P = 0.024) after accounting for patient factors, disease stage and country effects. Conclusions Severe malnutrition represents a high global burden in cancer surgery, particularly within lower income settings. Malnutrition is an independent risk-factor for 30-day mortality following elective surgery for gastric and colorectal cancer, suggesting perioperative nutritional interventions may improve outcomes after cancer surgery.


Author(s):  
Mingyue Zhao ◽  
Lingyi Zhang ◽  
Zhitong Feng ◽  
Yu Fang

The purpose of this study is to investigate physicians’ knowledge, attitudes and practice of generic medicine substitutions in China. We conducted a cross-sectional online questionnaire survey on physicians from secondary or tertiary hospitals in China from 2020 December to 2021 April. Descriptive statistical and ordered logistic regression were used for analysis. A total of 1225 physicians were included in the final analysis, and only 330 (26.94%) of them scored 4 or above in the knowledge part, which means that the physicians have a good knowledge of generic substitutions. Of the total, 586 (47.83%) agreed or strongly agreed that generic drugs could be substituted for originator drugs and 585 (47.75%) always or often prescribed generic medicines. The percentage of physicians with a positive attitude toward or that practice prescribing generic medicine is below 50%, which needs to be improved in China. Physicians’ knowledge, their attitude toward generic substitution, if familiar with the policy of generic substitution, and incentives for prescribing generic medicines are influencing factors for the practice of generic substitution. Our studies show that the practice of generic substitution by physicians could be improved by several measures in China. We suggested that the physicians should be taught more about the bulk-buy policy and the generic-originator equivalence evaluation policy. Moreover, government incentives to promote generic substitution should be established. Our study also suggested that physicians with less working experience and female physicians should learn more about generic substitution.


Author(s):  
Marina Yiasemidou

AbstractThe COVID-19 pandemic and infection control measures had an unavoidable impact on surgical services. During the first wave of the pandemic, elective surgery, endoscopy, and ‘face-to-face’ clinics were discontinued after recommendations from professional bodies. In addition, training courses, examinations, conferences, and training rotations were postponed or cancelled. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a significant negative impact on training. At the same time, they have given space to new technologies, like telemedicine and platforms for webinars, to blossom. While the recovery phase is well underway in some parts of the world, most surgical services are not operating at full capacity. Unfortunately, some countries are still battling a second or third wave of the pandemic with severely negative consequences on surgical services. Several studies have looked into the impact of COVID-19 on surgical training. Here, an objective overview of studies from different parts of the world is presented. Also, evidence-based solutions are suggested for future surgical training interventions.


Author(s):  
Ana Kober Leite ◽  
Leandro Luongo Matos ◽  
Claudio R. Cernea ◽  
Luiz Paulo Kowalski

Abstract Introduction The COVID-19 pandemic has had a high impact on surgical training around the world due to required measures regarding the suspension of elective procedures and the dismissal of nonessential personnel. Objectives To understand the impact the pandemic had on head and neck surgery training in Brazil. Methods We conducted a 29-question online survey with head and neck surgery residents in Brazil, assessing the impact the pandemic had on their training. Results Forty-six residents responded to the survey, and 91.3% of them reported that their residency was affected by the pandemic, but most residents were not assigned to work directly with patients infected with the new coronavirus (71.4%). All residents reported decrease in clinic visits and in surgical procedures, mostly an important reduction of ∼ 75%. A total of 56.5% of the residents described that the pandemic has had a negative impact on their mental, health and only 4 (8.7%) do not have any symptoms of burnout. The majority (78.3%) of the residents reported that educational activities were successfully adapted to online platforms, and 37% were personally infected with the virus. Conclusion Most surgical residencies were greatly affected by the pandemic, and residents had an important decrease in surgical training. Educational activities were successfully adapted to online modalities, but the residency programs should search for ways of trying to compensate for the loss of practical activities.


2011 ◽  
Vol 56 (4) ◽  
pp. 206-209 ◽  
Author(s):  
B M Stutchfield ◽  
E M Harrison ◽  
S J Wigmore ◽  
R W Parks ◽  
O J Garden

With recent ‘working-time'-related changes to surgical training structure, the value of dedicated research during surgical training has been questioned. Online survey examining career and academic outcomes following a period of surgically related dedicated research at a Scottish University between 1972 and 2007. Of 58 individuals identified, contact details were available for 49 and 43 (88%) responded. Ninety-five percent ( n = 41) of respondents continue to pursue a career in surgery and 41% ( n = 17) are currently in academic positions. Ninety-one percent ( n = 39) had published one or more first-author peer-reviewed articles directly related to their research, with 53% ( n = 23) publishing three or more. Respondents with a clinical component to their research published significantly more papers than those with purely laboratory-based research ( P = 0.04). Eighty-one percent ( n = 35) thought that research was necessary for career progression, but only 42% ( n = 18) felt research should be integral to training. In conclusion, the majority of surgical trainees completing a dedicated research period, published papers and continued to pursue a surgical career with a research interest. A period of dedicated research was thought necessary for career progression, but few thought dedicated research should be integral to surgical training.


Author(s):  
Naomi Weier ◽  
Dilip Nathwani ◽  
Karin Thursky ◽  
Thomas Tängdén ◽  
Vera Vlahović-Palčevski ◽  
...  

Abstract Background Healthcare professionals are increasingly expected to lead antimicrobial stewardship (AMS) initiatives. This role in complex healthcare environments requires specialized training. Objectives Little is known about the types of AMS training programmes available to clinicians seeking to play a lead role in AMS. We aimed to identify clinicians’ awareness of AMS training programmes, characteristics of AMS training programmes available and potential barriers to participation. Methods AMS training programmes available were identified by members of the ESCMID Study Group for Antimicrobial Stewardship (ESGAP) via an online survey and through an online search in 2018. Individual training programme course coordinators were then contacted (September–October 2018) for data on the target audience(s), methods of delivery, intended outcomes and potential barriers to accessing the training programme. Results A total of 166/250 ESGAP members (66%) responded to the survey, nominating 48 unique AMS training programmes. An additional 32 training programmes were identified through an online search. AMS training programmes were from around the world. Less than half (44.4%) of respondents were aware of one or more AMS training programmes available, with pharmacists more aware compared with medical doctors and other professionals (73% versus 46% and 25%, respectively). AMS training programmes were most commonly delivered online (59%) and aimed at medical doctors (46%). Training costs and a lack of recognition by health professional societies were the most frequently cited barriers to participation in AMS training programmes. Conclusions The development of a systematic inventory of AMS training programmes around the globe identifies opportunities and limitations to current training available. Improving access and increasing awareness amongst target participants will support improved education in AMS.


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