scholarly journals TP8.2.15 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Khurram Khan ◽  
Giuliana Torpiano ◽  
Norman Galbraith ◽  
Morag McLellan ◽  
Alison Lannigan
Keyword(s):  
Surgical Training ◽  
Annual Review ◽  
Surgical Trainee ◽  
Training Groups ◽  
Surgical Trainees ◽  
The Impact

Abstract Aims The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Methods All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

scholarly journals 982 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Khan ◽  
G Torpiano ◽  
N Galbraith ◽  
M McLellan ◽  
A Lannigan
Keyword(s):  
Surgical Training ◽  
Annual Review ◽  
Surgical Trainee ◽  
Training Groups ◽  
Surgical Trainees ◽  
The Impact

Abstract Aim The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Method All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

scholarly journals SP10.2.6 The Quantitative Impact of COVID-19 on surgical training in the United Kingdom

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Joshua Clements ◽  
Joshua Burke ◽  
Carly Hope ◽  
Deirdre Nally ◽  
Gareth Griffiths ◽  
...  
Keyword(s):  
United Kingdom ◽  
Surgical Training ◽  
Elective Surgery ◽  
Outcome Data ◽  
Annual Review ◽  
Surgical Specialty ◽  
The United Kingdom ◽  
Surgical Trainees ◽  
Rate Ratios ◽  
The Impact

Abstract Aims COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the United Kingdom. Methods Anonymised operative logbook numbers were collated from e-logbook and ARCP outcome data were collated from the Intercollegiate Surgical Curriculum Programme (ISCP) database for trainees across core and the ten higher surgical specialities. Operative logbook numbers and ARCP outcomes were compared between pre-COVID dates. Effect sizes are reported as incident rate ratios (IRR) with 95% confidence intervals (CI). Results 5599 surgical trainees in 2019 and 5310 in 2020 in surgical specialty training were included. The IRR was reduced across all subspecialties because of the COVID-19 pandemic (0.55; 95% CI 0.53-0.57). Elective surgery (0.60; 95% CI 0.59-0.61) was affected more than emergency surgery (0.88; 95% CI 0.86-0.89). Regional variance with reduced operative activity was demonstrated across all specialities. 1 in 8 in their final year of training have not been able to achieve curriculum requirements and have had training extended. 1 in 4 trainees entering their final year of training are behind their expected training trajectory. Conclusion COVID-19 continues to have a significant impact on surgical training in the UK. Urgent, co-ordinated action is required by key stakeholders to mitigate for these effects and maintain future surgical training.

scholarly journals 962 COVID-19 And ST3 National Selection in Surgery: What Happens to Core Surgical Trainees When We Remove the Face-to-Face Interview?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Leiberman ◽  
M Trivedy ◽  
A Kausar
Keyword(s):  
Surgical Training ◽  
Freedom Of Information ◽  
Progression Rate ◽  
Surgical Trainee ◽  
Face To Face ◽  
Surgical Trainees ◽  
Higher Surgical Training ◽  
National Selection ◽  
The Uk ◽  
The Impact

Abstract Introduction The 2020 ST3 recruitment year for Higher Surgical Training (HST) did not have a face-to-face interview due to COVID-19. Candidates were solely scored on portfolio self-assessment alone. We have assessed the impact on Core Surgical Trainee progression into ST3 by comparing the 2020 recruitment year with 2019. Method Total numbers of applicants to ST3 for all 7 surgical sub-specialties that recruit at ST3 level were obtained via Freedom of Information requests from Health Education England (HEE). These were sorted by those who were in CST, had completed CST or had an alternative equivalence certificate. Results Overall applicant numbers were up in 2020, mainly from an increase in applicants with a Certificate of Readiness to Enter Higher Surgical Training. Overall ST3 positions appointed to were down. CST progression rate was down slightly, with an increase in appointees >10 years since graduation. Conclusions The 2020 recruitment year for ST3 HST had a higher number of applicants and lower places available than 2019. The majority of the extra applicants were trainees who have not completed CST in the UK. CST progression rate to HST was down slightly. The lack of face-to-face interview may benefit some candidates graduating >10 years ago.

scholarly journals Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort

2021 ◽  
Author(s):  
Orla Hennessy ◽  
Amy Lee Fowler ◽  
Conor Hennessy ◽  
David Brinkman ◽  
Aisling Hogan ◽  
...  
Keyword(s):  
Surgical Training ◽  
World Health Organisation ◽  
World Health ◽  
Training Methods ◽  
Viral Spread ◽  
Surgical Services ◽  
Global Pandemic ◽  
Surgical Trainees ◽  
Secondary Survey ◽  
The Impact

Abstract Background The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees. Aim To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees. Methods Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two. Results Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p < 0.0001). Exposure to formal teaching and education sessions returned to pre-COVID levels (p < 0.0001). Initially, 23% of trainees had an examination cancelled; 53% of these trainees have subsequently sat these examinations. Of note 27.7% had courses cancelled, and 97% of these had not been rescheduled. Conclusion Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.

scholarly journals P38 COVID-19 impact on Surgical Training And Recovery Planning (COVID-STAR) Survey

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Surgical Trainee ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Training Time ◽  
Surgical Trainees ◽  
And 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 &gt; 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 &gt; 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, &gt; 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.

scholarly journals Impact of the COVID-19 pandemic on core surgical training

2020 ◽  
Vol 65 (4) ◽  
pp. 133-137 ◽  
Author(s):  
Khurram Shahzad Khan ◽  
Rona Keay ◽  
Morag McLellan ◽  
Sajid Mahmud
Keyword(s):  
Surgical Training ◽  
Teaching Hospital ◽  
General Surgery ◽  
Negative Impact ◽  
Outpatient Clinics ◽  
Box Trainer ◽  
Surgical Trainees ◽  
Long Term Impact ◽  
The Impact

Background and aims COVID-19 pandemic has caused significant disruption in training which is even more pronounced in the surgical specialties. We aim to assess the impact of COVID-19 pandemic on core surgical training. Methods All core surgical and improving surgical trainees in West of Scotland region were invited to participate in an online voluntary anonymous survey via SurveyMonkey. Results 28 of 44 (63.6%) trainees responded, 15 (53.6%) were CT1/ST1. 14 (50.0%) working in teaching hospital and 15 (53.6%) working in general surgery. 20 (71.4%) felt that due to the pandemic they have less opportunity to operate as the primary surgeon. 21 (75.0%) have not attended any outpatient clinics. 8 (28.6%) did not have any form of access to the laparoscopic box-trainer. 20 (71.4%) felt their level of confidence in preforming surgical skills has been negatively impacted. 18 (64.3%) found it difficult to demonstrate progress in portfolio. 21 (75.0%) trainees have not attended any teaching. 10 (35.7%) trainees have been off-sick. 8 (28.6%) trainees have felt slightly or significantly more stressed. Conclusion COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. The long term impact on the current cohort of trainees is yet to be seen.

Postoperative surgical trainee opioid prescribing practices (POST-OPP): A national survey

2019 ◽  
Vol 15 (4) ◽  
pp. 307-322 ◽  
Author(s):  
David J. Hall, MD ◽  
Juan C. Mira, MD ◽  
Melissa R. Hoffman, MD, ND ◽  
Hari B. Keshava, MD, MS ◽  
Kevin R. Olsen, MD ◽  
...  
Keyword(s):  
Pain Management ◽  
Medical School ◽  
General Surgery ◽  
Online Survey ◽  
Management Training ◽  
Prescribing Practices ◽  
Surgical Trainee ◽  
Opioid Prescribing ◽  
Surgical Trainees ◽  
The Impact

Background: Increasing opioid-related deaths have heightened focus on combating the opioid epidemic. The impact of surgical trainees on opioid-related deaths is unclear, and there is little data examining the association between trainee pain management education and opioid prescribing practices.Methods: An anonymous, online survey was distributed to members of the Resident and Associate Society of the American College of Surgeons. The survey covered five themes: education and knowledge, prescribing practices, clinical case scenarios, policy, and beliefs and attitudes. Linear mixed models were used to evaluate the influence of respondent characteristics on reported morphine milligram equivalents (MME) prescribed for common general surgery clinical scenarios.Results: Of 427 respondents, 54 percent indicated receiving training in postoperative pain management during medical school and 66 percent during residency. Only 35 percent agreed that they had received adequate training in prescribing opioids. There was a significant association between undergoing formal pain management training in medical school and prescribing fewer MME for common outpatient general surgery scenarios (94 ± 15.2 vs 108 ± 15.0; p = 0.003). Similarly, formal pain management training in residency was associated with prescribing fewer MME in the survey scenarios (92.6 ± 15.2 vs 109 ± 15.2; p = 0.002).Conclusion: In this survey, nearly two-thirds of surgical residents felt that they were inadequately trained in opioid prescribing. Our findings additionally suggest that improving education may result in increased resident comfort with managing surgical pain, potentially leading to more responsible opioid prescribing. Further work will facilitate residency programs’ development of educational curricula for opioid prescribing best practices.

scholarly journals Visuospatial and Technical Ability in the Selection and Assessment of Higher Surgical Trainees in the London Deanery

2007 ◽  
Vol 89 (6) ◽  
pp. 591-595 ◽  
Author(s):  
P Tansley ◽  
S Kakar ◽  
S Withey ◽  
P Butler
Keyword(s):  
Surgical Training ◽  
Practical Skills ◽  
Surgical Trainee ◽  
Surgical Department ◽  
Technical Ability ◽  
Surgical Trainees ◽  
Competency Based ◽  
Higher Surgical Training ◽  
Training Programmes ◽  
Selection And Assessment

INTRODUCTION Despite awareness of the limitations of current selection and competency assessments, there is little consensus and alternatives have not been readily accepted. Essential surgical skills include visuospatial and technical ability. The aim of this study was to survey current methods of higher surgical trainee selection and assessment. We suggest ways to improve the process. MATERIALS AND METHODS Nine surgical training programmes in the London deanery were surveyed through questionnaires to programme directors, existing trainees and examination of deanery publications. RESULTS Testing of visuospatial and technical ability was piloted at selection only in a single general surgical department. Practical skills were assessed in 3/9 (33%) specialties (ENT, plastic and general surgery). Once selected, no specialty tested visuospatial and technical ability. Practical skills were tested in only 1/9 (11%) specialties (plastic surgery). The remaining 8/9 (89%) were ‘assessed’ by interview. CONCLUSIONS Lack of visuospatial and technical ability assessment was identified at selection and during higher surgical training. Airlines have long recognised early identification of these qualities as critical for efficient training. There is a need for more objective methods in this area prior to selection as time to assess surgical trainees during long apprenticeships is no longer available. We advocate a suitably validated competency-based model during and at completion of training.

scholarly journals O9 The Effects of Coronavirus (COVID-19) on operative and work-based assessment (WBA) activity on surgical training

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Training Programme ◽  
Continuous Variables ◽  
Data Governance ◽  
Training Activity ◽  
Surgical Trainees ◽  
Percentage Difference ◽  
The Impact ◽  
And Training

Abstract Background COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. The COVID-STAR qualitative study demonstrated a perceived negative impact of COVID-19 on numerous aspects of surgical training across all specialties and training grades. The aim of this study is to investigate how COVID-19 has affected operative case exposure and work-based assessments for surgeons in training. Methods Anonymized data has been sought from the Intercollegiate Surgical Curriculum Programme (ISCP) database for operations and work-based assessments in each specialty, involving surgical trainees on an approved training programme at defined Pre-COVID (16/03/19 – 11/05/19) and COVID (16/03/2020 – 11/05/20) timepoints. Primary outcome measures are the percentage (%) difference in WBA and operative activity between time points respectively. Differences in training activity between time periods will be tested using Pearson χ2 and Kruskal–Wallis tests for categorical and continuous variables respectively. Results This study has been approved by the ISCP Data Analysis, Audit and Research Group, and data will be managed in accordance with ISCP data governance. The hypothesis of this study is that COVID-19 has caused a reduction in the operative and WBA activity of trainees across all specialties. Conclusion This study seeks to quantify the impact of COVID-19 on operative training activity and completion of WBAs in clinical practice. This information will inform major stakeholders involved in optimising surgical training in the COVID-19 recovery phase.

scholarly journals Differences in progression by surgical specialty: a national cohort study

2021 ◽  
Author(s):  
carla hope ◽  
Jon Lund ◽  
gareth griffiths ◽  
david humes
Keyword(s):  
Cohort Study ◽  
Surgical Training ◽  
General Surgery ◽  
Primary Outcome Measure ◽  
Older Age ◽  
Annual Review ◽  
Surgical Specialty ◽  
Surgical Trainees ◽  
National Cohort ◽  
To Receive

The aim of surgical training across the ten surgical specialties is to produce competent day one consultants. Progression through training is assessed by the Annual Review of Competency Progression (ARCP). Objective This study aimed to examine variation in ARCP outcomes within surgical training and identify differences between specialties. Design A national cohort study using data from United Kingdom Medical Education Database (UKMED) was performed. ARCP outcome was the primary outcome measure. Multi-level ordinal regression analyses were performed, with ARCP outcomes nested within trainees. Participants Higher surgical trainees (ST3-ST8) from 9 UK surgical specialties were included (vascular surgery was excluded due to insufficient data). All surgical trainees across the UK with an ARCP outcome between 2010 to 2017 were included. Results Eight thousand two hundred and twenty trainees with an ARCP outcome awarded between 2010 and 2017 were included, comprising 31,788 ARCP outcomes. There was substantial variation in the proportion of non-standard outcomes recorded across specialties with general surgery trainees having the highest proportion of non-standard outcomes (22.5%) and urology trainees the fewest 12.4%. After adjustment, general surgery trainees were 1.3 times more likely to receive a non-standard ARCP outcome compared to trainees in T&O (OR 1.33 95%CI 1.21-1.45). Urology trainees were 36% less likely to receive a non-standard outcome compared to T&O trainees (OR 0.64 95%CI 0.54-0.75). Female trainees and older age were associated with non-standard outcomes (OR 1.11 95%CI 1.02-1.22; OR 1.04 95%CI 1.03-1.05). Conclusion There is wide variation in the training outcome assessments across surgical specialties. General surgery has higher rates of non-standard outcomes compared to other surgical specialities. Across all specialities, female sex and older age were associated with non-standard outcomes.

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