scholarly journals P-O05 Deconstructing Operations to Improve Recording of Surgical Training Experience

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ffion Dewi ◽  
Darren Scroggie ◽  
Samir Pathak ◽  
Natalie Blencowe ◽  
Andrew Hollowood ◽  
...  
Keyword(s):  
Surgical Training ◽  
University Teaching ◽  
Surgical Experience ◽  
Training Experience ◽  
Suggested Approach ◽  
Worked Example ◽  
Surgical Trainees ◽  
And Performance ◽  
The Impact ◽  
Training Opportunities

Abstract Background A new outcomes-based curriculum is soon to be implemented for UK surgical trainees. Performance will be evaluated against the standard expected of a new consultant. Accurate recording of operative experience and performance will therefore be crucial to demonstrate achievement of this standard. The current eLogbook system for recording surgical experience has many benefits including simplicity and accessibility, but may misrepresent actual experience because most operations are considered as a whole; unlike some colorectal operations, involvement in steps within many upper gastrointestinal (UGI) operations cannot be recorded. Methods Impact on training by the COVID-19 pandemic led to discussion and identification of cultural and logistical barriers to accurate recording of experience. To address these, a modification to enhance the current eLogbook system was developed by trainees and trainers at a university teaching hospital. An existing typology was used to deconstruct common UGI operations into their component steps, which can be recorded at this more detailed level.  Results The modified deconstructed logbook concept is described using a worked example, which can be applied to any operation. We also describe the integration of a component-based training discussion into the surgical team brief and debrief; this complements the deconstructed logbook by promoting a training culture. Conclusions Using the described techniques, trainees of all levels can comprehensively and accurately describe their surgical experience. Senior trainees will benefit from recording complex operations which they are not expected to complete in their entirety, whilst less experienced trainees will benefit from the ability to record their involvement in more basic parts of operations. The suggested approach will reduce misrepresentation of experience, encourage proactive planning of training opportunities, and reduce the impact of crises such as pandemics on surgical training.

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 Establishing a surgical skills laboratory and dissection curriculum for neurosurgical residency training

2015 ◽  
Vol 123 (5) ◽  
pp. 1331-1338 ◽  
Author(s):  
James K. C. Liu ◽  
Varun R. Kshettry ◽  
Pablo F. Recinos ◽  
Kambiz Kamian ◽  
Richard P. Schlenk ◽  
...  
Keyword(s):  
Surgical Training ◽  
Training Programs ◽  
Core Competencies ◽  
Technical Skills ◽  
Surgical Skills ◽  
Training Experience ◽  
Surgical Trainees ◽  
Modern Health Care ◽  
External Pressures ◽  
Skills Laboratory

Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory. The authors have established a surgical skills laboratory by acquiring equipment and funding from nondepartmental resources, through institutional and private educational grants, along with product donations from industry. A separate educational curriculum for junior- and senior-level residents was devised and incorporated into the neurosurgical residency curriculum. The initial dissection curriculum focused on cranial approaches, with spine and peripheral nerve approaches added in subsequent years. The dissections were scheduled to maximize the use of cadaveric specimens, experimenting with techniques to best preserve the tissue for repeated uses. A survey of residents who participated in at least 1 year of the curriculum indicated that participation in the surgical skills laboratory translated into improved understanding of anatomical relationships and the development of technical skills that can be applied in the operating room. In addition to supplementing the technical training of surgical residents, a surgical skills laboratory with a dissection curriculum may be able to help provide uniformity of education across different neurosurgical training programs, as well as provide a tool to assess the progression of skills in surgical trainees.

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 Autonomy in the Operating Room: A Multicenter Study of Gender Disparities During Surgical Training

2021 ◽  
Vol 13 (5) ◽  
pp. 666-672
Author(s):  
Jenny X. Chen ◽  
Edward H. Chang ◽  
Francis Deng ◽  
Shari Meyerson ◽  
Brian George ◽  
...  
Keyword(s):  
Surgical Training ◽  
Gender Disparities ◽  
Training Level ◽  
Surgical Performance ◽  
Surgical Trainees ◽  
Significant Difference ◽  
Multivariable Regression ◽  
Operative Performance ◽  
And Performance ◽  
Multivariable Regression Models

ABSTRACT Background Gender disparities are prevalent in medicine, but their impact on surgical training is not well studied. Objective To quantify gender disparities in trainee intraoperative experiences and explore the variables associated with ratings of surgical autonomy and performance. Methods From September 2015 to May 2019, attending surgeons and trainees from 71 programs assessed trainee autonomy on a 4-level Zwisch scale and performance on a 5-level modified Dreyfus scale after surgical procedures. Multivariable regression models were used to examine the association of trainee gender with autonomy and performance evaluations. Results A total of 3255 trainees and attending surgeons completed 94 619 evaluations. Attendings gave lower ratings of operative autonomy to female trainees than male trainees when controlling for training level, attending, and surgical procedure (effect size B = −0.0199, P = .008). There was no difference in ratings of autonomy at the beginning of training (P = .32); the gap emerged as trainees advanced in years (B = −0.0163, P = .020). The gender difference in autonomy was largest for the most complex cases (B = −0.0502, P = .002). However, there was no difference in attending ratings of surgical performance for female trainees compared to male trainees (B = −0.0124, P = .066). Female trainees rated themselves as having less autonomy and worse performance than males when controlling for training level, attending, procedure, case complexity, and attending ratings (autonomy B = −0.0669, P &lt; .001; performance B = −0.0704, P &lt; .001). Conclusions While there was no significant difference in ratings of operative performance, a small difference between ratings of operative autonomy for female and male surgical trainees was identified.

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 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 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.

scholarly journals Robotic and Advanced Laparoscopic Surgical Training in European Gynecological Oncology Trainees

2017 ◽  
Vol 27 (2) ◽  
pp. 375-381 ◽  
Author(s):  
Carmen Gan ◽  
Michaela Bossart ◽  
Jurgen Piek ◽  
Michael Halaska ◽  
Dimitrios Haidopoulos ◽  
...  
Keyword(s):  
Surgical Training ◽  
Open Surgery ◽  
Nonparametric Tests ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Training Experience ◽  
Web Based ◽  
Gynecological Oncology ◽  
Training Opportunities ◽  
Trainee Experience

IntroductionAdvanced minimal access surgical training is an important component of training in gynecological oncology (GO). Europe-wide data on this topic are lacking. We present data on availability and trainee experience of advanced laparoscopic surgical (ALS) and robotic surgical (RS) training in GO across Europe.MethodA prospective web-based anonymized survey of European GO trainees was sent to the European Network of Young Gynaecological Oncologists members/trainees. It included sociodemographic information and specific questions pertaining to training experience or satisfaction in laparoscopic and robotic surgery. χ2test was used for evaluating categorical variables and Mann-Whitney/Kruskal-Wallis (nonparametric) tests for continuous variables between 2 and more independent groups.ResultsA total of 113 GO trainees from 29 countries responded. The mean (standard deviation) age was 35.2 (6.1) years, 59.3% were men, 40.7% were women, and 46% were in accredited training posts. The ALS and RS training was offered in only 43% and 23% of institutes respectively, and 54% and 23% of trainees had undergone some form of formal or informal training in ALS and RS respectively. A total of 62.4% felt that RS should be a formal component of GO training programs. A total of 61% and 35% planned to go outside their institute for ALS or RS training respectively. Trainees rating (1–5 scale) of their open surgery and ALS or RS skills (3.3/2.6/1.9) and training experience (3.5/2.8/2.1), respectively, were higher for open surgery than ALS or RS (P< 0.0005). Accredited posts were more likely than nonaccredited posts to offer ALS training (60%/31%,P= 0.002), formal training schedules (27.9%/4.4%,P= 0.003), and use of logbooks (46%/23%,P= 0.035).ConclusionsTraining and experience in ALS and RS are poorly rated by GO trainees across Europe, and only few centers offer this. There is an urgent need to expand and harmonize training opportunities for ALS and RS. Most trainees want RS included as a formal component of their training.

scholarly journals Time spent in theatre predicts training opportunities and progression for core surgical trainees

2012 ◽  
Vol 94 (10) ◽  
pp. 352-353 ◽  
Author(s):  
Sophie-Anne Welchman ◽  
Denis Wilkins ◽  
Harvey Chant
Keyword(s):  
Surgical Training ◽  
Operating Theatre ◽  
Time Constraints ◽  
Surgical Trainees ◽  
Explicit Training ◽  
Structured Approach ◽  
Training Opportunities

Operative skills are the defining attribute of a surgeon. Traditional surgical training encourages trainees to take every opportunity to spend time observing and assisting in the operating theatre. There is an impression that the time constraints of working schedules, the breakdown of the traditional consultant team and the structured approach adopted by the Intercollegiate Surgical Curriculum Programme (ISCP) have discouraged trainees from spending time in the operating theatre outside of explicit training sessions.

Interview Scores Correlate with Fellow Microsurgical Skill and Performance

2017 ◽  
Vol 34 (03) ◽  
pp. 211-217 ◽  
Author(s):  
Charles Butler ◽  
Hiroo Suami ◽  
Patrick Garvey ◽  
Jun Liu ◽  
Jesse Selber ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Selection Process ◽  
Training Experience ◽  
Interview Process ◽  
Evaluation Of Performance ◽  
Surgical Trainees ◽  
Academic Center ◽  
And Performance ◽  
Almost All ◽  
First Time

Background The interview process for surgical trainees aims to select those individuals who will perform best during training and have the greatest potential as future surgeons. The objective of this study was to evaluate the relationship between criteria assessed at interview, technical skills, and performance, for the first time, to optimize the selection process for a Microsurgery fellowship. Methods Twenty microsurgery fellows in three consecutive annual cohorts at a single academic center were prospectively evaluated. At interview, subjects were scored for multiple standardized domains. At the start and at end of the fellowship, microsurgical technical skill was assessed both in the laboratory and operating room (OR) using a validated assessment tool. At the end of the fellowship, there was a final evaluation of performance. Results At the start, microsurgical skill significantly correlated with almost all domains evaluated at interview, most closely with prior plastic surgery training experience. At the end of the fellowship, skill level improved in all trainees, with the greatest improvement made by the lowest ranked and skilled trainees. The highest ranked trainees, however, made the greatest improvement in speed. Conclusions The results of this study, for the first time, validate the current interview process to correctly select the highest performing and most skilled candidates and support the effectiveness of a 1-year microsurgical fellowship in improving microsurgical skill in all trainees, irrespective of their initial ability. The importance of valuing the relative quality of prior training and experience at selection is also highlighted.

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