Procedure-based assessments: the past, the present and the future

2019 ◽  
Vol 96 (1131) ◽  
pp. 7-8
Author(s):  
Ahmed Abdelaal
Keyword(s):  
Surgical Training ◽  
Surgical Trainee ◽  
The Past ◽  
Surgical Trainees ◽  
The Future ◽  
The Uk ◽  
Almost All

One of the most significant changes to the structure of surgical training in the UK was the introduction of workplace-based assessments (WBAs). Since its integration into the Intercollegiate Surgical Curriculum Programme, we as surgical trainees became the children of WBAs. Procedure-based assessment (PBA) is one of the pillars of WBAs and no surgical trainee portfolio is complete without a significant number of PBAs completed. As a senior trauma and orthopaedics trainee myself, I have encountered PBA on a regular basis, both as a trainee and as an assessor to my junior colleagues. My journey in understanding and implementing PBAs has not been a smooth one. This is also a reflection of almost all surgical trainees across all specialties. In this review, I aim to shed some light on my perspective on PBA, its values, limitations and concerns that have risen as a result of its introduction. I also aim to use my experiences to highlight possible ways of improvement in PBA.

scholarly journals A Critical Appraisal of the Evidence of Current Methods of Assessment for Surgical Trainees

2013 ◽  
Vol 95 (6) ◽  
pp. 7-11
Author(s):  
AJ Batchelder ◽  
MJ McCarthy
Keyword(s):  
Surgical Training ◽  
Critical Appraisal ◽  
Junior Doctors ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
The Uk ◽  
Supervision And Training ◽  
And Training

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.

scholarly journals Post-EWTR: Is the UK Still a Centre of Excellence for Surgical Training?

2012 ◽  
Vol 94 (8) ◽  
pp. 268-273 ◽  
Author(s):  
MEA Khan ◽  
AD Jordan ◽  
T Strange ◽  
S Vig
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Specialist Training ◽  
Current Generation ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
Centre Of Excellence ◽  
The Uk ◽  
Radical Transformation

Surgical training in the UK has undergone a radical transformation over the past few years. The limitation of working hours imposed by the European workingTime regulations (EWTR) and a shorter path to consultancy through Modernising Medical Careers has resulted in a shortening of training hours between qualification and completion of specialist training. Some estimate total training hours have reduced by 50%, from 30,000 in the old system to just 15,000 currently. Quite reasonably, there is concern that the current generation of surgical trainees will be less skilled and less competent than their predecessors.

scholarly journals Cross-sectional study of the financial cost of training to the surgical trainee in the UK and Ireland

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018086 ◽  
Author(s):  
John O’Callaghan ◽  
Helen M Mohan ◽  
Anna Sharrock ◽  
Vimal Gokani ◽  
J Edward Fitzgerald ◽  
...  
Keyword(s):  
Medical Students ◽  
Surgical Training ◽  
Postgraduate Training ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Trainee ◽  
Cross Sectional ◽  
Training Costs ◽  
Surgical Trainees ◽  
The Uk

ObjectivesApplications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training.DesignProspective, cross-sectional, questionnaire-based study.Setting/ParticipantsA non-mandatory online questionnaire for UK-based trainees was distributed nationally. A similar national questionnaire was distributed for Ireland, taking into account differences between the healthcare systems. Only fully completed responses were included.ResultsThere were 848 and 58 fully completed responses from doctors based in the UK and Ireland, respectively. Medical students in the UK reported a significant increase in debt on graduation by 55% from £17 892 (2000–2004) to £27 655 (2010–2014) (p<0.01). 41% of specialty trainees in the UK indicated that some or all of their study budget was used to fund mandatory regional teaching. By the end of training, a surgical trainee in the UK spends on average £9105 on courses, £5411 on conferences and £4185 on exams, not covered by training budget. Irish trainees report similarly high costs. Most trainees undertake a higher degree during their postgraduate training. The cost of achieving the mandatory requirements for completion of training ranges between £20 000 and £26 000 (dependent on specialty), except oral and maxillofacial surgery, which is considerably higher (£71 431).ConclusionsMedical students are graduating with significantly larger debt than before. Surgical trainees achieve their educational requirements at substantial personal expenditure. To encourage graduates to pursue and remain in surgical training, urgent action is required to fund the mandatory requirements and annual training costs for completion of training and provide greater transparency to inform doctors of what their postgraduate training costs will be. This is necessary to increase diversity in surgery, reduce debt load and ensure surgery remains a popular career choice.

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 &gt;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 &gt;10 years ago.

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 TEMPORAL SYSTEM OF THE OSSETIAN VERB COMPARED WITH OTHER IRANIAN LANGUAGES

Kavkaz-forum ◽  
2020 ◽  
Author(s):  
Э.Б. САТЦАЕВ
Keyword(s):  
Grammatical Category ◽  
Future Tense ◽  
Interesting Phenomenon ◽  
The Past ◽  
Persian Language ◽  
Temporal System ◽  
The Future ◽  
Present Tense ◽  
Almost All

Время – грамматическая категория глагола, служит временной состояния, либо события. В различных языках наличествует соответствующее количество временных форм. Индоевропейский глагол в историческом плане имел три временные системы – презенс, аорист и перфект. В Авесте засвидетельствованы формы всех индоевропейских времен, наклонений и залогов. В ней в изъявительном наклонении раз­личаются следующие времена: настоящее время, имперфект, перфект и плюсквамперфект. В презенсе авестийского глагола выделяются два типа основ. Эти основы делятся на классы, количество которых доходит до двадцати двух. Глагольная система, которая наличествует в среднеиранских языках, значительно изменилась по сравнению с древнеиранскими языками. Однако древнеиранская временная система практически во всех иранских языках данного периода сохранилась. В новоперсидском языке насчитывается восемь времен. Идентичное количество временных форм можно наблюдать также в афганском языке, представленном в восточноиранской языковой подгруппе. Среди иранских языков осетинский характеризуется скудостью временных форм. В осетинском языке можно выделить три глагольные основы, от которых образуются формы соответствующих времен. В осетинских глаголах обнаруживаются следы древнеарийских классов настоящего времени. В современных иранских языках основное противоположение лежит между прошлым и не прошлыми временами. В изъявительном наклонении осетинский язык знает три времени: настоящее, прошедшее и будущее. Наиболее интересным явлением в осетинском языке является образование будущего времени, аналогичная с осетинским языком модель образования будущего времени наблюдаются в согдийском и хорезмийском языках, ко­торые считаются наиболее близкими к осетинскому языку. Tense is a grammatical category of a verb that serves as a temporary localization of an event or state. Different languages have a different number of temporary forms. Historically, the Indo-European verb had three temporal systems – present, aorist and perfect. In the Avesta, forms of all Indo-European times, moods and pledges are attested. The following tenses are distinguished in it in the indicative mood: present, imperfect, perfect and pluperfect. There are two types of stems in the presence of the Avestan verb. These basics are divided into classes, the number of which reaches twenty-two. The verb system in the Middle Iranian languages has changed significantly compared to the ancient Iranian, however, the ancient Iranian temporal system in almost all Iranian languages of this period has been preserved. There are eight tenses in the New Persian language. Almost the same number of temporal forms is observed in Afghan, which is part of the Eastern Iranian subgroup. Among the Iranian languages, Ossetian is a scarcity of temporary forms. In the Ossetian language, three verbal stems can be distinguished, from which the forms of the corresponding tenses are formed. In Ossetian verbs, traces of the ancient Aryan classes of the present tense are found. In modern Iranian languages, the main opposition lies between the past and non-past times. In the indicative mood, the Ossetian language knows three tenses: present, past and future. The most interesting phenomenon in the Ossetian language is the formation of the future tense, a model of the formation of the future tense similar to the Ossetian language is observed in the Sogdian and Khorezm languages, which are considered the closest to the Ossetian language.

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 Military General Surgical Training Opportunities on Operations in Afghanistan

2009 ◽  
Vol 91 (5) ◽  
pp. 417-419 ◽  
Author(s):  
Adam J Brooks ◽  
Arul Ramasamy ◽  
David Hinsley ◽  
Mark Midwinter
Keyword(s):  
Surgical Management ◽  
Surgical Training ◽  
Trauma Surgery ◽  
Organ Injury ◽  
Surgical Trauma ◽  
Training Opportunity ◽  
Injury Management ◽  
Surgical Trainees ◽  
Specific Organ ◽  
The Uk

INTRODUCTION In the UK, general surgical specialist trainees have limited exposure to general surgical trauma. Previous work has shown that trainees are involved in only two blunt and one penetrating trauma laparotomies per annum. During their training, nearly half of trainees will not be involved in the surgical management of liver injury, 20% will not undertake a trauma splenectomy and only a quarter will see a trauma thoracotomy. Military general surgical trainees require training in, and exposure to, the surgical management of trauma and specifically military wounding patterns that is not available in the UK. The objective of this study was to determine whether operative workload in the sole British surgical unit in Helmand Province, Afghanistan (Operation HERRICK) would provide a training opportunity for military general surgical trainees. PATIENTS AND METHODS A retrospective theatre log-book review of all surgical cases performed at the Role 2 (Enhanced) treatment facility at Camp Bastion, Helmand Province on Operation HERRICK between October 2006 and October 2007, inclusive. Operative cases were analysed for general surgical trauma, laparotomy, thoracotomy, vascular trauma and specific organ injury management where available. RESULTS A total of 968 operative cases were performed during the study period. General surgical procedures included 51 laparotomies, 17 thoracotomies and 11 vascular repairs. There were a further 70 debridements of general surgical wounds. Specific organ management included five cases of liver packing for trauma, five trauma splenectomies and four nephrectomies. CONCLUSIONS A training opportunity currently exists on Operation HERRICK for military general surgical specialist trainees. If the tempo of the last 12 months is maintained, a 2-month deployment would essentially provide trainees with the equivalent trauma surgery experience to the whole of their surgical training in the UK NHS. Trainees would gain experience in military trauma as well as specific organ injury management.

scholarly journals Surgical training in the UK

2007 ◽  
Vol 89 (1) ◽  
pp. 12-14
Author(s):  
L Williams
Keyword(s):  
Surgical Training ◽  
High Standard ◽  
Training System ◽  
The Future ◽  
The Uk ◽  
Very High ◽  
The Eu

The surgical training system in the UK has long been considered to be of a very high standard. However, it is currently under threat from many changes. To assure the quality of the future surgical consultant workforce we have moved away from apprentice-type training towards more ordered education. Although the reduction in hours and years will mean less overall experience there is a genuine belief that improved education and assessment can compensate. It says much for our island mentality that although we belong to the EU we consider European surgical training to be distinct from our own.

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