Strategic organisational skills predict surgical training success

2020 ◽  
pp. postgradmedj-2020-138763
Author(s):  
Osian Penri James ◽  
David Bryan Thomas Robinson ◽  
Luke Hopkins ◽  
Chris Bowman ◽  
Arfon Powell ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Surgical Training ◽  
Primary Outcome ◽  
Arrival Time ◽  
Neck Surgery ◽  
Annual Review ◽  
Arrival Times ◽  
Boot Camps ◽  
Operative Experience ◽  
National Training

IntroductionSurgical career progression is determined by examination success and Annual Review of Competence Progression (ARCP) outcome, yet data on organisational skills are sparse. This study aimed to determine whether organisational skills related to Core Surgical Training (CST) outcome. Primary outcome measures include operative experience, publications, examination success (Membership of the Royal College of Surgeons or the Diploma in Otolaryngology—Head and Neck Surgery (MRCS/DO-HNS)) and ARCP outcome.MethodsThe study was conducted prospectively at three consecutive CST induction boot camps (2017–2019) providing clinical and simulation training for 125 trainees. Arrival time at course registration was the selected surrogate for organisational skills. Trainees were advised to arrive promptly at 8:45 for registration and that the course would start at 9:00. Trainee arrival times were grouped as follows: early (before 8:45), on time (8:45–8:59am) or late (after 9:00). Arrival times were compared with primary outcome measures.SettingHealth Education and Improvement Wales’ School of Surgery, UK.ResultsMedian arrival time was 8:53 (range 7:55–10:03), with 29 trainees (23.2%) arriving early, 63 (50.4%) on-time and 33 (26.4%) late. Arrival time was associated with operative experience (early vs late; 206 vs 164 cases, p=0.012), publication (63.2% vs 18.5%, p=0.005), MRCS/DO-HNS success (44.8% vs 15.2%, p=0.029), ARCP outcome (86.2% vs 60.6% Outcome 1, p=0.053), but not National Training Number success (60.0% vs 53.3%, p=0.772).ConclusionsBetter-prepared trainees achieved 25% more operative experience, were four-fold more likely to publish and pass MRCS, which aligned with consistent desirable ARCP outcome. Timely arrival at training events represents a skills-composite of travel planning and is a useful marker of strategic organisational skills.

SP2.1.16Prognostic significance of Drivers at Work and Learning Styles in surgical training

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
Luke Hopkins ◽  
Osian P James ◽  
Oliver Luton ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Learning Styles ◽  
Outcome Measures ◽  
Surgical Training ◽  
Primary Outcome ◽  
Response Rate ◽  
Career Progression ◽  
Training Assessment ◽  
Boot Camps ◽  
Surgical Trainees ◽  
National Training

Abstract Aims Drivers at Work (DW) and Learning Styles (LS) refer to a range of contentious theories that aim to account for differences in career progression, yet seldom feature in training assessment. This study aimed to quantify the influence of Core Surgical Trainees’ (CST) DW and LS on career progression. Methods Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single Statutory Education Body. Primary outcome measures were MRCS and National Training Number (NTN) success. Results Of 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p = 0.003). The spectrum of DW was: Please People (25%), Be Perfect (21.3%), Hurry Up (18.5%), Be Strong (13.9%), and Try Hard (0%, p < 0.001). DW was either unequivocal or not provided by 23 CSTs (21.3%). The spectrum of LS was: Converging (34.3%), Accommodating (28.7%), Diverging (23.1%), and Assimilating (13.9%, p = 0.021). MRCS success was not associated with DW (p = 0.703) or LS (p = 0.598). Men were more likely to have Converging LS (29/70, 41.4%), and women Diverging LS (15/38, 39.5%, p = 0.018) and to have team-based LS (Accommodating / Diverging, 26/38 vs. 30/70, p = 0.010). NTN success was associated with LS (p = 0.038) with Convergers achieving most NTNs (65.4%). Conclusions LS are associated with important differences in career progression with Converging LS three-fold more likely to achieve NTNs than Diverging LS.

SP2.2.1Improving surgical training: core programme performance related to rotation theme, design, and trainee protocol engagement

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Performance Management ◽  
Outcome Measures ◽  
Surgical Training ◽  
General Surgery ◽  
Primary Outcome ◽  
Multivariable Analysis ◽  
Scientific Article ◽  
Specialty Training ◽  
Surgical Specialty ◽  
National Training

Abstract Aims Core Surgical Training (CST) and Improving ST (IST) programmes are in flux and their design controversial. This study aimed to evaluate the relative performance of a single Statutory Education Board’s (SEB) CST and IST programmes related to rotation design, theme, and protocol engagement. Methods Individual rotations numbering 181 were analysed prospectively over six-years (2014 to 2020). Primary outcome measures were MRCS pass and specialty National Training Number (NTN) appointment. Results Overall MRCS pass was 68.5% and NTN appointment 39.2%. NTN appointment related to rotation design varied from zero to 100% (median 40.0%). Conversion to NTN varied by specialty theme and ranged from: General surgery CST 35.6% to General surgery (IST pilot) 87.5% (p = 0.004). Multivariable analysis revealed NTN appointment was associated with: operative logbook caseload >464 (OR 3.02, p = 0.068), scientific article publication (OR 4.82, p = 0.006), and universal ARCP Outcome 1 (OR 37.83, p < 0.001), and IST (OR 55.54, p = 0.006). Conclusions Focused rotational design allied to enhanced performance management, and protocol engagement, were associated with improved conversion to higher surgical specialty training.

Prognostic significance of drivers at work and learning styles in surgical training

2021 ◽  
pp. postgradmedj-2021-140930
Author(s):  
Katie Mellor ◽  
Luke Hopkins ◽  
David Bryan Thomas Robinson ◽  
Osian Penri James ◽  
Oliver Luton ◽  
...  
Keyword(s):  
Learning Styles ◽  
Surgical Training ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Training Programme ◽  
Scholarly Activity ◽  
Boot Camps ◽  
Surgical Trainees ◽  
National Training ◽  
Career Progress

Purpose of the studyDrivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical trainees’ (CST) DW and LS on career progress.Study designDW questionnaires and Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single-statutory education body. Primary outcome measures were membership of the Royal College of Surgeons (MRCS) examination and national training number (NTN) success.ResultsOf 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p=0.003). DW spectrum was: please people (25.0%), be perfect (21.3%), hurry up (18.5%), be strong (13.9%) and try hard (0%, p<0.001). DW was either equivocal (n=14) or not provided (n=9) by 21.3% of CSTs. LS were: converging (34.3%), accommodating (28.7%), diverging (23.1%) and assimilating (13.9%, p=0.021). Men were more likely to be convergers (29/70, 41.4%), and women divergers (15/38, 39.5%, p=0.018) also preferring team-based LS (accommodating/diverging, 26/38 (68.4%) vs 30/70 (42.9%), p=0.010). MRCS success was not associated with DW (p=0.329) or LS (p=0.459). On multivariable analysis, NTN success was associated with LS (accommodators 64.5%, divergers 32.0%, OR 10.90, p=0.014), scholarly activity (OR 1.71, p=0.001), improving surgical training programme (OR 36.22, p=0.019) and universal ARCP 1 outcome (OR 183.77, p<0.001).ConclusionsLS are associated with important differences in career progress with accommodator twofold more likely than diverger to achieve NTN.

A National Survey of Robotic Surgery Training Among Otolaryngology—Head and Neck Surgery Residents

2021 ◽  
pp. 000348942199696
Author(s):  
Hilary C. McCrary ◽  
Sierra R. McLean ◽  
Abigail Luman ◽  
Patricia O’Sullivan ◽  
Brigitte Smith ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Head And Neck ◽  
National Survey ◽  
Neck Surgery ◽  
The United States ◽  
Head And Neck Surgery ◽  
Residency Programs ◽  
Surgery Training ◽  
Robotic Surgery Training ◽  
Operative Experience

Objective: The aim of this study is to describe the current state of robotic surgery training among Otolaryngology—Head and Neck Surgery (OHNS) residency programs in the United States. Methods: This is a national survey study among OHNS residents. All OHNS residency programs were identified via the Accreditation Council for Graduate Medical Education website. A total of 64/127 (50.3%) of OHNS programs were selected based on a random number generator. The main outcome measure was the number of OHNS residents with access to robotic surgery training and assessment of operative experience in robotic surgery among those residents. Results: A total of 140 OHNS residents participated in the survey, of which 59.3% (n = 83) were male. Response rate was 40.2%. Respondents came from middle 50.0% (n = 70), southern 17.8% (n = 25), western 17.8% (n = 25), and eastern sections 14.3% (n = 20). Most respondents (94.3%, n = 132) reported that their institution utilized a robot for head and neck surgery. Resident experience at the bedside increased in the junior years of training and console experience increased across the years particularly for more senior residents. However, 63.4% of residents reported no operative experience at the console. Only 11.4% of programs have a structured robotics training program. Conclusion: This survey indicated that nearly all OHNS residencies utilize robotic surgery in their clinical practice with residents receiving little formal education in robotics or experience at the console. OHNS residencies should aim to increase access to training opportunities in order to increase resident competency. Level of Evidence: IV

scholarly journals Effect of Core Stabilizing Training on Young Individuals Presenting Different Stages of Degenerative Disc Disease—Preliminary Report

2021 ◽  
Vol 18 (7) ◽  
pp. 3499
Author(s):  
Tomasz Kuligowski ◽  
Błażej Cieślik ◽  
Natalia Kuciel ◽  
Agnieszka Dębiec-Bąk ◽  
Anna Skrzek
Keyword(s):  
Lumbar Spine ◽  
Outcome Measures ◽  
Degenerative Disc Disease ◽  
Preliminary Report ◽  
Primary Outcome ◽  
Core Stability ◽  
Post Intervention ◽  
Disc Disease ◽  
Degenerative Disc

The aim of this study was to assess the efficacy of stabilizing training for the deep core muscles of the lumbar spine in subjects with degenerative disc disease. This study was conducted on 38 participants. The participants were divided into two groups: the extrusion group (EXT, n = 17) and the protrusion group (PRO, n = 21). All the subjects underwent a four-week-long core stability exercise-based treatment (five sessions/week). Clinical outcome measures were assessed pre-intervention (pre), post-intervention (post) and four weeks after the intervention (follow-up). The primary outcome measures were the spinal range of motion (ROM; Spinal Mouse® device) and the Oswestry Disability Index (ODI). In the PRO group, the ROM decreased from 88.52° pre-intervention to 83.33° post-intervention and to 82.82° at follow-up (p = 0.01), while the ODI decreased from 16.14 points pre-intervention to 6.57 points post-intervention, with 9.42 points at follow-up (p < 0.01). In the EXT group, the ROM decreased from 81.00° pre-intervention to 77.05° post-intervention, then increased to 77.94° at follow-up (p = 0.03), while the ODI decreased from 22.58 points pre-intervention to 15.41 points post-intervention and to 14.70 points at follow-up (p < 0.001). Although the stabilizing exercise sessions improved the clinical outcomes in each group, we cannot make conclusions as to whether the type of intervertebral disc damage significantly affects the results of stabilizing exercise-based treatment.

scholarly journals The Impact of the COVID-19 Pandemic on Head and Neck Surgery Training: A Brazilian National Survey

2021 ◽  
Author(s):  
Ana Kober Leite ◽  
Leandro Luongo Matos ◽  
Claudio R. Cernea ◽  
Luiz Paulo Kowalski
Keyword(s):  
Head And Neck ◽  
Surgical Training ◽  
Online Survey ◽  
Negative Impact ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Educational Activities ◽  
Residency Programs ◽  
Surgery Training ◽  
The Impact

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.

scholarly journals Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038829
Author(s):  
Ross McQueenie ◽  
Barbara I Nicholl ◽  
Bhautesh D Jani ◽  
Jordan Canning ◽  
Sara Macdonald ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Adverse Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Uk Biobank ◽  
Long Term Conditions ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Clinical Records

ObjectiveTo investigate how the type and number of long-term conditions (LTCs) impact on all-cause mortality and major adverse cardiovascular events (MACE) in people with rheumatoid arthritis (RA).DesignPopulation-based longitudinal cohort study.SettingUK Biobank.ParticipantsUK Biobank participants (n=502 533) aged between 37 and 73 years old.Primary outcome measuresPrimary outcome measures were risk of all-cause mortality and MACE.MethodsWe examined the relationship between LTC count and individual comorbid LTCs (n=42) on adverse clinical outcomes in participants with self-reported RA (n=5658). Risk of all-cause mortality and MACE were compared using Cox’s proportional hazard models adjusted for lifestyle factors (smoking, alcohol intake, physical activity), demographic factors (sex, age, socioeconomic status) and rheumatoid factor.Results75.7% of participants with RA had multimorbidity and these individuals were at increased risk of all-cause mortality and MACE. RA and >4 LTCs showed a threefold increased risk of all-cause mortality (HR 3.30, 95% CI 2.61 to 4.16), and MACE (HR 3.45, 95% CI 2.66 to 4.49) compared with those without LTCs. Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in participants with RA compared with those without RA or LTCs: twofold increased risk of all-cause mortality (HR 2.20, 95% CI 1.55 to 3.12) and threefold increased risk of MACE (HR 3.17, 95% CI 2.27 to 4.64). These findings remained in a subset (n=3683) with RA diagnosis validated from clinical records or medication reports.ConclusionThose with RA and other LTCs, particularly comorbid osteoporosis, are at increased risk of adverse outcomes, although the role of corticosteroids could not be evaluated in this study. These results are clinically relevant for the monitoring and management of RA across the healthcare system, and future clinical guidelines for RA should acknowledge the importance of multimorbidity.

scholarly journals Detection of specific areas and densities for ultrasound tomography

2019 ◽  
pp. 121-127
Author(s):  
Victoria Erofeeva ◽  
Vasilisa Galyamina ◽  
Kseniya Gonta ◽  
Anna Leonova ◽  
Oleg Granichin ◽  
...  
Keyword(s):  
Image Reconstruction ◽  
Ultrasound Imaging ◽  
Arrival Time ◽  
Detection Accuracy ◽  
Problem Solution ◽  
Ultrasound Tomography ◽  
Arrival Times ◽  
Whole Process ◽  
Imaging Reconstruction ◽  
Tomography Data

In this paper we consider the problem of ultrasound tomography. Recently, an increased interest in ultrasound tomography has been caused by non-invasiveness of the method and increased detection accuracy (as compared to radiation tomography), and also ultrasound tomography does not put at risk human health. We study possibilities of detection of specific areas and determining their density using ultrasound tomography data. The process of image reconstruction based on ultrasound data is computationally complex and time consuming. It contains the following parts: calculation of the time-of-flight (TOF) of a signal, detection of specific areas, calculation of density of specific areas. The calculation of the arrival time of a signal is a very important part, because the errors in the calculation of quantities strongly influence the total problem solution. We offer ultrasound imaging reconstruction technology that can be easily parallelized. The whole process is described: from extracting the arrival times of signals raw data feeding from physical receivers to obtaining the desired results.

scholarly journals A Virtual Reality-Based Self-Help Intervention for Dealing with the Psychological Distress Associated with the COVID-19 Lockdown: An Effectiveness Study with a Two-Week Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8188
Author(s):  
Giuseppe Riva ◽  
Luca Bernardelli ◽  
Gianluca Castelnuovo ◽  
Daniele Di Lernia ◽  
Cosimo Tuena ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Psychological Distress ◽  
Outcome Measures ◽  
Perceived Stress ◽  
Social Connectedness ◽  
Primary Outcome ◽  
Post Intervention ◽  
Stress Levels ◽  
Secondary Outcomes

The aim of this study is to investigate the effectiveness of a novel self-administered at-home daily virtual reality (VR)-based intervention (COVID Feel Good) for reducing the psychological burden experienced during the COVID-19 lockdown in Italy. A total of 40 individuals who had experienced at least two months of strict social distancing measures followed COVID Feel Good between June and July 2020 for one week. Primary outcome measures were depression, anxiety, and stress symptoms, perceived stress levels, and hopelessness. Secondary outcomes were the experienced social connectedness and the level of fear experienced during the COVID-19 pandemic. Linear mixed-effects models were fitted to evaluate the effectiveness of the intervention. Additionally, we also performed a clinical change analysis on primary outcome measures. As concerning primary outcome measures, participants exhibited improvements from baseline to post-intervention for depression levels, stress levels, general distress, and perceived stress (all p < 0.05) but not for the perceived hopelessness (p = 0.110). Results for the secondary outcomes indicated an increase in social connectedness from T0 to T1 (p = 0.033) but not a significant reduction in the perceived fear of coronavirus (p = 0.412). Among these study variables, these significant improvements were maintained from post-intervention to the 2-week follow-up (p > 0.05). Results indicated that the intervention was associated with good clinical outcomes, low-to-no risks for the treatment, and no adverse effects or risks. Globally, evidence suggests a beneficial effect of the proposed protocol and its current availability in 12 different languages makes COVID Feel Good a free choice for helping individuals worldwide to cope with the psychological distress associated with the COVID-19 crisis, although large scale trials are needed to evaluate its efficacy.

scholarly journals Evaluating measures of quality of life in adult scoliosis: a protocol for a systematic review and narrative synthesis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
James E. Archer ◽  
Charles Baird ◽  
Adrian Gardner ◽  
Alison B. Rushton ◽  
Nicola R. Heneghan
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Outcome Measures ◽  
Study Design ◽  
Systematic Reviews ◽  
Primary Outcome ◽  
Adult Scoliosis ◽  
Measurement Properties ◽  
Narrative Synthesis

Abstract Background Adult scoliosis represents a distinct subgroup of scoliosis patients for whom the diagnosis can have a large impact on their health-related quality of life (HR-QOL). Therefore, HR-QOL patient-reported outcome measures (PROMs) are essential to assess disease progression and the impact of interventions. The objective of this systematic review is to evaluate the measurement properties of HR-QOL PROMs in adult scoliosis patients. Methods We will conduct a literature search, from their inception onwards, of multiple electronic databases including AMED, CINAHL, EMBASE, Medline, PsychINFO and PubMed. The searches will be performed in two stages. For both stages of the search, participants will be aged 18 and over with a diagnosis of scoliosis. The primary outcome of interest in the stage one searches will be studies which use PROMs to investigate HR-QOL as defined by the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy, the secondary outcome will be to assess the frequency of use of the various PROMs. In stage two, the primary outcome of interest will be studies which assess the measurement properties of the HR-QOL PROMs identified in stage one. No specific measurement property will be given priority. No planned secondary outcomes have been identified but will be reported if discovered. In stage one, the only restriction on study design will be the exclusion of systematic reviews. In Stage two the only restriction on study design will be the exclusion of full-text articles not available in the English language. Two reviewers will independently screen all citations and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or risk of bias) will be appraised using the Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) checklist. The overall strength of the body of evidence will then be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A narrative synthesis will be provided with information presented in the main text and tables to summarise and explain the characteristics and findings of the included studies. The narrative synthesis will explore the evidence for currently used PROMs in adult scoliosis patients and any areas that require further study. Discussion The review will help clinicians and researchers identify a HR-QOL PROM for use in patients with adult scoliosis. Findings from the review will be published and disseminated through a peer-reviewed journal and conference presentations. Systematic review registration This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), reference number: CRD42020219437

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