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.

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 &lt; 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.

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.

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 626 Barriers Faced by Female Surgical Trainees – A Qualitative Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Morgan ◽  
K Manning ◽  
L Wyld
Keyword(s):  
Qualitative Study ◽  
Diversity Training ◽  
Qualitative Interviews ◽  
Training Programme ◽  
Full Time ◽  
Unconscious Bias ◽  
Coping With Stress ◽  
Raising Children ◽  
Surgical Trainees ◽  
National Training

Abstract Aim Today women make up 56% of medical students, yet just 12% of surgical consultants, a number that has remained static since 2013. This qualitative study aimed to explore the barriers to female success in modern surgery. Method Semi-structured qualitative interviews were undertaken primarily with female surgical trainees to determine the barriers they face. Male trainees and Training Programme Directors were also interviewed for triangulation. Results Nineteen interviews were performed (15 female trainees, 3 male trainees and 1 TPD) between October 2019 and March 2020. Family pressures and becoming a mother were significant barriers for women training in surgery, a barrier that did not apply to male trainees who were fathers, often resulting in women choosing to train less than full time (LTFT). Unfortunately, LTFT training presents further obstacles for female trainees. The set-up of the National training programme in surgery provides many non-gender specific barriers, chiefly moving hospital every 6 months resulting in disrupted training and long commutes. Sexism and discrimination are still common, both from colleagues and patients. Many participants perceived inherent differences between genders in communication and methods for coping with stress. Conclusions Greater gender equality in surgery may be achieved by changes in the structure and organisation of training to reduce the tension between the professional role and the predominantly female-led role of raising children. Better equality and diversity training and awareness at all levels in surgery may help to mitigate some of the conscious and unconscious bias that still exists.

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 &gt;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 &lt; 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.

scholarly journals Changes in UK ophthalmology surgical training: analysis of cumulative surgical experience 2009–2015

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018526 ◽  
Author(s):  
Jeremy Hoffman ◽  
Fiona Spencer ◽  
Daniel Ezra ◽  
Alexander C Day
Keyword(s):  
Surgical Training ◽  
Secondary Level ◽  
Training Programme ◽  
Median Number ◽  
Specialist Training ◽  
Surgical Experience ◽  
Training Scheme ◽  
Higher Surgical Training ◽  
National Training ◽  
The Uk

ObjectiveTo investigate changes in the patterns of cumulative surgical experience for ophthalmologists in the UK following the introduction of a new national training scheme.DesignRetrospective review of all surgical training records submitted to the UK Royal College of Ophthalmologists by trainees for the award of Certificate of Completion of Training (CCT) for the period 2009–2015.SettingSecondary level care, UK.Participants539 trainees achieving CCT over the 7-year study period.InterventionsHigher specialist training or ophthalmology specialist training.Outcome measuresNumber of CCT awards by years and procedures performed for cataract surgery, strabismus, corneal grafts, vitreoretinal (VR) procedures, oculoplastics and glaucoma.ResultsCataract surgical experience showed little change with median number performed/performed supervised (P/PS) 592, IQR: 472–738; mean: 631. Similarly, the median number of strabismus (P/PS 34), corneal grafts (assisted, 9) and VR procedures (assisted, 34) appeared constant. There was a trend towards increasing surgical numbers for oculoplastics (median 116) and glaucoma (57). Overall case numbers for ophthalmic specialist training (OST) trainees (7-year training programme) were higher than higher surgical training (HST) trainees (4.5-year programme) with the exception of squint (P/PS), corneal grafts (P/PS) and VR cases (P/PS).ConclusionsOverall case numbers reported at time of CCT application appear stable or with a marginal trend towards increasing case numbers. HST (4.5-year programme) case numbers do not include those performed before entry to HST, and although case numbers tended to be higher for OST trainees (7-year programme) compared with HST trainees, they were not proportionately so.

scholarly journals The ISCP Systems Group: Enhancements to the Learning Agreement and ARCP

2011 ◽  
Vol 93 (6) ◽  
pp. 198-200 ◽  
Author(s):  
Ian Eardley ◽  
Maria Bussey ◽  
Jeremy Brooks-Martin
Keyword(s):  
Surgical Training ◽  
Training Programme ◽  
Educational Needs ◽  
Learning Culture ◽  
Formative Feedback ◽  
Annual Review ◽  
Programme Director ◽  
Surgical Trainees ◽  
Educational Supervisor ◽  
Standards Of Conduct

The Intercollegiate Surgical Curriculum Programme (ISCP) is bringing about a change of learning culture for surgical trainees in which learning is transparent and there is explicit formative feedback. A key principle is that surgical trainees should be able to demonstrate that their learning has met defined standards of conduct and practice. The programme director (PD) is responsible for the training programme within which trainees now have regular appraisals with an assigned educational supervisor (AES) using a learning agreement (LA) and a review of progress through an annual review of competence progression (ARCP). These support trainees by helping them to identify their educational needs and then, in conjunction with their AES, to plan and manage their surgical training.

scholarly journals Curtailment of Higher Surgical Training in the UK: Likely Effects in Otology

2005 ◽  
Vol 98 (6) ◽  
pp. 259-261 ◽  
Author(s):  
J Ray ◽  
E Hadjihannas ◽  
R M Irving
Keyword(s):  
Skull Base ◽  
Surgical Training ◽  
Questionnaire Survey ◽  
Training Programme ◽  
Surgical Trainees ◽  
Operative Experience ◽  
Higher Surgical Training ◽  
One Year ◽  
The Uk

Higher surgical training in the UK faces a cut of two years. We conducted a questionnaire survey to assess the operative experience of current higher surgical trainees in otological surgery and the likely effect of the proposed reduction from six to four years. 91 (65%) of the 142 higher surgical trainees responded with details of major otological procedures performed (independently or assisting) over one year. In the present six-year scheme a typical trainee performs 72 myringoplasties, 79 mastoidectomies, 7 skull base procedures and 28 other procedures. In the first four years, however, his or her experience is only 39 myringoplasties, 44 mastoidectomies, 4 skull base procedures and 7 others. The large shortfall in experience that might result from shortening of the training programme would need to be met by intensification of the training or institution of accredited otology fellowships. Very similar dilemmas are faced by other surgical specialties.

scholarly journals 602 Specialty Training Progression from Core Surgical Training: Is There Evidence from Plastic Surgery of The Importance of Location, Location, Location?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Vinnicombe ◽  
M Little ◽  
K Johal
Keyword(s):  
Plastic Surgery ◽  
Surgical Training ◽  
Specialty Training ◽  
Surgical Trainees ◽  
Significant Difference ◽  
National Training ◽  
Competitive Nature

Abstract Introduction Obtaining a National Training Number (NTN) in Plastic Surgery is highly competitive (&lt;40 posts per year), with applicant:post ratios between 3.73 to 4.19 in 2017-2019. Our aim was to compare deaneries for numbers successfully progressing directly from CT2 into a ST3 post in Plastic Surgery. Method Data for surgical trainees progressing directly from CT2 to ST3 (2017-2019) in all specialties was obtained from the GMC. The percentage of those directly progressing that obtained a Plastic Surgery NTN and the total number progressing was calculated. Results A total of 840 trainees obtained a NTN directly from CT2 between 2017 and 2019, 61 of whom did so in plastic surgery. Of those directly progressing, there was no significant difference between deaneries for the percentage of plastic surgery posts obtained. The highest number of trainees progressed from London deaneries (16 total (26%); 7 South, 6 NC&E, 3 NW) and the lowest number from Yorkshire and Humber (1). Conclusions Higher numbers of those undertaking core surgical training in London progress directly from CT2 to ST3 in Plastic Surgery. Low total numbers highlight the competitive nature of obtaining a Plastic Surgery NTN, necessitating many to undertake additional experience prior to obtaining a training number.

scholarly journals SP2.1.17Prognostic significance of competition ratios in surgical specialty training selection

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Multivariable Analysis ◽  
Scientific Publication ◽  
Primary Outcome Measure ◽  
Youden Index ◽  
Critical Ratio ◽  
Surgical Specialty ◽  
Surgical Trainees ◽  
Training Post ◽  
National Training

Abstract Aims A Competition Ratio (CR) indicates the ratio of total applications for a training post when compared with numbers of specialty posts available. This study aimed to evaluate CRs’ influence on National Training Number (NTN) selection in a single UK Statutory Education Body. Methods Consecutive Core Surgical Trainees numbering 154 (median years since graduation: four, 105 male, 49 female) were studied over a six-year period. Annual specialty specific CRs were obtained from Health Education England’s website, and primary outcome measure was UK National Training Number (NTN) appointment. Results Overall NTN appointment was 45.5%. Median CR was 2.36; range OMFS 0.70 (2020) to Neurosurgery 22.0 (2020). Multivariable analysis revealed that NTN success was associated with: CR (OR 0.46, p = 0.003), a single scientific publication (OR 6.25, p = 0.001), cohort year (2019, OR 12.65, p = 0.003), and Universal ARCP Outcome 1 (OR 45.24, p &lt; 0.001). CRs predicted NTN appointment with a Youden index defined critical ratio of 4.42; 28.6% (n = 8) vs. 49.2% (n = 62), p = 0.018. Conclusions CRs displayed 30-fold variation, with CRs below 4.42 associated with two-fold better NTN promotion, but strong clinical competence and academic reach again emerged as the principal drivers of career advancement.

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