scholarly journals Surgical training is undermined by inadequate provision of laparoscopic surgical simulators

2014 ◽  
Vol 96 (9) ◽  
pp. 304-307 ◽  
Author(s):  
PM Brennan ◽  
JJM Loan ◽  
MA Hughes ◽  
IAM Hennessey ◽  
RW Partridge
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Working Time ◽  
Surgical Simulators ◽  
Surgical Trainees

In parallel with the introduction of working time regulations that have led to changes in working patterns, surgical trainees are taking longer to achieve operative competencies and logging fewer surgical cases. 1–3 The existing style of surgical training appears to provide insufficient operative exposure in limited working hours.

Changes in working patterns hit emergency general surgical training

2008 ◽  
Vol 90 (2) ◽  
pp. 60-63 ◽  
Author(s):  
N Kara ◽  
PV Patil ◽  
SM Shimi
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Working Time ◽  
European Working Time Directive ◽  
Confidential Enquiry ◽  
Surgical Trainees ◽  
European Working ◽  
Level Of Experience ◽  
Working Time Directive

The last decade has seen major changes in the working pattern of surgical trainees. This commenced with the introduction of the maximum 72-hour working week in 1991. The European Working Time Directive reduced the working hours to a maximum of 56 hours, with the intention to reduce it further to 48 hours by 2009. This is additionally affected by compliance with the SiMAP and Jaeger Rulings. The results of the Calman report coupled with those of the Confidential Enquiry into Perioperative Deaths (CEPOD) report have also had a significant effect on the amount and level of experience obtained during surgical training.

Outcomes following a dedicated period of research during surgical training

2011 ◽  
Vol 56 (4) ◽  
pp. 206-209 ◽  
Author(s):  
B M Stutchfield ◽  
E M Harrison ◽  
S J Wigmore ◽  
R W Parks ◽  
O J Garden
Keyword(s):  
Surgical Training ◽  
Academic Outcomes ◽  
Online Survey ◽  
Career Progression ◽  
Working Time ◽  
Research Interest ◽  
Surgical Trainees ◽  
Surgical Career ◽  
Training Structure ◽  
Research Period

With recent ‘working-time'-related changes to surgical training structure, the value of dedicated research during surgical training has been questioned. Online survey examining career and academic outcomes following a period of surgically related dedicated research at a Scottish University between 1972 and 2007. Of 58 individuals identified, contact details were available for 49 and 43 (88%) responded. Ninety-five percent ( n = 41) of respondents continue to pursue a career in surgery and 41% ( n = 17) are currently in academic positions. Ninety-one percent ( n = 39) had published one or more first-author peer-reviewed articles directly related to their research, with 53% ( n = 23) publishing three or more. Respondents with a clinical component to their research published significantly more papers than those with purely laboratory-based research ( P = 0.04). Eighty-one percent ( n = 35) thought that research was necessary for career progression, but only 42% ( n = 18) felt research should be integral to training. In conclusion, the majority of surgical trainees completing a dedicated research period, published papers and continued to pursue a surgical career with a research interest. A period of dedicated research was thought necessary for career progression, but few thought dedicated research should be integral to surgical training.

scholarly journals Teaching and Assessing Surgical Competence

2006 ◽  
Vol 88 (5) ◽  
pp. 429-432 ◽  
Author(s):  
WEG Thomas
Keyword(s):  
Working Hours ◽  
Working Time ◽  
Political Pressure ◽  
Complex Issue ◽  
Surgical Competence ◽  
Current Climate ◽  
Surgical Trainees ◽  
Working Time Directive ◽  
Reduced Time

Surgical competence and its assessment is one of the most hotly debated topics engaging the profession. In the current climate of diminishing working hours and shorter training, the surgical profession is having to address the complex issue as to how surgery as a craft specialty should be taught, and how to assess when an individual is competent within their chosen sphere as well as how that competence should be maintained. Internationally, there is political pressure upon the professional to achieve contracted activity to comply with political imperatives and, at the same time, to achieve a greater degree of specialisation. Within Europe, the working time directive has led to a shift system of rotas and this, along with a shorter overall period of training, has led to reduced time available to surgical trainees in which to learn their craft.

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 752 Evaluating the Use of Immersive Virtual Reality Simulation in Orthopaedic Trauma Cases; A Construct Reality Study

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Feeley ◽  
E Sheehan ◽  
K Merghani
Keyword(s):  
Construct Validity ◽  
Surgical Training ◽  
Content Validity ◽  
Working Hours ◽  
Proximal Femoral Nail ◽  
Training Methods ◽  
Intermediate Group ◽  
Training Scheme ◽  
Femoral Nail ◽  
Surgical Trainees

Abstract Introduction Changing surgical training models as a result of reduced working hours, shorter schemes and the recent pandemic has resulted in reduced operative hours being logged by trainees. Novel and validated training methods are needed to rectify the deficit faced by surgical trainees, to maintain continued development and retention of skill throughout their training scheme. Method A comparative interventional study was carried out in a regional trauma unit hospital. Volunteers were stratified into novice, intermediate and expert groups based on self-reported levels of experience. Each carried out a simulated proximal femoral nail on a virtual platform following instruction on its use. Face and content validity was also assessed. Results The proximal femoral nail module demonstrated construct validity. Intermediate surgeons performed significantly better than novices (P=.03), with shorter procedural times (P=.013) Three of the intermediate group achieved the proficiency level set by the expert group. Time taken to completion for expert surgeons was less than intermediate group, although this did not reach significance (P=.16). Face and content validity was reported for the module. Conclusions The proximal femoral nail module on the Precision OS platform demonstrated good face, content, and construct validity under expert scrutiny. Further research evaluating use of virtual platforms to optimise surgical training is needed.

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.

Making the Most of Surgical Training

2009 ◽  
Vol 91 (5) ◽  
pp. 164-167 ◽  
Author(s):  
Hayley Allan ◽  
Stella Vig
Keyword(s):  
Surgical Training ◽  
Working Time ◽  
European Working Time Directive ◽  
Training Time ◽  
Surgical Disease ◽  
Surgical Trainees ◽  
European Working ◽  
The Hours ◽  
Working Time Directive

It is widely believed that it is impossible to train surgical trainees to Certificate of Completion of Training (CCT)-level in a mere 48-hour week; that trainees cannot gain sufficient exposure to surgical disease or carry out an acceptable number of procedures to gain the confidence and competence for CCT within the time now available. The European Working Time Directive (EWTD) is a reality and hospitals are already implementing strict controls to ensure its trainees do not exceed the hours they are allowed to work, resulting in a consultant-led service that further restricts training time and opportunity.

scholarly journals Finished Core Training but not 'Registrar Ready'? Making a Case for a Third Year of Core Surgical Training

2013 ◽  
Vol 95 (8) ◽  
pp. 1-5
Author(s):  
A Baskaradas ◽  
N Sivarasan ◽  
MC Solan
Keyword(s):  
Surgical Training ◽  
Royal College ◽  
Working Hours ◽  
Working Time ◽  
Junior Doctors ◽  
Drastic Reduction ◽  
European Working ◽  
The Subject ◽  
Core Training

The implementation of the european Working time regulations in 1993 saw the reduction of junior doctors' working hours from 72 hours to 48 hours per week. While this is argued to be a safeguard for patient and doctor health, these reforms have resulted in a drastic reduction in obligatory training and have been the subject of much scrutiny, including from the royal college of surgeons of england.

Basic Surgical Training in the Era of the European Working Time Directive: What are the Problems and Solutions?

2008 ◽  
Vol 53 (4) ◽  
pp. 18-21 ◽  
Author(s):  
RJE Skipworth ◽  
JD Terrace ◽  
LA Fulton ◽  
DN Anderson
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
High Standard ◽  
Training Programme ◽  
High Tech ◽  
Learning Tools ◽  
Surgical Trainees ◽  
European Working ◽  
Problems And Solutions ◽  
Training Programmes

Background and Aims Imposed reductions in working hours will impact significantly on the ability of surgical trainees to achieve competency. The objective of this study was to obtain the opinions of Scottish surgical trainees concerning the training they receive, in order to inform and guide the development of future, high-standard training programmes. Methods An anonymous questionnaire was sent to basic surgical trainees on the Edinburgh, Aberdeen and Dundee Basic Surgical Rotations commencing after August 2002. Results Thirty six questionnaire responses were analysed. Very few of the returned comments were complimentary to the existing training structure; indeed, most comments demonstrated significant trainee disappointment. Despite “regular” exposure to operative sessions, training tutorials and named consultant trainers, the most common concern was a perceived lack of high-quality, structured, operative exposure and responsibility. Textbooks and journals remain the most frequently utilised learning tools, with high-tech systems such as teleconferencing, videos, CD-ROMS, and DVDs being poorly exploited. Conclusions Current surgical training is not meeting the expectation of the majority of its trainees. To solve this problem will require extensive revision of attitudes and current educational format. A greater emphasis on the integration of 21st century learning tools in the training programme may help bridge this gap.

The number of employed as a macroeconomic indicator of working time dynamics

2020 ◽  
Vol 16 (5) ◽  
pp. 935-945
Author(s):  
I.A. Zaikova
Keyword(s):  
Comparative Analysis ◽  
Manufacturing Sector ◽  
Working Hours ◽  
Working Time ◽  
Labor Costs ◽  
Factors Affecting ◽  
Time Dynamics ◽  
Developed Economies ◽  
The Relationship ◽  
Macroeconomic Indicator

Subject. The working time of workers at any stage of economic development is a value reflecting the level of labor productivity. Any progress in productivity contributes to changes in the volume of labor costs and the number of employed. Depending on the relationship between the total volume of labor costs and the number of employed, the duration of working time per one worker may change (it may increase, decrease, or remain unchanged). Objectives. The study aims to confirm the importance of such a macroeconomic indicator as the number of employed in varying working hours. Methods. The study rests on the comparative analysis of countries with developed economies based on some indicators like dynamics of the working time fund, dynamics of the number of employed, average number of hours worked during the year per employee, etc. The analyzed timespan is 25 years (from 1991 to 2016). Results. The comparative analysis revealed that in the non-production sphere and the economy as a whole the macroeconomic determinants correlate so that the length of working time per worker reduces. When considering the analysis results for the manufacturing sector, no single trend was identified. Conclusions. One of the key factors affecting the change in working hours is the number of employed. The relationship between the working time fund and the number of employed directly determines the dynamics of working time per worker.

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