From tennis balls to pearls: Bridging the communication gap to surgical trainees

Briefing and debriefing are common practices for safety in high risk industries but are not systematically done in surgery. Regular debriefing of performance after operative surgery can greatly assist surgical trainees' development and help optimize learning from the limited time they spend in the Operating Room (OR). We developed and tested the NOTSS (Non-Technical Skills for Surgeons) behaviour rating system with subject matter experts. It allows surgeons to observe trainees' behaviour in the OR and provide them with structured feedback for improvement. This paper describes process of debriefing and the results of a pilot usability trial. The majority of participants reported that the NOTSS system was useful for debriefing trainees, provided a common language to discuss non-technical skills, and was a valuable adjunct to current assessment tools. Some surgeons found interpersonal skills more difficult to rate than cognitive skills. 73% felt that routine use of the system would enhance patient safety.

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845 Flattening the Learning Curve: The Evaluation of Extended Laparoscopic Simulation Training for Novice Surgeons

British Journal of Surgery ◽

10.1093/bjs/znab134.171 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S A Joiya ◽

M Hamid ◽

Z Siddiqui

Keyword(s):

Learning Curve ◽

Skill Acquisition ◽

Postoperative Recovery ◽

Task Completion ◽

Complication Rates ◽

Novice Group ◽

Surgical Trainees ◽

Long Duration ◽

Hospital Stays ◽

Novice Surgeons

Abstract Introduction Associated with faster postoperative recovery, reduced length of hospital stays and scarring; laparoscopy has become the favoured approach for many surgical procedures across a range of specialties. However, due to its challenging learning curve, it has also been associated with increased theatre time and higher complication rates. Method A prospective, observational study with box trainers was carried out by novice medical students and trainees to evaluate the efficacy of long duration courses on skill acquisition. The novice group undertook a 5-week curriculum composed of lectures, demonstrations and spaced timed-assessments involving 3 tasks: hoop placement, stacking of sugar cubes and surgical cutting. Results Time taken for novice participants to complete a task individually and collectively improved markedly from the first to the third attempt, with an overall 44% reduction in time observed over the 5-weeks. We invited back 6 novice participants and 6 core surgical trainees after 4-weeks to complete the same tests. There was a further 18% time improvement in the novice group, with 44% faster task completion. Conclusions Given the success of this study and other simulation courses reported in the literature, we recommend more courses adopt a spaced-out approach; and a simulation curriculum for surgical trainees to cultivate greater skill acquisition.

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An analysis of the cost of postgraduate training in surgery in Ireland compared to other specialties

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02641-z ◽

2021 ◽

Author(s):

Earley H. ◽

Mealy K.

Keyword(s):

Surgical Training ◽

Financial Support ◽

Postgraduate Training ◽

Medical Training ◽

Medical Council ◽

List Type ◽

Training Costs ◽

Considerable Cost ◽

Surgical Trainees ◽

The Cost

Abstract Introduction Postgraduate specialty training in Ireland is associated with considerable cost. Some of these are mandatory costs such as medical council fees, while others are necessary to ensure career progression, such as attendance at courses and conferences. In particular, surgical specialities are believed to be associated with high training costs. It is unknown how these costs compare to those borne by counterparts in other specialities. Aims The aims of this study were to Quantify the amount that trainees in Ireland spend on postgraduate training Determine whether a difference exists between surgery and other non-skill-based specialties in terms of expenditure on training Methods A standardised non-mandatory questionnaire was circulated to trainees across two training centres in Ireland. Trainees at all levels were invited to participate. Results Sixty responses were obtained. Fifty-seven questionnaires were fully completed and included for analysis. The median expenditure on training was higher for surgical than non-surgical specialities. Subgroup analysis revealed surgical training was associated with higher expenditure on higher degrees and courses compared to medical training (p = 0.035). > 95% of trainees surveyed felt that greater financial support should be available for trainees during the course of their training. Conclusions This study demonstrated that a career in surgery is associated with higher ongoing costs for higher degrees and courses than counterparts in non-surgical training. All surgical trainees surveyed felt that better financial support should be available. Increasing financial support for may be a tangible way to mitigate against attrition during training.

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Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02739-4 ◽

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.

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