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Surgical Trainees (surgical + trainee)
Selected AbstractsA qualitative evaluation of the Care of the Critically Ill Surgical Patient courseANZ JOURNAL OF SURGERY, Issue 10 2009Mario Giuseppe Zotti Abstract Background:, The Care of the Critically Ill Surgical Patient (CCrISP) course was adapted by the Royal Australasian College of Surgeons, being made compulsory for all Basic Surgical Trainees in 2001. The aim of this study was to evaluate whether the course objectives were achieved and identify strengths and weaknesses. Methods:, A retrospective cohort study was completed, after CCrISP Committee support of the proposed conduct, by distribution of questionnaires to instructors and trainees who had completed CCrISP in 2006 or earlier. The questionnaires were qualitative and designed to evaluate the success of CCrISP objectives. Results:, Fourteen instructors and 40 Victorian trainees completed the questionnaires. The major weaknesses identified by the instructors were the trainees' management of complications, nutrition, multiple injuries and sedation, procedural skills and mentoring. Trainees identified weaknesses in procedural skills and mentoring. Both groups identified the strongest areas being the emphasis on communication skills, utilization of clinical knowledge and acumen, management of shock and haemorrhage and management of the acute abdomen. The trainees further identified the systematic approach to the critically ill surgical patient as a major strength. Conclusion:, The primary objectives of the CCrISP course have been met. This study has identified teaching of communication skills, shock and haemorrhage and the systematic approach being the strengths of the course, whereas further refining of the mentoring process and reconsidering the importance of procedural skills is needed, both of which are secondary objectives. [source] Workplace-based assessment: assessing technical skill throughout the continuum of surgical trainingANZ JOURNAL OF SURGERY, Issue 3 2009Jonathan Beard Abstract The Royal Colleges of Surgeons and Surgical Specialty Associations in the UK have introduced competence-based syllabi and curricula for surgical training. The syllabi of the Intercollegiate Surgical Curriculum Programme (ISCP) and Orthopaedic Curriculum and Assessment Programme (OCAP) define the core competencies, that is, the observable and measureable behaviours required of a surgical trainee. The curricula define when, where and how these will be assessed. Procedure-based assessment (PBA) has been adopted as the principal method of assessing surgical skills. It combines competencies specific to the procedure with generic competencies such as safe handling of instruments. It covers the entire procedure, including preoperative and postoperative planning. A global summary of the level at which the trainee performed the assessed elements of the procedure is also included. The form has been designed to be completed quickly by the assessor (clinical supervisor) and fed-back to the trainee between operations. PBA forms have been developed for all index procedures in all surgical specialties. The forms are intended to be used as frequently as possible when performing index procedures, as their primary aim is to aid learning. At the end of a training placement the aggregated PBA forms, together with the logbook, enable the Educational Supervisor and/or Programme Director to make a summary judgement about the competence of a trainee to perform index procedures to a given standard. [source] Attitudes towards skills examinations for basic surgical traineesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2005S.D. Bann Summary Objective measures of surgical skill and cognition are becoming available. A questionnaire study examining surgeons' beliefs towards a skills-based examination, current standards and possible benefits was devised. Three hundred pairs of standardised anonymous questionnaires were sent to consultants and their basic surgical trainees (BSTs) irrespective of surgical speciality. Responses were requested using a Likert scale (1,5, 3 = neutral response). Two-hundred and two replies were received (including 54 pairs). BST experience ranged from 6 to 60 months (mean 24 months). When questioned regarding current training in basic surgical skills, only 34% believed that they were given adequate training at present. Sixty-four per cent of respondents believed the introduction of a skills examination would raise standards and 66% believed it necessary. Eighty-three per cent of respondents believed that they or their BST would practice these skills, if an examination were introduced and 85% wanted or would provide dedicated teaching time for this. However, 68% had no access to a dedicated skills facility, and uptake of these, where available, was variable. When questioned about their ability to perform the six appropriate tasks, there was a poor correlation of scoring between the groups. Consultants and their BSTs do not believe that they are given adequate training in basic skills. The introduction of an examination would lead to practice of these skills and is seen as a positive move. [source] Regional audit: Perioperative management of MRSA orthopaedic patients in the Oxford regionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2004N. Aslam Summary Aim:, Methicillin resistant staphylococcus aureus (MRSA) colonisation or infection is of particular importance in patients undergoing operations involving implanteable materials, such as in orthopaedic surgery. An audit of the perioperative management of orthopaedic patients in the Oxford region was carried out to assess the level of clinician awareness and the uniformity of current guidelines between hospitals. Methods:, A postal questionnaire was designed for asking information on various aspects of perioperative management of MRSA patients and was sent to each hospital. Results:, Responses were obtained from nine of 10 hospitals in the region. The average response rate for each hospital was 75%, and the overall individual response rate was 67.5% (27/40). Seventy-eight per cent of respondents knew that there was a pre-admission screening policy. Fifteen per cent were unaware of any MRSA policy. Forty-four per cent indicated that teicoplanin was used for prophylaxis in implant surgery whilst 44% used vancomycin. Eighteen per cent believed that cefuroxime was used for prophylaxis. Forty-eight per cent of hospitals had an MRSA-free zone for orthopaedic patients. Conclusion:, This study indicates a lack of uniformity in the perioperative management of MRSA-positive patients in the region and a lack of awareness of both MRSA guidelines and their implementation. Uniformity of MRSA guidelines is necessary to allow better clinician awareness and compliance, especially in surgical trainees who are travelling between different training hospitals in the region. Implementation of such a policy with re-audit of subsequent awareness and compliance is proposed. [source] Intraoperative magnification: Who uses it?,MICROSURGERY, Issue 6 2004Ch.B. FRCS Ed (Tr. & Orth.), Paul Max Jarrett M.B. Surgeons over recent decades have made increasing use of intraoperative magnification to enhance the outcome of surgical procedures, yet no published information exists regarding the extent of magnification use within surgical specialties. A sample of surgeons consisting of 148 specialists and senior surgical trainees in the west of Scotland was surveyed by postal questionnaire regarding their frequency and types of magnification use. Patterns of use were similar within each specialty, but varied markedly between specialties. Otolaryngologists and plastic, maxillofacial, and ophthalmic surgeons use both loupes and microscopes frequently. Cardiothoracic and pediatric surgeons tend only to utilize loupes, whereas neurosurgeons tend only to use microscopes. General surgeons, urologists, orthopedic surgeons, and gynecologists are infrequent users or nonusers of magnification, and when required will utilize loupes rather than microscopes. As a clear pattern of magnification use exists, it should be possible to anticipate the equipment needs of surgeons when providing theater services. © 2004 Wiley-Liss, Inc. Microsurgery 24:420,422, 2004. [source] Opportunities for surgical trainees: project hernia in GhanaTHE CLINICAL TEACHER, Issue 1 2008David Sanders No abstract is available for this article. [source] A randomized trial evaluating a cognitive simulator for laparoscopic appendectomyANZ JOURNAL OF SURGERY, Issue 9 2010Benjamin P. T. Loveday Abstract Background:, The Integrated Cognitive Simulator (ICS) is a software application that integrates text, anatomy, video and simulation for training clinical procedures. The aim of this randomized controlled trial was to determine the usability of the ICS laparoscopic appendectomy module, and to determine its effectiveness in training the cognitive skills required for the procedure. Methods:, Junior surgical trainees were randomized into control and intervention groups. The latter had access to the ICS. Participants had three assessments: a pre-study questionnaire to determine demographics, 20 multiple choice questions to assess procedural knowledge (training effectiveness) after 2 weeks, and a questionnaire to assess usability after 4 months. Results:, Fifty-eight trainees were randomized. The overall response rate was 57%. The median scores for interface, functionality, usefulness and likelihood of utilization (usability) were 5/7 or higher. In the multiple choice questions (training effectiveness), first-year trainees in the intervention group scored higher than the control group (14.9 versus 12.1, P= 0.04), but second-year trainees did not. Use of the ICS did not alter the participants' perceived need for intra-operative guidance. Conclusions:, The ICS is considered highly usable by trainees. The ICS is effective for training cognitive skills for laparoscopic appendectomy among first-year surgical trainees. Training cognitive skills alone does not increase confidence in the ability to perform motor tasks. [source] Acute Surgical Unit: a new model of careANZ JOURNAL OF SURGERY, Issue 6 2010Michael R. Cox Abstract The traditional on-call system for the management of acute general surgical admissions is inefficient and outdated. A new model, Acute Surgical Unit (ASU), was developed at Nepean Hospital in 2006. The ASU is a consultant-driven, independent unit that manages all acute general surgical admissions. The team has the same make up 7 days a week and functions the same every day, including weekends and public holidays. The consultant does a 24-h period of on-call, from 7 pm to 7 pm. They are on remote call from 7 pm to 7 am and are in the hospital from 7 am to 7 pm with their sole responsibility being to the ASU. The ASU has a day team with two registrars, two residents and a nurse practitioner. All patients are admitted and stay in the ASU until discharge or transfer to other units. Handover of the patients at the end of each day is facilitated by a comprehensive ASU database. The implementation of the ASU at Nepean Hospital has improved the timing of assessment by the surgical unit. There has been significant improvement in the timing of operative management, with an increased number and proportion of cases being done during daylight hours, with an associated reduction in the proportion of cases performed afterhours. There is greater trainee supervision with regard to patient assessment, management and operative procedures. There has been an improvement in the consultants' work conditions. The ASU provides an excellent training opportunity for surgical trainees, residents and interns in the assessment and management of acute surgical conditions. [source] The role of surgical trainees in overseas surgical missionsANZ JOURNAL OF SURGERY, Issue 5 2010Diana Tam MBBS No abstract is available for this article. [source] Operative experience in the Victorian general surgical training programmeANZ JOURNAL OF SURGERY, Issue 12 2003Kenneth Wong Background: The Royal Australasian College of Surgeons recommends minimum operative and endoscopy training requirements for advanced trainees in general surgery. This study examines the influences of trainee seniority, geographical location of surgical rotation, and surgeons' remuneration arrangements on the operative and endoscopy experiences of general surgical trainees in Victoria. Methods: Trainee log books covering two 6-month training periods in the year 2001 were analysed for depth and breadth of reported operative and endoscopy experience. Results: A total of 81 trainee log books was reviewed. Senior trainees were significantly more likely to have a higher primary operator experience. Total operative caseload and primary operator experience, in terms of major operative cases, were greater in rural rotations. Endoscopy experience was significantly greater in rural rotations. Operative exposure to gynaecological, laparoscopic, orthopaedic, paediatric and plastic surgical procedures was significantly greater in rural rotations. Surgeons' remuneration arrangements were not significantly related to trainee operative experience. Conclusions: Rural surgical rotations enhance the depth and breadth of operative experience of Victorian general surgical registrars, allowing greater exposure to subspecialty surgical procedures. [source] Teaching on the run: Teaching skills for surgical traineesANZ JOURNAL OF SURGERY, Issue 1 2001Fikri M. Abu-Zidan No abstract is available for this article. [source] | ||||||||||