563 Help! I’m Starting Surgery: An Educational QI Project to Improve the Surgical Induction Process and FY1's Confidence in Starting Surgery at Bolton Hospital

Abstract

Abstract Introduction The surgical induction process for FY1's at Bolton consisted of 280-pages of pre-reading and a series of short talks delivered on their first day. Foundation doctors were surveyed (n=20) and only 25% were satisfied/very satisfied with this process. Aim To improve satisfaction ratings and junior doctor's confidence in surgical skills required to be a competent surgical FY1 through a series of PDSA cycles. Method PDSA Cycle 1: Creation of the survival guide. PDSA cycle 2: Pre-reading was condensed into the survival guide and a 12-week teaching programme was introduced. PDSA cycle 3: The induction agenda was updated, and a tour of the department was added. PDSA cycle 4: Introduction of a Q&A session with a previous surgical junior. Results Through the above cycles (PDSA Cycle 1–5) satisfaction ratings improved from 25% to 41%, 28%, 83% and 85% respectively. Junior doctors’ confidence increased on average from 41% to over 90% in each cycle. These skills included: requesting scans, consenting for endoscopy, prescribing, assessing unwell patients, clerking, and managing and explaining post-operative complications. Conclusions Following the creation of the survival guide, eradication of extensive pre-reading and the above PDSA cycles, satisfaction ratings improved and FY1's confidence in surgical skills increased. The findings of PSDA cycle 2 could be attributed to the pandemic as induction took place on Microsoft teams rather than face-to-face. To ensure future sustainability, the guide and induction process should be updated and analysed every rotation.