Excellence In Surgical Training Research Articles

The Association of Surgeons in Training (ASiT) Consensus Statement on Major Trauma Training in the UK.

Since the establishment of the Major Trauma Networks in 2012, it is estimated that an extra 1,600 lives have been saved across England. Although the delivery of trauma care has improved significantly, the provision of trauma training has not and remains fragmented. The Association of Surgeons in Training (ASiT), an independent organisation run by trainees, is dedicated to excellence in surgical training within the United Kingdom (UK) and Republic of Ireland (ROI). The aim of this study was to develop a consensus statement representing the views of the ASiT on the future of trauma surgery training. A modified nominal group technique was used in five stages: 1, scoping exercise; 2, virtual consultation; 3, nominal group consensus meeting; 4, virtual feedback from stakeholders; and 5, virtual confirmation by the ASiT Council. The design and reporting of the consensus followed best practice methodology for consensus research. Overall, 62 participants gave 90 statements across stages 1-3. Eleven key themes were identified, all of which met the consensus of the ASiT Council. The key findings were widespread support for increased exposure to trauma for medical students and early surgical trainees as well as an increased use of simulation methods and improved focus on non-technical skills within trauma surgery. This study sets out the position of the ASiT on the future of trauma surgery training and how training in major trauma surgery in the UK and ROI could be improved.

For the People and the Profession.

In 1982 Dean Warren delivered the presidential address "Not for the Profession… For the People" in which he identified substandard surgical residency programs graduating residents who were unable to pass American Board of Surgery exams. Drs. Warren and Shires as members of the independent ACGME began to close the substandard programs in order to improve surgical care for average Americans i.e. "for the people". By 2003 these changes dramatically reduced the failure rate for the ABS exams and trained good surgeons who could operate independently however the residents were on duty for every other or every third night. In 2003 the ACGME mandated duty hour restrictions in order improve resident wellness and improve the training environment for the profession. However, work hour restrictions reduced the time surgical residents spent in the hospital environment primarily when residents had more autonomy and had exposure to emergency cases which degraded readiness for independent practice. Surgical educators in the 2 decades after the work hour restrictions have improved techniques of training so graduates could not only pass the board exams but also be prepared for independent practice. Surgical residency training has improved by both the changes implemented by the independent ACGME in 1981 and by the work hour restrictions mandated in 2003. Five recommendations are made to ensure that Dr Warren's culture of excellence in surgical training continues in an environment that enhances wellbeing of the trainee i.e. "For the People and the Profession".

BEST of Surgical Training: the pan-London Core Surgical Training induction programme: “There’s no I in team, but there is a me.”

BackgroundIn the UK, Core Surgical Training (CST) marks the start of a surgical career, but previous experience and skills vary widely. Whilst Individual hospital Trusts offer local inductions, these are generally of a generic, administrative nature rather than advising trainees on how best to harness training opportunities. We designed a regional induction programme, ‘Building Excellence in Surgical Training’ (BEST) to address this, develop essential technical and non-technical skills, and engender support networks. MethodsAll incoming London Core Surgical Trainees (annual cohort size 90) were invited to participate, during the week prior to commencement of training. Trainees undertook 3 modules (portfolio, surgical skills and human factors-based simulation) and a research paper presentation day. We collected qualitative and quantitative data through a structured evaluation form, pre and post course Likert-scale scores and self-assessment utilising the non-technical skills for surgeons (NOTSS) framework. Results972 CSTs have completed BEST over the past 12 years. In 2019, significant improvements were seen in: confidence for starting CST, 45% (n = 22/49)-83% (n = 33/40,p = 0.00045); feeling the core programme cared about them, 55% (n = 27/49)-98% (n = 41/42, p =< 0.00001); getting to know peers 16% (n = 8/49)-88% (n = 35/40, p =< 0.00001); understanding human factors 82% (n = 40/49)-95% (n = 36/38, p = 0.00427); gaining confidence of trainers, 49% (n = 23/47)-86% (n = 31/36, p = 0.00114), and ability to speak out over patient safety concerns, 78% (n = 38/49)-97% (n = 37/38,p = 0.00019). NOTSS assessments showed significant improvement across all 4 criteria (n = 142, p =< 0.00001). ConclusionBEST equips trainees with the fundamental skills and confidence to safely embark on surgical training and provides tools to navigate the challenges training presents. The ethos of collaboration and support will aid the development of more resilient and empowered surgeons, vital in this era.

Aspiring to excellence in surgical training

What do junior doctors think about surgical training?

Association of surgeons in training 40th anniversary conference: Liverpool #ASiT2016.

The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patient alike. ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges and specialty associations, and represents trainees in all ten surgical specialities. We were delighted to be celebrating our 40th Anniversary Conference in the fantastic city of Liverpool with over 700 delegates in attendance and in the company of many ASiT Past Presidents. The conference programme focused on how to overcome threats to training in light of the recent turbulent events associated with the junior doctor contract dispute with inspiring talks from Professor Sir Bruce Keogh, NHS Medical Director and Rt Hon Heidi Alexander MP, Shadow Health Secretary. The other central topic to the conference was 'celebrating excellence in surgical training' and we were thankful to many other high profile speakers who attended to help in this celebration. In addition, over £4000 was distributed between more than 30 prizes and was awarded by the incoming President, Mr Adam Williams, to delegates who presented the highest scoring academic work from over 1200 submitted abstracts.

The Association of Surgeons in Training Conference: #ASiT2015 Glasgow

The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. ASiT is in-dependent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations and represents trainees in all ten surgical specialties.ASiT was delighted to welcome a number of distinguished guests and speakers to Glasgow for #ASiT2015. The theme of ‘The Future of Surgery’ delved into challenges surgical training faces, exciting developments into using technology to help patients, a glance at the past with the development of the Glasgow Coma Score and whether mortality truly is the future of measured outcomes. More than £3500 of prizes was awarded by the incoming President, Miss. Rhiannon Harries to the highest scoring papers presented selected from over 1000 abstracts submitted.

Association of Surgeons in Training Conference: Belfast 2014

The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations and represents trainees in all ten surgical specialties.ASiT was delighted to welcome all four surgical Royal College Presidents and over 650 delegates to Belfast for ASiT 2014. With a theme of Marginal Gains, the conference programme explored collaboration, simulation training and human factors, complimented by debates including the Shape of Training Review (ShOT), several focussed parallel sessions and ten subsidised pre-conference training courses. Almost £4000 was awarded by the incoming President, Mr Vimal Gokani, to delegates across more than 30 prizes for delegates who presented the highest scoring academic work from over 1200 submitted abstracts.

Silver Scalpel: Awarding Outstanding Teaching and Training

Ramez Kirollos, a consultant neurosurgeon from Cambridge, has taken the title of surgical trainer of the year as he picks up the Silver Scalpel award for 2010. Now in its tenth year, the Silver Scalpel is organised, funded and awarded by the Association of Surgeons in Training (ASiT) to recognise excellence in surgical training. It is awarded annually to inspirational trainers who have scored highly across five categories: leadership, resourcefulness, training and development, professionalism, and communication. In March this year, Mr Kirollos was presented with the award.

Dissecting Out Excellence in Surgical Training: Reviewing 10-Years of Silver Scalpel Award Nominations

user-friendliness of the system and overall satisfaction. The clinical team completed a four item questionnaire. Both questionnaires used a standard five-point Likert type scale (1 strongly disagree – 5 strongly agree). Results: Median patient scores for the domains of quality of the consultation were 5, user-friendliness of the system were 5 and overall patient satisfaction were 5. Patients felt that confidentiality was assured and that the consultation was effective. Median staff scores assessing effectiveness, review length and outcomes were 5. Discussion: This demonstrates high patient and staff satisfaction with bariatric surgical follow-up utilising remote videoconferencing, suggesting similar satisfaction compared to conventional clinical review. There were no clinical or technical problems with the system. Geographically remote specialist bariatric consultation facilitates easier access to services and offers potential cost savings.

Does anybody care about the trainer?

'Deans, royal colleges and the British Medical Association all beat the drum for surgical trainees but when it comes to those who deliver the training at the coalface it's a different story' – so says Ray Clarke, a consultant paediatric ENT surgeon and former winner of the Silver Scalpel award for excellence in surgical training. 'No matter how you remodel, modernise, streamline or restructure training programmes, surgical training still relies heavily on mentorship, support and role modelling by committed postgraduate trainers. Otherwise it just doesn't happen' says Mr Clarke, who teaches at Alder Hey Children's Hospital in Liverpool.

Trainer taming: part 1⇓

Your trainer knows what he or she wants from you—but what can you expect from your trainer? <b>Ray Clarke</b> was last year9s winner of the Silver Scalpel, a national award for excellence in surgical training. This is the first of three articles offering an insider9s guide to getting the best from your trainer