Royal College Of Surgeons In Ireland Research Articles

The higher education’s role in the multisectoral evolution of the diabetes mobile unit programme

Abstract Background The global prevalence of obesity and diabetes is increasing. Overweight and obesity during early childhood increase the risk of developing type 2 diabetes. The diabetes mobile unit (DMU) programme is a collaborative initiative between the Bahrain Diabetes Society, the Royal College of Surgeons in Ireland (RCSI) Medical University of Bahrain, the Ministry of Education, and other stakeholders. Objectives To develop a sustainable educational programme to empower nursing and medical students to educate schoolchildren on healthy lifestyle choices and potentially reduce the risk of obesity and type 2 diabetes. Results The DMU programme is incorporated into the undergraduate nursing and medical curricula. It fosters experiential learning in public health education and promotion, encourages trainee-trainer mentorship, and cultivates essential graduate skills, thus enhancing their career prospects. Since 2012, the programme inducted 300 staff and students and educated 7,000 children. In 2023, the programme was re-launched in alignment with RCSI’s three strategic pillars: learning and teaching, research, and community engagement. The programme expanded its stakeholders’ network and incorporated strategies to promote interprofessional learning among staff, students, and alumni. The outcome of these endeavours included publishing an interactive storybook, creating innovative educational tools, and ongoing research. Conclusions This novel programme highlights the role of higher education in promoting multisectoral collaboration for public health awareness initiatives. The key to the programme’s success is synchronizing education, research and community engagement in higher education curricula and various contexts. Key messages • Multisectoral collaboration is essential in developing evidence-based and culturally congruent programmes. • Linking education, research, and community is vital to achieving sustainable development goals.

Graduate and Undergraduate Medical Curricula That Address the Needs of People Who Experience Homelessness: A Scoping Review Protocol

Background The impact that increased homelessness has on the healthcare system should be of great concern to medical providers and the institutions that train them. While the demand for medical providers who understand the healthcare needs of homeless individuals is high, traditional medical curricula do not adequately address this. Objectives This scoping review aims to examine published undergraduate and graduate medical curricula that address the healthcare needs of homeless individuals to support the development and evaluation of homeless healthcare curricula globally. Methods This paper will utilise Arksey & O’Malley’s framework for scoping reviews to ensure a systematic scoping review. Research will be conducted in accordance with the Joanna Briggs Institute's (JBI) Updated Methodological Guidance for the Conduct of Scoping Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR). Due to financial and time constraints, only articles published after 2000 and written in English will be reviewed. A comprehensive search strategy will be developed that includes searches in PubMed, Scopus, Embase and CINAHL with additional hand-searching of key articles. Each article will be screened independently by two reviewers. A third reviewer will resolve any disagreements. Data extraction will begin with a pre-defined extraction form (Extended Data File 3) and will be subsequently analysed with JBI’s current guidelines on inductive approaches to qualitative content analysis. Conclusion Research findings will be distributed to individuals who oversee the university’s medical curricula at the Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences. Discussions will be held to assess opportunities for the implementation/integration of homeless healthcare curricula. Furthermore, these findings will be disseminated globally to healthcare providers and administrators at conferences, hospitals and clinics.

All hands on deck during the COVID-19 pandemic. Maintaining face-to-face medical education and clinical placements.

Medical students must have robust educational experiences, graduate and commence timely employment. Here, we describe how the Royal College of Surgeons in Ireland (RCSI) delivered clinical placements in medical programmes over the first three waves of the COVID-19 pandemic in Ireland, including a student-centred, holistic approach to students' educational, social and health needs with strong student involvement, re-organising the university's primary care team, developing COVID-19 PCR testing on site and re-focusing communications and student services. This resulted in re-arranging the students into learning communities, and students and staff electronically recorded their COVID-19 symptom status daily. In-person observed structured clinical examination and other clinical exams progressed. No lockdown of any campus occurred. Over the two senior years, 693 students completed 15,000 weeks of clinical and experiential learning across 104 sites, similar to previous years, including anatomy practicals, procedural skills training, simulated ward rounds and patient encounters, case-based presentations and small group tutorials. The compliance rate with the daily symptom tracker was 91%. The percentage response rate and the number of students providing feedback from October 2020 to April 2021 was as high as 50%. The overall response rate was 33%. By mid-May, 93-95% of students in the two senior years had had at least one dose of the SARS-CoV-2 vaccine, with 99% fully vaccinated by the start of the next academic year in autumn 2021. Over the period of testing for SARS-CoV-2, just over 22,000 samples were processed, of which 0.79% were positive; no medical student acquired COVID-19 or was associated with nosocomial transmission. The total investment by the RCSI in Dublin, was €9.3m (€1.2 in capital expenditure and €8.1 in operational expenses). Continuing face-to-face clinical placements during a pandemic was possible through a multi-model approach that prioritised two-way communication, compliance with national public health advice and student screening.

Communication and Contextual Factors in Robotic-Assisted Surgical Teams: Protocol for Developing a Taxonomy.

Robotic-assisted surgery (RAS) has been rapidly integrated into surgical practice in the past few decades. The setup in the operating theater for RAS differs from that for open or laparoscopic surgery such that the operating surgeon sits at a console separate from the rest of the surgical team and the patient. Communication and team dynamics are altered due to this physical separation and visual barriers imposed by the robotic equipment. However, the factors that might comprise effective communication among members of RAS teams and the contextual factors that facilitate or inhibit effective communication in RAS remain unknown. We aim to develop a taxonomy of communication behaviors and contextual factors that influence communication in RAS teams. We also aim to examine the patterns of communication behaviors based on gender. We will first perform a scoping review on communication in RAS to develop a preliminary taxonomy of communication based on the existing literature. We will then conduct semistructured interviews with RAS team members, including the surgeon, assisting surgeon or trainee, bedside or first assistant, nurses, and anesthetists. Participants will represent different disciplines, including urology, general surgery, and gynecology, and have a range of experiences in RAS. We will use a reflexive thematic analysis to analyze the data and further refine the taxonomy. We will also observe live robotic surgeries at Royal College of Surgeons in Ireland (RCSI)-affiliated hospitals. We will observe varying lengths and conditions of RAS procedures to a capture a wide range of communication behaviors and contextual factors to help finalize the taxonomy. Although we anticipate conducting 30 interviews and 30 observations, we will collect data until we achieve data sufficiency. We will conduct data collection in parallel with data analysis such that if we identify a new behavior in an interview, we will follow up with questions related to that behavior in additional interviews and/or observations. The taxonomy from this project will include a list of actionable communication behaviors, contextual factors, their descriptions, and examples. As of May 2024, this project has been approved by the RCSI Research and Ethics Committee. Data collection started in June 2024 and will continue throughout the year. We plan to publish the findings as meaningful results emerge in our data analysis in 2024 and 2025. The results from this project will be used to observe and train surgical teams in a simulated environment to effectively communicate with each other and prevent communication breakdowns. The developed taxonomy will also add to the knowledge base on the role of gender in communication in RAS and produce recommendations that can be incorporated into training. Overall, this project will contribute to the improvement of communication skills of surgical teams and the quality and safety of patient care. PRR1-10.2196/54910.

Surgical Handover Core Outcome Measures (SH-CORE): a protocol for the development of a core outcome set for trials in surgical handover

BackgroundSurgical handover is associated with a significant risk of care failures. Existing research displays methodological deficiencies and little consensus on the outcomes that should be used to evaluate interventions in this area. This paper reports a protocol to develop a core outcome set (COS) to support standardisation, comparability, and evidence synthesis in future studies of surgical handover between doctors.MethodsThis study adheres to the Core Outcome Measures in Effectiveness Trials (COMET) initiative guidance for COS development, including the COS-Standards for Development (COS-STAD) and Reporting (COS-STAR) recommendations. It has been registered prospectively on the COMET database and will be led by an international steering group that includes surgical healthcare professionals, researchers, and patient and public partners. An initial list of reported outcomes was generated through a systematic review of interventions to improve surgical handover (PROSPERO: CRD42022363198). Findings of a qualitative evidence synthesis of patient and public perspectives on handover will augment this list, followed by a real-time Delphi survey involving all stakeholder groups. Each Delphi participant will then be invited to take part in at least one online consensus meeting to finalise the COS.Ethics and disseminationThis study was approved by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee (202309015, 7th November 2023). Results will be presented at surgical scientific meetings and submitted to a peer-reviewed journal. A plain English summary will be disseminated through national websites and social media. The authors aim to integrate the COS into the handover curriculum of the Irish national surgical training body and ensure it is shared internationally with other postgraduate surgical training programmes. Collaborators will be encouraged to share the findings with relevant national health service functions and national bodies.DiscussionThis study will represent the first published COS for interventions to improve surgical handover, the first use of a real-time Delphi survey in a surgical context, and will support the generation of better-quality evidence to inform best practice.Trial registrationCore Outcome Measures in Effectiveness Trials (COMET) initiative 2675. http://www.comet-initiative.org/Studies/Details/2675.

Performance in Irish Selection and Future Performance in Surgical Training

Selection processes for surgical training should aim to identify candidates who will become competent independent practitioners and should aspire to high standards of reliability and validity. To determine the association between measured candidate factors at the time of an Irish selection and assessment outcomes in surgical training, examined via rate of progression to Higher Specialist Training (HST), attrition rates, and performance as assessed through a multimodal framework of workplace-based and simulation-based assessments. This retrospective observational cohort study included data from all successful applicants to the Royal College of Surgeons in Ireland (RCSI) national Core Surgical Training (CST) program. Participants included all trainees recruited to dedicated postgraduate surgical training from 2016 to 2020. These data were analyzed from July 11, 2016, through July 10, 2022. Selection decisions were based on a composite score that was derived from technical aptitude assessments, undergraduate academic performance, and a 4-station multiple mini-interview. Assessment data, attrition rates, and rates of progression to HST were recorded for each trainee. CST performance was assessed using workplace-based and simulation-based technical and nontechnical skill assessments. Potential associations between selection and assessment measures were explored using Pearson correlation, logistic regression, and multiple linear-regression analyses. Data were available for 303 trainees. Composite scores were positively associated with progression to HST (odds ratio [OR], 1.09; 95% CI, 1.05-1.13). There was a weak positive correlation, ranging from 0.23 to 0.34, between scores and performance across all CST assessments. Multivariable linear regression analysis showed technical aptitude scores at application were associated with future operative performance assessment scores, both in the workplace (β = 0.31; 95% CI, 0.14-0.48) and simulated environments (β = 0.57; 95% CI, 0.33-0.81). There was evidence that the interpersonal skills interview station was associated with future performance in simulated communication skill assessments (β = 0.55; 95% CI, 0.22-0.87). In this study, performance at the time of Irish national selection, measured across technical and nontechnical domains in a multimodal fashion, was associated with future performance in the workplace and in simulated environments. Future studies will be required to explore the consequential validity of selection, including potential unintended effects of selection and ranking on candidate performance.

Improving the Quality of Operative Notes in Vascular Surgery: A Retrospective Analysis.

Background and objective Missing information or mistakes in patients' medical records, including those related to intraoperative and postoperative information, in an operative note can have profound clinical, ethical, and medicolegal implications. Operative notes should be informative, clear, and inclusive of the necessary data and should be collated immediately following surgery. In this study, we aimed to determine the ways to improve the quality of operative notes in the field of vascular surgery. Methods In this retrospective analysis, we compared the operative notes of 32 patients in the Department of Vascular and Endovascular Surgery, University Hospital Galway, against the standard set by the Royal College of Surgeons in Ireland (RCSI) (Code of Practice for Surgeons RCSI, 2018)and presented the results to our departmental staff. To facilitate an improvement in the quality of operative notes, a structured poster checklist was designed and displayed in the operating theatre. Furthermore, a scanner was set up in the operating theatre with clear and easy-to-follow instructions for uploading the operative notes into our hospital's online and digital patient record system (EVOLVE). An explanatory video was circulated among the staff. Three months after the first cycle, two further retrospective cycles were performed. Results A total of 96 patients' operative notes were analysed. Following the intervention, a significant improvement in documentation was noted concerning the dates; procedures followed; as well as the details of surgeons, assistants, anesthetists, incisions, surgery types, operative diagnoses, complications, additional procedures, tissue details, prostheses involved, closure techniques, postoperative plans, and surgeons' signatures. We also observeda significant increase in the uploading of the operative notes in the EVOLVE system. Conclusions The quality of the operative notesimproved considerably after staff education, poster display, and scanner installment in the operating theatre. It is important to have an efficient and well-structured plan to improve the process of operative note-keeping, thereby ultimately enhancing overall patient care.

The impact of badmouthing of medical specialties to medical students.

This study aimed to evaluate the proportion of Irish medical students exposed to 'badmouthing' of different specialities and to ascertain: the degree of criticism of specialities based on the seniority of clinical or academic members of staff; if 'badmouthing' influenced student career choice in psychiatry; and attitudes of medical students towards psychiatry as a speciality and career choice. Medical students in three Irish universities were invited to complete an online survey to determine the frequency and effect of non-constructive criticism on choice of medical specialty. The online questionnaire was distributed to Royal College of Surgeons in Ireland (RCSI), University of Galway (UoG) and University College Dublin (UCD) in the academic year 2020-2021. General practice (69%), surgery (65%) and psychiatry (50%) were the most criticised specialties. Criticism was most likely to be heard from medical students. 46% of students reported reconsidering a career in psychiatry due to criticism from junior doctors. There was a positive perception of psychiatry with 27% of respondents considering psychiatry as a first-choice specialty. Criticism of psychiatry by doctors, academics and student peers negatively influences students' career choice, which could be contributing to recruitment difficulties in psychiatry.

Evaluation of the type and frequency of extemporaneous formulations dispensed in hospital and community pharmacies

BackgroundExtemporaneous compounding is practiced globally by pharmacists to allow for dispensing of personalised doses of medicinal products not commercially available. Extemporaneous compounding must result in a product which is safe and effective. However, data on formulation and expiry of extemporaneous products may not be readily available. Pharmacists access various resources including compounding databases to obtain information on composition, preparation, and expiry of extemporaneous preparations. ObjectivesThe aim of this study was to evaluate the type and frequency of extemporaneous compounding in hospital and community pharmacies in the Republic of Ireland (ROI) and to obtain contemporary information on compounding practices and resources used. MethodsAll community and hospital pharmacists registered with the Pharmaceutical Society of Ireland, were invited to participate in an on-line survey. The study was approved by the Royal College of Surgeons in Ireland (RCSI) research ethics committee. ResultsA total of 202 pharmacists responded to the survey, of which 145 were community-based, 52 hospital-based, and 5 practicing in both. On average, hospital and community pharmacists (n = 138) dispensed <2–10 prescriptions for extemporaneous products per month. Pharmacists reported compounding 13 different types of extemporaneous preparations. Of these, dermatological preparations and oral liquid formulations (OLFs) were most commonly compounded. Extemp.ie, an Irish compounding database, was the most frequently used resource for compounding guidance and product expiry. ConclusionsThe results of this study show that extemporaneous compounding is still practiced in hospital and community pharmacies in the ROI. The limited response of 4.6% obtained may reflect that extemporaneous compounding is concentrated in a relatively small number of pharmacies. There remains a clinical need for extemporaneous products in the ROI and extemporaneous compounding continues to be an invaluable skillset for pharmacists.

Informed Written Consent for Emergency and Elective General Surgery at a Model 4 Hospital: A Closed-Loop Audit.

Introduction The objective of this investigation was to conduct an audit of the consent form standards signed by patients before elective or emergency general surgery at our institution. The investigation involved a comparison of these standards with those outlined in the "HSE National Consent Policy 2022" established by the Health Service Executive (HSE) and the Royal College of Surgeons in Ireland (RCSI). In the event of discrepancies, we intended to complete the audit loop by educating general surgeons on the essential standards for obtaining written consent in both elective and emergency general surgical procedures. Methods To assess the quality of patient consent, a pre-interventional phase was conducted over one week. Information was gathered exclusively through electronic medical record systems. Subsequent to the data analysis, an in-person educational session was conducted to enlighten non-consultant hospital doctors (NCHDs) in surgery about the significance of informed written consent and the criteria for lawful consent according to local guidelines established by the HSE and the RCSI. Three months following the intervention, a follow-up cycle was carried out to evaluate whether there were any improvements in the standards of consent. Results In the initial phase, prior to intervention, a total of 95 consent forms were collected. The patient's name, date of birth (DOB), and hospital board number (BN) were accurately recorded in all consent forms. However, only 66% (n=63) were accurately documented without the use of abbreviations or acronyms. Following the intervention, 145 consent forms were gathered. All appropriately indicated the patient's name, DOB, and BN. However, 84% (n=122) of consent forms were correctly labeled without the use of abbreviations or acronyms (p=0.0017). Conclusion This closed-loop review illustrates that the quality of consent can be notably enhanced through a straightforward educational intervention led by NCHDsin general surgery. Such interventions can be instructive, leading to improved consent form documentation. This, in turn, enhances patient safety and helps prevent potential medico-legal repercussions for both healthcare providers and institutions.

2 Medical student learning in the operating room: Through the lens of the surgical teacher

Abstract Aims and Objectives The aims were to deduce surgeons' experiences and challenges of teaching medical students in the operating room and solutions to overcome them. The objectives to achieve this was using pre-existing published and grey literature relating to surgeons' experiences teaching medical students in the operating room. Methods A systematised literature review based on a comprehensive search strategy, including quality assessment, was conducted. Two databases, MEDLINE and EMBASE, were searched since inception until March 2022. Grey literature was searched for in The Royal College of Surgeons in Ireland (RCSI) bulletin, as they publish relevant manuscripts related to surgical education. Title and abstract review was performed by two reviewers on 220 papers. The identified studies were then assessed against the eligibility criteria. Results A total of 8 papers were included in this review. Following the analysis of the literature, the commonalities captured were categorised into themes for thematic analysis. Themes included student preparation and organisational aspects, attitudes towards active participation of learner, student learning priorities, undergraduate curricula awareness and learning objectives, educational environment of the operating room and teaching techniques and engagement in the operating room. Conclusion Numerous commonalities were captured in the literature, replicable in multiple countries, highlighting the need for a standardised undergraduate surgical curriculum. Many of the challenges of teaching identified by surgeons are modifiable, therefore more initiatives need to be in place to extract the educational potential in the operating room.

SP11.17 The predictive paradigm: examining the validity of a national selection process in surgical training

Abstract Introduction Selection processes should conform to a ‘predictive paradigm’, identifying candidates who will become competent professionals. This study investigates the ability of a centralised, multi-modal national selection process to predict the future performance of surgical trainees. Methods A retrospective analysis of prospectively collected data from successful applicants to the Royal College of Surgeons in Ireland (RCSI) Core Surgical Training (CST) programme from 2016-2020 was conducted. Performance in subsequent assessments, attrition rates, and rates of progression to Higher Specialist Training (HST) were recorded. Selection decisions were based on a total score, composed of technical aptitude assessments, undergraduate academic performance, and a four-station multi-interview. CST performance was assessed using workplace-based and simulation-based assessments. Associations between selection and assessment measures were explored using Pearson correlation, binary logistic regression, and multiple linear regression analyses. Results Data was available for 303 trainees. Composite scores were positively associated with likelihood of progressing to HST (Exp(B) 1.09, 95% CI 1.05 – 1.13, p&amp;lt;0.001), and were significantly associated with performance across all CST assessments (r .23 - .34, P&amp;lt;0.001). On multivariate analysis, technical aptitude scores were the strongest predictor of future operative performance, both in the workplace (B 0.31, 95% CI .14 - .48, p&amp;lt;0.001) and simulated environments (B .57, 95% CI .33 - .81, p&amp;lt;0.001). The ‘interpersonal skills’ interview station was the strongest predictor of performance in simulated non-technical skill assessments (B .55, 95% CI .22 - .87, p&amp;lt;0.001). Conclusion Performance at the time of national selection, measured across technical and non-technical domains in a multi-modal fashion, is associated with future performance in the workplace and in simulation-based assessments.

Screening medical students for SARS-CoV-2 to facilitate face-to-face clinical teaching and prevent onward spread to patients

Screening medical students for SARS-CoV-2 to facilitate face-to-face clinical teaching and prevent onward spread to patients

Educational change in a crisis: what has changed and what is here to stay in undergraduate teaching and learning in General Practice.

The aim of the study was to explore the decisions and decision-making strategies employed by academic GPs tasked with adapting the delivery of undergraduate general practice education curricula to virtual platforms during the COVID-19 pandemic and to investigate how their experiences of this adaptation might influence the development of future curricula. Approaching the study from a constructivist grounded theory (CGT) perspective, we recognised that experiences shape perception, and an individual's 'truths' are socially constructed. Nine academic GPs from three university GP departments participated in semistructured interviews conducted via Zoom©. Anonymised transcripts were iteratively analysed, generating codes, categories, and concepts using a constant comparative approach. The study was approved by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee. Participants described the transition to online delivery of the curriculum as a 'response approach'. The elimination of in-person delivery necessitated the changes rather than any strategic development process. With varying levels of experience in eLearning, participants described the need for and engagement with collaboration both internally within institutions and externally between institutions. Virtual patients were developed to replicate learning in a clinical environment. How these adaptions were evaluated by learners differed across the institutions. The value and limitations of student feedback as a driver for change differed between participants. Two institutions plan to incorporate aspects of blended learning going forward. Participants recognised the impact of limited social engagement between peers on social determinants of learning. Prior experience in eLearning appeared to colour participants' perceptions of its value; those experienced in online delivery were inclined to recommend some level of continuation post-pandemic. We now need to consider which elements of undergraduate education can be delivered effectively online into the future. Maintaining the socio-cultural learning environment is of critical importance but must be balanced by efficient, informed and strategic educational design.

Erratum: Three-dimensional In Vitro Biomimetic Model of Neuroblastoma using Collagen-based Scaffolds.

An erratum was issued for:Three-dimensional In Vitro Biomimetic Model of Neuroblastoma using Collagen-based Scaffolds. The Authors section wasupdated. The Authors section was updated from: Ciara Gallagher*1,2,3 Catherine Murphy*1,2,3 Fergal J. O'Brien3,4,5 Olga Piskareva1,2,3,5,6 1Cancer Bioengineering Group, Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland 2School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland 3Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland 4Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland 5Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland 6National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin, Ireland * These authors contributed equally to: Ciara Gallagher*1,2,3 Catherine Murphy*1,2,3 Graeme Kelly4 Fergal J. O'Brien3,5,6 Olga Piskareva1,2,3,6,7 1Cancer Bioengineering Group, Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland 2School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland 3Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland 4Department of Chemistry, Royal College of Surgeons in Ireland (RCSI), 123 St. Stephen's Green, Dublin 2, Ireland 5Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland 6Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland 7National Children's Research Centre, Our Lady's Children's Hospital Crumlin, Dublin, Ireland * These authors contributed equally.

Exploring medical students’ perceptions of the challenges and benefits of volunteering in the intensive care unit during the COVID-19 pandemic: a qualitative study

ObjectivesIn March 2020, the WHO declared SARS-CoV-2 a pandemic. Hospitals across the world faced staff, bed and supply shortages, with some European hospitals calling on medical students to fill the...

The Past, Present and Future of Surgical Education in Ireland

The Royal College of Surgeons in Ireland (RCSI) was founded primarily to advance the standards of surgical training and surgical practice in Ireland. Over the course of almost 240 years, the College evolved as a comprehensive University of Medicine and Health Sciences, delivering education not only in Surgery but also in Medicine, Physiotherapy, Pharmacy and Nursing. RCSI today has a large global footprint and runs healthcare education programmes in several international locations. The College works in close collaboration with the other surgical Royal Colleges in Great Britain and the four colleges have a common surgical curriculum. RCSI recognises the increasing challenges facing traditional surgical training models and therefore has developed structured education programmes to support the conventional apprenticeship model. Surgical training in Ireland includes comprehensive training in both technical (operative) skills and non-technical (human factors) skills. RCSI is committed to the integration of simulation in surgical training and has invested heavily in state-of-the-art simulation facilities and in next-generation education technologies such as virtual reality, augmented reality and Artificial Intelligence-based educational technologies. Formal surgical training programmes in Ireland are complemented by a range of Masters programmes in Surgical Science and Practice and also Human Factors in Patient Safety.

COVID-19 and anatomy: Stimulus and initial response.

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world.

An updated and more efficient search strategy to identify primary care–relevant clinical prediction rules

ObjectivesThe aim of the study was to develop an improved search strategy for clinical prediction rules. Study Design and SettingWe first refined a list of 30 primary care–relevant journals and improved the efficiency of the Haynes Narrow Filter/Teljour/Murphy Inclusion Filter with 26 items by removing one term (Modified Haynes 26 filter). We then developed the “Royal College of Surgeons in Ireland (RCSI) filter” and compared it with the modified HNF/TMIF26 for its ability to detect prediction rules in the primary care literature. All abstracts and, if necessary, full text were reviewed independently in parallel by primary care physicians. The key outcomes were the percentage of prediction rules identified out of the total identified by both search strategies (sensitivity) and the number of articles that had to be reviewed to identify them (efficiency). ResultsThe Modified Haynes 26 filter returned 1,701 abstracts vs. 1,062 for the RCSI filter. The RCSI filter identified 105 of 111 of all prediction rules identified by either filter, compared with 107 of 111 by the Modified Haynes 26 filter (94.6% vs. 96.4%; P = 0.52). In addition, 9.9% of abstracts found using the RCSI filter were prediction rules, compared with only 6.3% using the Modified Haynes 25 filter (P = 0.001). ConclusionWe have developed a novel “RCSI filter” that more efficiently identifies prediction rules in the medical literature.

Objective assessment of surgical trainees’ non-technical skills: Improved performance following a two-year program of instruction

BackgroundNon-technical skills (NTS) encompass personal skills such as communication, situational awareness, decision making, teamwork and leadership. Poor performance of these skills has been shown to contribute to medical error. The Royal College of Surgeons in Ireland (RCSI) has delivered a mandatory program of instruction in NTS to all surgical trainees since 2005. We investigated whether the NTS of surgical trainees improved after the first two years of this program. MethodsBaseline data was collected in a three-station OSCE assessment of NTS at the beginning of Year one and again at end of Year two of surgical training. ResultsTrainees’ mean percentage NTS scores improved significantly over the two-year period for the NTS assessment (P < .001). A significant difference was demonstrated using within-subject (paired) t-tests between the Year one and two time points for all three OSCE stations: Consent (−5.39; P < .001); Colleague Conflict (−8.63; P < .001); and Disclosure of Error (−7.56; P < .001). ConclusionsRCSI offers a unique mandatory program of instruction in NTS. There was a statistically and practically significant improvement in the NTS scores of surgical trainees over the two-year period of the program.