Improving core surgical training in a major trauma centre

Injury. 2016 Jun;47(6):1202-5. doi: 10.1016/j.injury.2016.03.013. Epub 2016 Mar 24.

Abstract

Introduction: English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres.

Objectives: To determine if T&O core surgical training in MTCs meets Joint Committee on Surgical Training (JCST) quality indicators including performance of T&O operative procedures and consultant supervised session attendance.

Methods: An audit cycle assessing the impact of a weekly departmental core surgical trainee rota. The rota included allocated timetabled sessions that optimised clinical and surgical learning opportunities. Intercollegiate Surgical Curriculum Programme (ISCP) records for T&O core surgical trainees at a single MTC were analysed for 8 months pre and post rota introduction. Outcome measures were electronic surgical logbook evidence of leading T&O operative procedures and consultant validated work-based assessments (WBAs).

Results: Nine core surgical trainees completed a 4 month MTC placement pre and post introduction of the core surgical trainee rota. Introduction of core surgical trainee rota significantly increased the mean number of T&O operative procedures led by a core surgical trainee during a 4 month MTC placement from 20.2 to 34.0 (p<0.05). The mean number of hip hemiarthroplasty procedures led by a core surgical trainee during a 4 month MTC placement was significantly increased (0.3 vs 2.4 [p=0.04]). Those of dynamic hip screw fixation (2.3 vs 3.6) and ankle fracture fixation (0.7 vs 1.6) were not. Introduction of a core surgical trainee rota significantly increased the mean number of consultant validated WBAs completed by a core surgical trainee during a 4 month MTC placement from 1.7 to 6.6 (p<0.0001).

Conclusions: Introduction of a departmental core surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs.

Keywords: Centre; Core; Major; Surgical; Training; Trauma.

MeSH terms

  • Clinical Competence / standards*
  • Education, Medical, Graduate
  • Educational Measurement
  • Humans
  • Multiple Trauma / surgery*
  • Orthopedic Procedures / education*
  • Orthopedic Procedures / standards
  • Orthopedics / education*
  • Orthopedics / standards
  • Problem-Based Learning
  • Quality Improvement / standards*
  • Quality Indicators, Health Care*
  • Trauma Centers*
  • United Kingdom