Teams within surgery have been through countless cycles of refinement with an ever-increasing list of surgical team members. This results in a more dispersed team, making effective teamwork harder to achieve. Furthermore, the ad hoc nature of surgical teams means that team familiarity is not always given. The impact of this is seen across the field, with inadequacies leading to disastrous outcomes. This is a review of research that has been done into the topic of surgical teams. It will investigate barriers and consider the evidence available on how to improve the current system. Studies show an increased effectiveness of surgical teams with structures that allowed consistency in team members. The research advocates that advancements made in improving teamwork and efficiency can prove to be a low-cost but high-yield strategy for development. This can be in terms of simulated training, staff turnover management and fixed team allocation.
BackgroundA clinical audit measures specific clinical outcomes or processes against a predefined standard. However, many clinicians are unable to carry out audits given their time constraints. Alternatively, medical students may often wish to complete audits early in their career to strengthen their portfolios. As such, the student clinical audit platform was designed to connect willing supervisors and these medical students.MethodsProject supervisors were members of a regional trainee-led network. Interested students were familiarised with the various aspects of an audit and allocated to supervisors with similar interests. There was regular communication to track progress and anonymised feedback forms were distributed to all students and supervisors after a year.ResultsA total of 17 responses were received from the 19 students who were involved in a project. Based on a 5-point Likert scale, students displayed a mean improvement in their understanding of a clinical audit (1.18±1.07, p<0.001), the confidence to approach a supervisor (1.29±1.21, p<0.001) and the ability to conduct an audit by themselves in the future (1.77±1.15, p<0.001). Of the seven affiliated supervisors, five provided feedback with 80% indicating they had projects which remained inactive and all happy with the quality of work produced by their students.ConclusionDespite limitations to this programme, the platform produced projects which were disseminated both locally and nationally, demonstrating positive collaboration between medical students and clinicians. We present our findings and evaluations to encourage similar audit platforms to be adopted at other locations.
The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing them within the context of the wider literature pertaining to surgical leadership education.
Introduction Clinical audit projects work to decrease the occurrence of clinical mistakes and ensure current practice is optimal for patients. However, many clinicians are unable to carry out regular audits given their time constraints. Conversely, medical students are often eager to complete audits early in their career to strengthen their portfolios. As such, the clinical audit platform was designed to connect willing supervisors and these medical students. Method A medical school Trauma & Orthopaedics (T&O) society organised clinical audit teaching sessions for interested students. Allocation of students to project supervisors was based on similar topic interests. There was regular communication to track progress and anonymised feedback forms were distributed to all students and supervisors after the programme. Results A total of 17 responses were received from the 19 students who were involved in a project. Based on a 5-point Likert scale, students displayed a mean improvement in their understanding of a clinical audit (1.18 ± 1.07, p < 0.001), the confidence to approach a supervisor (1.29 ± 1.21, p < 0.001) and the ability to conduct an audit by themselves in the future (1.77 ± 1.15, p < 0.001). Eagerness to pursue a career in T&O increased from 35.3% to 70.6% of students following the programme. Of the 7 affiliated supervisors, 5 provided feedback and all were happy with the quality of work produced. Conclusions The platform produced high quality projects which were disseminated both locally and nationally, demonstrating positive collaboration between students and clinicians. We present our findings to encourage similar audit platforms to be adopted at other locations.
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