Laparoscopic management of tubal ectopic pregnancy: availability of training

Qureshi, Najum S; Wiener, J. J.; Weerakkody, Asoka

doi:10.1576/toag.8.4.251.27276

Cited by 11 publications

(10 citation statements)

References 19 publications

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“…This has also been identified in a survey amongst Welsh trainees [10] and, hence, probably reflects the status of training programmes all over the UK. As a matter of urgency, hospitals must be encouraged to provide accommodation and equipment for simulator training.…”

Section: Resultsmentioning

confidence: 53%

“…The literature suggests that laparoscopy is better and more cost-effective than laparotomy in the surgical management of ectopic pregnancy [5], and the RCOG recommends its use in its guideline on ectopic pregnancy [9]. In a recent Welsh survey, 30% of the respondents stated that ectopic pregnancy was managed laparoscopically only during routine hours in some trusts [10]. Such out-of-hours management of ectopic pregnancy further limits training and suggests that some consultants are either not trained or are reluctant to come in from home when on-call to do the procedure laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopy training for obstetrics and gynaecology trainees? A pilot study in the Eastern Deanery, UK

Majmudar

Slack

2008

Gynecol Surg

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Training in laparoscopic surgery has been difficult to implement, worldwide. This survey aims to identify the current status of laparoscopic training in the Eastern Deanery, UK. We hope to identify factors which influence training and propose solutions towards improving it. Methods: All 75 trainees within the 14 National Health Service (NHS) Hospitals of the Eastern Deanery were sent out a postal questionnaire in September 2006. The response rate was 89.3%. Seventy four to eighty three percent were performing various level 1 procedures and only a small percentage were doing level 2 and level 3 procedures. All respondents felt the necessity to be independently competent in level 1 and 2 procedures by the end of their training programme but two-thirds remained sceptical about achieving their training objectives. The main factors hindering training were: inability to be the primary surgeon (87%), lack of theatre time (60%) and availability of simulator training (55%). The results reflect the lack of provision for laparoscopic training at most hospitals in the UK Eastern Deanery. This has also been reflected in another survey amongst Welsh trainees. Individual hospitals must be encouraged to provide simulator training. The training programme should allocate more time for supervised simulator sessions and live surgical training. The provision of Consultant led emergency daytime lists could provide a unique training opportunity in the management of ectopic pregnancies and ovarian cysts. Designated teaching lists and individualised training programmes are other solutions.

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Section: Resultsmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Laparoscopy training for obstetrics and gynaecology trainees? A pilot study in the Eastern Deanery, UK

Majmudar

Slack

2008

Gynecol Surg

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“…In the 1980s, a doctor would have spent 40,000 hours in training before appointment as a Consultant and now the figure is just over 12,000 (Qureshi et al 2006). Providing training to produce Consultants of similar quality as in the past in a shorter period is challenging and requires using every single teaching and training opportunity.…”

Section: Discussionmentioning

confidence: 99%

Postgraduate trainees' assessment of the educational value of ward rounds in obstetrics and gynaecology

Qureshi

Swamy

2008

Journal of Obstetrics and Gynaecology

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Ward rounds have been regarded as a traditional forum for the teaching and training of trainees. The aim of this research project was to look at what role ward rounds play in the medical education of trainees in obstetrics and gynaecology. A questionnaire comprising 10 statements devised around the theme of quality of medical education and the overall experience of ward rounds was distributed at the Specialist Registrars monthly training days. A total of 46 completed questionnaires were received. The ward rounds took place at least twice weekly at the Welsh Deanery hospitals, however, none of the trainees regarded these ward rounds as 'teaching' ward rounds. A total of 32 (70%) of the trainees disagreed or were uncertain that they learnt something new on ward rounds each day and 34 (74%) of trainees agreed or strongly agreed that in the presence of a consultant, SpRs are not given a chance to lead a ward round. The educational role of the ward rounds does not seem fully utilised in the Welsh Deanery Hospitals and needs to be developed further to suit the needs of junior doctors.

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“…RCOG is currently examining the role of simulators in formal training. A regional study from the UK revealed that all hospitals had the necessary laparoscopic equipment; so, simulator training could be a meaningful adjunct in augmenting training across the board [24]. The potential value of a simulator in such training is further emphasised by the anecdotal evidence that increasing medical or conservative management of patients with ectopic pregnancy reduces the opportunity for surgical training in theatre.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic tubal surgery for ectopic pregnancy: trainees’ perspective in the UK

2011

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Ectopic pregnancies (EP) account for approximately 1% of all pregnancies. Surgical management of such patients should be accomplished through the laparoscopic route. Presently, available data from national studies suggest that only a minority of women benefit from such an approach. Regional studies and single institution reports suggest that trainee involvement in these procedures vary widely. Competency in laparoscopic surgery for EP is a mandatory requirement for independent practice in the UK. In a recent survey of UK trainees of all grades in obstetrics and gynaecology, 53.4% of trainees reported that they were trained or being trained in such procedures. This study examines the perspectives of the trainees. We performed a national questionnaire survey of intermediate-and advanced-level trainees in the UK During a 12-month period, 52% of trainees had performed at least one procedure independently; 80% of trainees performed most of the procedure on at least one occasion. The satisfaction with training was rated as 3 on a five-point Likert scale. Thirty percent of the trainees had access to a laparoscopy simulator. We found a high level of trainee engagement with laparoscopic tubal surgery. The intensity of experience is likely inadequate to satisfy the learning curve. A holistic approach s required to ensure surgical competence.

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Laparoscopic management of tubal ectopic pregnancy: availability of training

Cited by 11 publications

References 19 publications

Laparoscopy training for obstetrics and gynaecology trainees? A pilot study in the Eastern Deanery, UK

Laparoscopy training for obstetrics and gynaecology trainees? A pilot study in the Eastern Deanery, UK

Postgraduate trainees' assessment of the educational value of ward rounds in obstetrics and gynaecology

Laparoscopic tubal surgery for ectopic pregnancy: trainees’ perspective in the UK

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