Surg J R Coll Surg E
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The reduction in working hours has driven interest in surgical simulation as a means of supplementing traditional training models. Simulation offers the opportunity for the rehearsal of a wide range of skills in a controlled, risk-free environment, allowing for the development of mastery at a pace appropriate to the learner and offers a means for objective verification of skills.
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Surg J R Coll Surg E · Jan 2011
ReviewThe impact of reduced working hours on surgical training in Australia and New Zealand.
There is a worldwide trend for reduced working hours for doctors, particularly in the developed western countries. This has been led by the introduction of the European Working Time Directive (EWTD) that has had a significant impact on work patterns and training. Australia currently has a more flexible working environment but this is changing. In New Zealand there is a contract for resident doctors defining a maximum 72 h of rostered work per week.
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Surg J R Coll Surg E · Jan 2011
ReviewUse of the operative logbook to monitor trainee progress, and evaluate operative supervision provided by accredited training posts.
The Surgical Education and Training (SET) program of the Royal Australasian College of Surgeons (RACS) represents a change from a time-based program to a competency-based program and much greater emphasis is placed on formative assessment and timely feedback (to Surgical Training Boards - STBs - as well as to the trainee). It demands early recognition of the trainee who is struggling to progress, the so-called "marginal trainee". ⋯ SET also places a demand on training posts--with the expectation that they are providing an environment that is conducive to learning and that the trainees are getting adequate learning opportunities. In the domain of operative skills, this largely implies that levels of operative teaching and supervision should be appropriate to the trainee's stage and ability.
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Surg J R Coll Surg E · Jan 2011
ReviewImpact of reduced working time on surgical training in the United Kingdom and Ireland.
The European Working Time Directive (EWTD) 48 h working week has been law in European countries since 1998. A phased approach to implementation was agreed for doctors in training, which steadily brought down working hours to 58 in 2004, 56 in 2007 and 48 in 2009. ⋯ Shorter sessions of work have led to complex rotas, frequent handovers with difficulties maintaining continuity of care with implications for patient safety. Although there has been over 10 years notice of the changes to the working week and progress has up to now been reasonable (helped, in part by a steady increase in consultant numbers) this latest reduction from 56 h to 48 h seems to have been the most difficult to manage.
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Surg J R Coll Surg E · Jan 2011
ReviewWorkplace-based assessment: the need for continued evaluation and refinement.
Workplace-Based Assessment (WBA) has been an integral part of the UK Intercollegiate Surgical Curriculum Programme (ISCP) since 2007 (www.iscp.ac.uk). The UK Postgraduate Medical Education and Training Board (now part of the General Medical Council) has defined WBA as 'the assessment of working practices based on what trainees actually do in the workplace, and predominantly carried out in the workplace itself' (www.gmc.org.uk). This article reviews the purpose of WBA and the methods in current use. It also discusses the misuse of WBA and possible solutions, including redesign of the rating scales.