ANZ journal of surgery
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The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. ⋯ In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators.
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Thromboembolism is a common cause of morbidity and mortality in patients with colorectal cancer, but thromboprophylaxis (TP) is underutilized. Current guidelines do not make specific recommendations for colorectal cancer patients and provide minimal guidance for the ambulatory setting, although emerging evidence suggests TP may be warranted during chemoradiotherapy or in the extended post-operative phase. A survey of Australasian colorectal surgeons was therefore performed to assess current TP practice and attitudes. ⋯ More data on thromboembolism risk during various treatment phases are required and should be promulgated in tumour-specific guidelines. Logistical barriers to adopting TP in the ambulatory setting should be addressed.
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ANZ journal of surgery · Sep 2013
Oncoplastic breast surgery: a regional Australian 2012 fellowship experience.
Oncoplastic breast surgery (OBS) is a developing subspecialty, although many countries are struggling with how to incorporate training in OBS as part of the established breast surgery subspecialization pathways. UK and Brazil have surged ahead with established formal training programmes, whereas countries such as Australia still rely on ad hoc training by interested surgeons. Our aim was to review the possibility of including regional training centres with appropriate OBS expertise into a future formal training programme in OBS. ⋯ Current British Association of Surgical Oncology (BASO) guidelines specify recommendations regarding BASO Level I and II OBS training, experience and exposure. Based on the experience during the fellowship presented in this audit, we discuss the merits of using regional Australian hospitals like Port Macquarie Base Hospital to make up the cohort of BASO Level I units to provide the core foundation experience in OBS to the next generation of Australian oncoplastic breast fellows.