Education News

2021 has seen many ups and downs, similar to the previous year unfortunately, but while this is being written we realise how many highlights there have been this year as well. With the lift of restrictions in the spring, we were able to run our first Wetlab of the year, to catch up from the postponed ST4A Core Cardiac course, which ran virtually at the end of 2020. The course was well-received and the momentum continued with the ST3A Introduction to cardiothoracic surgery course taking place in July, followed by the ST4B Core Thoracic course and ST7A Revision & Viva course in September.

We also saw the return of a few courses that had not run since before the start of the pandemic; the ST2 Essential skills in Cardiothoracic Surgery course at Nottingham City Hospital, the Introduction to Cardiothoracic Surgery course and the Cardiothoracic Surgery Update and Wetlab for Trust Appointed Doctors, which both took place at Ashorne Hill, Leamington Spa.

Unfortunately, 2021 has not been without its challenges and with the introduction of the Omicron variant, we had to make the difficult joint decision with J&J, to postpone our ST3B and ST8A courses that were due to take place in December. All efforts are going into the planning of rescheduling these courses but we won’t have an update until early 2022.

With the new NTN course curriculum now in place, the course portfolio has been realigned with the Cardiothoracic Surgery Curriculum 2021. Therefore, dates and course names will have changed from 2022. If you do have any questions regarding the changes, we are running a webinar on Tuesday 11^th January 2022 at 6:30pm. Please register here.

The 3^rd Consultant Masterclass ran as a hybrid event this year in May, where we explored various facets of mentoring. Please keep an eye out for information of the 4^th Consultant Masterclass taking place in 2022, which will be planned around the SCTS Annual Meeting.

The pandemic highlighted the importance of supporting all medical leaders through all stages of their professional lives and after receiving feedback from peers, there was a gap to be bridged. This resulted with the launch of the SCTS Consultant Education Academy, the first being the virtual Leadership masterclass series in collaboration with Vijaya Nath. This has been an exciting venture for 2021 and we look forward to the rest of the series in 2022.

This leads us to the educational offering for Trust Appointed Doctors, which has been a focus for SCTS Education. From the virtual Professional Development course that ran in September and the Cardiothoracic Update and Wetlab course, to the ST7A and ST8B courses that are now open to Trust Appointed Doctors. We look forward to further opportunities in 2022.

The NAHP course portfolio has increased tenfold with Ms Bhuvana Krishnamoorthy as NAHP Lead this year, running a number of virtual courses such as Cardiac, Thoracic and Transplant Study Days. As well as the latest Novice to experienced Endoscopic conduit harvesters course offered to Nurses, Allied Health Professionals, Surgical Care Practitioners, Physician associates, Physician assistants, Core trainees and Surgeons. We already know exciting plans are in motion for 2022.

2021 also saw the return of the Student Engagement Event, aimed at Medical Students and Sixth-form students, which took place in November in Leeds. Although Storm Arwen had other ideas, the hybrid event was a success and we look forward to the write-up in the January edition of the Bulletin.

Although Marian Ionescu has moved on to greener pastures and we thank him for his generous support of the fellowship programme over the years, we have welcomed new offerings such as the AstraZeneca fellowship. The SCTS-AZ Fellowship 2021 was awarded to Mr Alexander Smith, a London Thoracic Trainee who is out of programme this year undertaking a Master’s Degree in Medical Statistics on a full time basis at the London School of Hygiene and Tropical Medicine. We would like to congratulate Alex and wish him all the best with his studies. We will soon be sharing more exciting news on fellowship opportunities, so watch this space.

We would like to take this opportunity to thank all our SCTS Education committee members for their efforts throughout another challenging year and to our course directors and faculty members for the delivery of a huge portfolio of courses offered to all specialisms. Also a thank you to our industry partners who have continuously supported our efforts throughout these trying times.

We wish you a Happy Christmas & we look forward to future ventures with you all in 2022.

SCTS Education Team

Changes to SCTS Courses to Align with Cardiothoracic Surgery Curriculum 2021

The Education Committee of SCTS has designed the course delivery schedule such that it provides the trainee comprehensive support throughout their training. This article should serve to give trainees an idea about this structure and help them plan their future path.

Given the introduction of course realignment, in the time of disruption to course delivery in the face of the COVID-19 pandemic, the committee recongises that trainees may wish to explore more detail about the organisation and delivery of these courses.

A webinar took place on Tuesday 11th January 2022 at 18:30, to give the trainees and Trust Appointed Doctors an opportunity for interaction with the Tutors, Comms Lead and Trust Appointed Doctors Lead. If you weren't able to attend, please click below to watch the recording.

In August 2021, a new Cardiothoracic Surgery Curriculum was introduced with changes to the training pathway and duration of training.  Training will now normally be completed in an indicative time of seven years for those entering run-through training. The Education Committee of the SCTS has modified the NTN courses and their delivery to link to the new curriculum. This modification has led to the streamlining of courses from 12 to 10 and a change in the timing of the delivery of some courses. The training pathway is now structured such that it is divided into 3 phases as above and the courses have been aligned to these phases.

Phase 1: This phase of training will allow trainees to gain many of the general professional capabilities (GPCs) and the knowledge, clinical and technical skills in both cardiac and thoracic surgery, as defined in the ‘capabilities in practice (CiPs)’ and syllabus with an indicative time of 3 years for run-through trainees and 2 years for the uncoupled trainees. The courses for this stage of training are therefore designed to impart basic and generic skills for the specialty.

Phase 2: During this phase, trainees will train predominantly in eit­her cardiac or thoracic surgery with a small number training in cardiothoracic surg­ery to fulfil local requirements. Trainees are expected to continue to further develop GPCs and knowledge, clinical and technical skills in their areas of special interest. The indicative time for this phase of training is 2 years.

Phase 3: Trainees are expected to continue developing their general professional capabilities as well as knowledge, clinical and technical skills in their own special interest areas. The indicative time for this phase is 2 years. Most trainees would be expected to be approaching the end of their training in this phase and they will likely be considering to take the FRCS examination and ultimately preparing for a competitive consultant job selection process and interviews, as well as for the initial years of consultant practice.

References:

Cardiothoracic Surgery Curriculum, The Intercollegiate Surgical Curriculum programme. Available at: https://www.iscp.ac.uk/media/1108/cardiothoracic-surgery-curriculum-aug-2021-approved-oct-20.pdf

Training in cardiothoracic surgery: how far is the other side of the table? Optimising training and looking to the future. Available at: https://publishing.rcseng.ac.uk/doi/ref/10.1308/rcsbull.2021.33

The ST8A Thoracic Surgery Pre-Consultant course took place on Friday 25^th March at the Newcastle Surgical Training Centre. This bespoke cadaveric course was aimed at those ST8 trainees who missed the opportunity to attend the course at the J&J Institute in Hamburg, which unfortunately had to be cancelled due to the Omicron variant in December 2021. Fortunately, we were in a position to open up the course for Trust Appointed Doctors to attend, as well as Nationally Appointed Surgical Trainees.

The course had senior NTNs and TADs having hands on experience on various complex thoracic procedures, which they may have not encountered in their training but will face in their consultant career due to complexity and rarity. The faculty of Mr S Rathinam, Mr K Lau and Mr M Kalkat, facilitated the trainees to do a variety of complex procedures including the Grunenwald approach, Abruzzini operation, left sided approach to the carina, laryngotracheal resection-reconstruction and double sleeve resection-reconstruction.

The event was well received by the delegates with great feedback:

 ‘Very good selection of topics’

‘A good exposure to various approaches’

‘Great faculty and teaching’

‘Excellent faculty, facilities and equipment, a great course!

The ST8A Cardiac Surgery Pre-Consultant course took place on Monday 28^th & Tuesday 29^th March at the Newcastle Surgical Training Centre.

The faculty comprised of Ms D Harrington, Mr G Asimakopoulos, Mr D Mehta and Mr G Cooper. Each day was split between aortic & complex cardiac procedures; half a day each. On both days the groups worked in pairs to perform total arch replacement and valve sparing root replacement for aortic surgery, then VSD repair, both anterior and inferior. We also managed to successfully demonstrate other complex scenarios such as IVC tear, coronary sinus rupture and Commando procedure for endocarditis. 

Although this was the first time we have run this course in a human cadaveric model, we have received positive feedback:

‘Anatomy and tissues were of excellent quality, allowing for easy relatability to real-life practice. Our tutor was patient, attentive and very helpful. Due to the ratio of two delegates per tutor and cadaver, there was ample opportunity to practise. This was by far the best SCTS course I have attended so far.’

‘Excellent course and facility, with very resourceful and friendly faculty makes an excellent learning experience.’

SCTS Education are very grateful to the staff at Newcastle Surgical Training Centre for their excellent support, hospitality and cooperation in delivering this excellent course. Thank you to all delegates and Faculty for their dedication and hard work throughout the course.

Thank you also to our industry partner, Ethicon, who supported this bespoke offering to NTNs and TADs.

SCTS Education ran the first Proficiency Based Training Webinar with Professor Anthony Gallagher on Thursday 8^th September. The webinar focused on the research and evidence on proficiency in surgical practice and training, which encouraged attendees to reflect on their established practices.

'Training must be more than an (interesting) educational experience'

Please find the link below to view the recording of the webinar: 

The webinar was led by Professor Tony Gallagher, visiting Professor at KU Leuven in Belgium (Faculty of Medicine) and Ulster University (Faculty of Health and Life Sciences), Director of Research and Skill Development at Orsi Academy & Founder of Proficiency Based Progression Methodology.

Biography

Anthony G Gallagher Ph.D., D.Sc. MAE

email : ag.gallagher@ogcmetrics.com

Dr. Anthony Gerald Gallagher is currently Director of Research and Learning at the ORSI Academy in Melle (i.e., robotic surgery centre), Belgium and Visiting Professor at KU Leuven in Belgium (Faculty of Medicine) and Ulster University (Faculty of Health and Life Sciences). Before that he was Director of Research and Professor of Technology Enhanced Learning in the ASSERT Centre, College of Medicine and Health, University College Cork, Ireland.  He completed a B.Sc. (Hons.) in Psychology (1984 -1988) at the University of Ulster at Jordanstown in Northern Ireland and his Ph.D. at the Trinity College Dublin (1989 – 1992).  In 2013 he was awarded his D.Sc. (Ulster University) for his published work on ‘Assessment and training of surgeons and physicians for image guided medicine’. He was elected a  Member of the prestigeous Academia Europea (The Academy of Europe (founded by the Royal Society)) in 2021.  

He was the first academic from Ireland to be awarded a Fulbright Distinguished Scholarship and during this time worked with Prof. Richard Satava at Yale University (2000 – 2001).  In 2011 along with his colleague Prof. Gerry O’Sullivan (University College Cork) he completed an authored book, Fundamentals of Surgical Simulation; Principles and Practices which was published in 2011.  His principal research interests currently include simulation based training for robot assisted surgery and minimally invasive surgery, endovascular interventions, pacemaker implantation and validation of medical devices for training and assessment.  During his time at Yale he was the scientific lead in the first group to demonstrate in a prospective, randomized double-blinded study the power of virtual reality training for improved operating room performance.  In 2015 he gave The Hamilton Russell Memorial Lecture, Royal Australasian College of Surgeons (RACS), Perth, Australia as well as being the International Education Visitor, RACS. At NextMed/Medicine Meets Virtual Reality (MMVR22), Los Angeles, California, USA he was presented with the 20th Satava Award for his contributions to advanced technologies in medicine.

Over the past decade he has led the global paradigm shift in simulation based training for the acquisition surgical and procedureal skills.  He has developed state of the art methodology for “procedure characterisation”, metric development for the assessment and training of procedure-based skills and validation of the effectivenes of this approach. In a recent systematic review and meta analysis of prospective, randomized and blinded clinical trials using this approach for training surgocal and procedural skills (publsihed in Annals of Surgery, Mazzone et al.,) this approach (proficiency-based progression) demonstrated a 60% reduction in intra-operative performance errors in comparison to the quality assured conventional training. Metronic are in discussions with ORSI Acadmey to use this approaxch forthe roll-out of their new surgical robot.

His publications on simulation, competence and proficiency-based progression have initiated a paradigm shift in, not alone training of health professionals, but development of an integrated approach to procedural healthcare. With different clinical disciplines (surgery, interventional cardiology, interventional neuro radiology, anaethetsist, nursing and now robotic surgery) and leading simulation (e.g., Mentice Lims and Things, Sawbones etc) and medical device manufacturers e.g,, J&J, Medtronic, Boston Scientific, etc) Tony has developed a model for procedure characterisation which has become the gold standard for major procedural advances. Tony leads the ORI Academy research & Learning Group which collectively offers core competences and expertise in Technology Enhanced Learning; Health Information Systems; Human Computer Interface’ Clinical Practice; Ergonomics; Patient Safety; Health Services Research; Quality Improvement and Implementation Science. This range of expertise (perhaps uniquely) enables a comprehensive, system-based approached to the study of the overall utility of medical procedures and better and safer ways to train clinicians to perform them.

In a study published by the Journal of Surgical Education, on the 100 most cited articles in the area of surgical education Dr Gallagher achieved the greatest number of first author publications in the top 100, authored two of the top ten ranked articles including the number one cited paper “Virtual Reality Training improves Operating Room Performance”.  In total he co-authored eight of the top 100 articles and his publications underpinned three of the institutions he worked at (i.e., Queens University Belfast (UK), Yale University (USA) and Emory University (USA) being ranked in the the top 20 Institutions with the highest number of articles in the top 100). Dr. Gallagher is considered one of the leading exponents and international experts in the world for the design, application and validation of (VR) simulaion in medicine.