The specialty mentor effect in enhancing surgical experience of medical students: A randomised control trial

Does training less-than-full-time predict performance at the FRCR exams?: a UKMED cohort study

AIM

The proportion of less-than-full-time (LTFT) trainees in the National Health Service has been steadily increasing over the past decade. To date, there has been a paucity of data assessing their postgraduate training outcomes. We aimed to evaluate whether LTFT trainees show group-level differences in performance at the Fellowship of the Royal College of Radiologists (FRCR) exams, relative to their full-time counterparts.

MATERIALS AND METHODS

Retrospective cohort study of UK-trainees attempting the FRCR Part 1 (n=1,785) and 2B (n=1,435) examinations between 2014 and 2021, and the 2A examination between 2018 and 2021 (n=745), with linked sociodemographic variables. Chi-square tests assessed univariate associations between LTFT-training, region of primary medical degree, age, and gender, with exam performance. Multivariate regression analyses examined associations with FRCR performance after adjusting for other variables.

RESULTS

During the study period, 3.0% (55/1,785) of Part 1 candidates were LTFT, compared to 10.0% (75/745) of 2A candidates and 13.2% (190/1,435) of 2B candidates. Women and those over 34 were more likely to be LTFT (p<0.05). LTFT trainees were nearly half as likely to pass the 2A (OR:0.51, CI:0.30-0.89) and 2B (OR:0.55, CI:0.38-0.80) exams after adjusting for other variables. Significant associations were also observed for FRCR pass rates with ethnicity, age at exam and region of primary medical degree.

CONCLUSION

LTFT trainees have lower pass rates at the FRCR 2A and 2B exams after adjusting for other demographic factors. Royal Colleges and Training Programmes should explore the causes of this award gap and consider national and local efforts to facilitate equity in training for these trainees.

Surgical Priming Improves Operative Performance in Surgical Trainees: A Crossover Randomized Control Trial

OBJECTIVE

The aim of this study was to evaluate the impact of a surgical warm-up using a virtual reality simulator on operative performance.

DESIGN

This was a single-blinded cross-over randomized control trial in a single tertiary Orthopedic training center.

PARTICIPANTS

Orthopedic trainees were recruited, and each morning participants rostered to theatre were randomized to either undergo a simulated surgical procedure on a virtual reality simulation system prior to their first case as primary operator (priming arm), or to perform their usual preparatory routine for surgery (control arm). Consultant orthopedic trainers were recruited within the orthopedic unit to carry out subjective surgical performance assessments using a validated global rating scale tool on the first case the participant performed on the list as primary operator.

RESULTS

Over 3 study periods a total of 151 data points were collected, with 49 matched data points across priming status and procedural level of difficulty. Subjective assessment tools consistently demonstrated improved operative performance by participants following surgical priming (p = 0.001).

CONCLUSION

This study highlights that introduction of preoperative priming to improve operative preparation, and optimizes operative performance. This has not only implications for improved resident training, but also signals towards beneficial downstream effects on patient outcomes, and theatre list planning.