968 Delivering Human Factors and Non-Technical Skills Training Using Interactive Online Platforms in the COVID Era

Aim

To evaluate the impact and effectiveness of an interactive online human factors (HF) and non-technical skills (NTS) course delivered to Core Surgical Trainees during the COVID-19 pandemic

Method

A 1-day HF and NTS course was conducted online, using the Zoom platform, to Core Surgical Trainees in the North West. The course consisted of interactive lectures, small group teaching sessions, and self-directed learning with written reflections. Pre- and post-course surveys were administered, evaluating the participants’ awareness, knowledge and skills using a 5-part Likert scale, along with a multiple-choice assessment of knowledge. Statistical analysis was undertaken with significance considered at p < 0.05

Results

The course was attended by 63 CT1/2 participants, representing all surgical specialties. In the post-course evaluation, participants’ self-rating of awareness and knowledge for both HF and patient safety increased by between 10-20%. There was a significant increase in the mean post-course test score from 7.54 (SD ± 1.7) to 8.65 (SD ± 1.2) out of 10 (p < 0.0001). The course overall was rated relevant and useful (weighted averages 4.4 and 4.5 respectively)

Conclusions

To our knowledge, this is the first time a video conferencing platform has been used to deliver a live HF/NTS course. This study provides evidence supporting the use of such interactive online platforms in postgraduate surgical education. Training and professional development must continue, despite the evolving pressures from COVID-19. Embracing new methods of education delivery is required, with ongoing reporting and evaluation of education practice, sharing lessons learned and informing the evidence base in postgraduate surgical training during this time

Access to the evidence base from general practice: a survey of general practice staff in Northern and Yorkshire Region

AIM

To identify and describe current methods of making health related research evidence accessible to general practice staff in the Northern and Yorkshire Region.

METHOD

A postal survey questionnaire of general practice staff in the Northern and Yorkshire Region.

RESULTS

At least one completed questionnaire was obtained from 70% of the general practices surveyed, and the individual response rate to the survey was 45%. Just under 60% of all respondents reported having no access to the NHS internet and just under 50% also reported having no access to the internet. All respondents in this survey reported greater access to paper based information than to electronic databases. However, this research provides evidence of differential access to information resources between different professions in general practice with GPs clearly having easier access than other professions to both paper based resources and electronic databases. 70% of all respondents said that they would need to be trained to use either a computer, the internet, or to search databases if the opportunity for easy access to any of these information services was available.

CONCLUSIONS

At the time of this survey, general practices seemed to be struggling to set up the infrastructure and develop the skills that are necessary to make best use of available research evidence. In addition, there is a need for further investigation into the reasons why different professions working in the same practice setting have differential access to information resources available in primary care.

Costing substance misuse services

AIMS

To develop a methodology for obtaining the detailed costs of different substance misuse services and illustrate some of the specific problems by means of a case study.

DESIGN

Data on the resources required, clinical activity, and patient characteristics for one year were combined to provide detailed costs for different types of clinical events and patients.

SETTING

The clinical services of a publicly funded addiction unit in a large industrial city in the UK. The unit provides for alcohol and other drug misusers mainly on an outpatient basis but with inpatient care.

PARTICIPANTS

Over 1500 patients were included in the analysis with 75 per cent being male, and 80 per cent aged between 20 and 49. Nearly half of the clients had alcohol as their main drug of misuse with opiate users being the next largest group.

MEASUREMENT

Detailed costing by event and patient was possible as the staff type and time taken for each event were routinely recorded. A cost for each individual event was estimated and summed for each individual patient to give a cost estimate by patient for the financial year 1992/3.

FINDINGS

Core treatment outpatient events had an average cost of Pounds 48, with new assessments costing Pounds 87 but these averages hid high variations. The average cost per year for those receiving only outpatient care was Pounds 358; it was Pounds 1857 for those receiving both outpatient and inpatient care. Opiate misusers were on average more costly than alcohol misusers. The costs were skewed with 10 per cent of patients accounting for 56 per cent of the total annual costs.

CONCLUSIONS

Dealing with costs of non attendance, including all resource use, and coping with large individual variations in costs across individuals and intervention types are the main problems in devising cost figures. Cost data are useful but need to be combined with outcome data if they are to be used to improve patient services.

Allocating resources to health authorities: development of method for small area analysis of use of inpatient services

Every year about 22 billion pounds is allocated to health authorities for hospital and community services in England. The distribution of most of these funds is based on a formula developed to reflect the population's needs, but the existing formula has been criticised on several grounds. This paper describes the development of a method to determine the health needs for small geographical areas. Data from the hospital episodes statistics and 1991 census together with information on vital statistics and supply of health care facilities were used in the model. Two stage least squares regression was used to identify true indicators of need, and these were entered into a multilevel model to take account of variations in practice in different health authorities. The resulting formula should be more statistically robust and more sensitive to needs than previous approaches.

Allocating resources to health authorities: results and policy implications of small area analysis of use of inpatient services

A study designed to identify the principal determinants of use of inpatient facilities in NHS hospitals in England used the data and methods outlined in the previous paper. The model for the psychiatric sector contains mortality, self reported morbidity, and social variables indicating deprivation and the level of care at home. The non-acute model contains mortality and several socioeconomic variables. The models lay less weight on age than the current formula, and a national formula based on these models would, in the acute sector, redistribute resources to poorer areas compared with the current formula.