Previous Surgical Education Projects
Find previous projects from the group listed below:
- Clinical “Boot Camps”
- Scottish Surgical Simulation Collaborative
- “Improving Surgical Training” and the Scottish Core Surgical Simulation Strategy
- ILPs - Incentivised Laparoscopy Practice studies
- VA Simulation
- iView Expert
- COSMOS - Consultation Skills that Matter for Surgeons
- NOTSS and Pauses
Clinical “Boot Camps”
1. Scottish Surgical Boot Camps (piloted 2009, est 2011)
A multi-award-winning, holistic 4-day induction course, provided at the Highland Clinical Skills Centre by an NHS Highland/NES team for the Scottish Core Surgical Training Programmes, and accredited by RCSEd.
The course runs three times a year (~50 trainees per session). At a moment of maximum hunger and anxiety, we train new Core Surgical Trainees in both technical and non-technical skills, and we define values and standards. Topics include operative skills, managing surgical teamwork, leading ward rounds, optimising interactions with trainers, handling evidence, and thriving in the field.
The course has fostered a portfolio of simulations for other programmes, notably simulated ward rounds, and we have exported the model to other regions and countries.
It won the NES “Innovation in Training” award in 2016. Our qualitative study of the Boot Camp won the CAMES[1] award for Innovation in Simulation, at AMEE[2] 2016 (Research Fellows: Laura Nicol and Mike Gale).
The team has included Ken Walker, Angus Watson, Morag, Hogg, Ian Thomas and others. The faculty includes a diverse team of surgical trainers, trainees and fellows, educationalists, clinical skills facilitators, a clinical psychologist, an occupational health physician, and others.
The current director is Miss Morag Hogg.
2. Rural General Hospital (RGH) Boot Camp (est 2018)
A 3-day induction course for junior doctors posted to Scotland’s six Regional General Hospitals (RGHs), running three times annually. Faculty includes members from NHS Highland, Island Health Boards, and the Scottish Clinical Skills Managed Educational Network.
The course has won a NES Commendation for Innovation in Training.
The current director is Dr Fran Corcoran.
3. Advising on other Boot Camps
Our team has advised on the following boot camps and induction programmes:
- Scottish IMT (Internal Medicine Training) Boot Camps
- Canadian Medical Protection Association Surgical Induction
- Highland Psychiatry Boot Camp
- Highland IMG Boot Camp
- Scottish SAS Surgeons’ Boot Camp
- Yorkshire Core Surgical Boot Camp
Scottish Surgical Simulation Collaborative
From 2012 to 2018 Prof Walker chaired this new collaborative group (RCSEd, RCPSG, and NES), who developed strategies for integrating simulation into Scottish surgical training programmes.
The initiative began with Core Surgical Training, implementing recommendations from 2014. It provided simulation strategies for the “Improving Surgical Training” pilot in Scotland starting in 2018, and for Scottish General Surgery Training programmes from 2021.
Simulation strategies for multiple surgical training programmes are now being implemented through NES.
“Improving Surgical Training” and the Scottish Core Surgical Simulation Strategy
Design and implementation of a Simulation Strategy for the Scottish IST[3] pilot, now business-as-usual. It is the first comprehensive, curriculum-mapped and fully funded simulation strategy to be successfully integrated into a UK surgical training programme.
Despite the challenges posed by COVID-19, the strategy received positive feedback, was well-received in independent evaluations, and contributed to a transformation in recruitment for the Scottish Core- and General-Surgical Training programmes.
- Courses: Scot Surg Boot Camp, BaSiCS[4], Critical Care, Managing Surgical Crisis, Consultation Skills.
- Monthly training days in East and West of Scotland, including novel modules (eg stoma training, robotics, etc).
- Deliberate Practice: the Incentivised Laparoscopy Practice scheme (ILPs), vascular simulation practice (VASim), and hospital skills clubs.
While Professor Walker led the implementation, Professor Cleland led the supervision group for Adarsh Shah, a Surgical Research Fellow who conducted a qualitative evaluation of the IST reform. In four scholarly papers, they interpret the rich data through various theoretical lenses, drawing lessons on what worked, what did not, and why, across different units and regions of the UK. Significant insights were gained into managing change in surgical training.
ILPs - Incentivised Laparoscopy Practice studies (2014-2021)
This iterative project comprises a series of three studies. It is well-established that deliberate practice of laparoscopic motor skills reduces tissue trauma and allows trainees to allocate cognitive resources to higher non-technical skills. However, engaging and enabling trainees with take-home laparoscopic simulation is not as simple as merely distributing the kit.
- 2014-2016: Funded by RCSEd, RCPSG, and NHS Highland, we trialled a programme with Scottish Core Surgical Trainees but observed lower-than-expected trainee engagement. This was published in BMJ STEL and as an MSc thesis by Laura Nicol.
- 2016-2019: Funded by ASME/GMC, a multicentre qualitative study was conducted to explore the barriers and facilitators to engagement. The findings informed local programme redesign and identified broader cultural challenges in surgical training across the UK, particularly concerning portfolios. This work won the ASME/GMC Excellent Medical Education Award and Best Free Paper at ICOSET 2019. It was published in Surgical Endoscopy and as a PhD thesis by Vivienne Blackhall.
- 2019: Funded by NES, we refined the programme and improved engagement among Scottish Core Surgical trainees, although broader issues with UK training programmes persist. This was published in The Surgeon in 2023.
Research Fellows: Vivienne Blackhall and Laura Nicol. Find out more here.
VA Simulation (from 2018)
Our research fellow Rachel Falconer, co-supervised by Professor Watson and in collaboration with OrganLike, used novel 3D-printed hydrogel models to develop a home practice programme for vascular and Core trainees. This programme has since been incorporated as a take-home practice component of the Scottish Core Surgical Simulation Strategy.
iView Expert (from 2015)
Using head-camera video-cued recall and debrief to elucidate covert expertise without interrupting performance, this project is a collaboration with Dr Iya Whiteley from the UCL Centre for Space Medicine. Our narrative synthesis of non-medical literature and our feasibility study have both been published. Plans are underway to scale up through RCSEd’s new SERI Lab.
Research Fellows: Vivienne Blackhall and Ali Amin. Find out more here.
CoSMoS - Consultation Skills that Matter for Surgeons (from 2021)
Consultation Skills that Matter for Surgeons (CoSMoS) | RCSEd
Professor Walker leads an RCSEd group developing a longitudinal blended training package in consultation skills for surgical training programmes.
There is extensive evidence that patients who engage in effective shared decision-making experience better surgical outcomes, have fewer operations, and cope better with complications. However, there is a lack of training in this area within our specialties.
This initiative is a collaboration between the RCSEd ICONS (Informed Consent) course faculty from Newcastle and the Scottish IST faculty, with input from trainees, educationalists, and lay representatives.
The programme consists of four modules, employing a blended methodology with extensive video-facilitated analysis, simulations with volunteer patients, and rapid debriefing.
- Module A (Shared Decision Making) has already been delivered to over 100 CT2 trainees in the first three years.
- Video-assisted remote debriefing of workplace-based consultations will be added in 2024.
- This module, along with a “Managing Surgical Crisis” day, now forms part of the Scottish CT2 “Booster Camp.”
- Module B (covering “When It All Goes Wrong”) was piloted with ST3/4 trainees in April 2024. It includes conversations with patients, families, and colleagues (“second casualties”).
Modules A and B are planned for expansion across UK deaneries in 2025. A qualitative evaluation is currently underway, involving NHS Highland, RCSEd, and the University of Edinburgh.
Modules C and D are in development, focusing on childhood and end-of-life conversations, as well as subspecialty issues and consent.
Research Fellow: Emudiaga Emanuwa. Find out more here.
NOTSS and Pauses (from 2022)
An educational board game for surgical trainees, invented by Saskia Clark-Stewart (an NHS Lothian/University of Edinburgh Education Fellow and Surgical Trainee) following her needs assessment study. The game is set in an imaginary emergency operating theatre briefing meeting and aims to develop an understanding of the essential non-technical skills required.
Footnotes:
[1] Copenhagen Academy of Medical Education and Simulation
[2] Academy of Medical Educators in Europe
[3] Improving Surgical Training
[4] Basic Surgical Cadaveric Skills
