Interventions to improve ergonomics in the operating theatre: A systematic review of ergonomics training and intra-operative microbreaks.

Musculoskeletal occupational injury is prevalent within the surgical community. This is a multi-factorial issue, but is contributed to by physical posture, environmental hazards and administrative deficiency. There is growing awareness of this issue, with several behavioural, educational and administrative techniques being employed. The literature on this topic is, however, sporadic and difficult to access by healthcare practitioners. The aim of this systematic review was to evaluate the literature on the current interventions used to minimise musculoskeletal occupational injury in surgeons and interventionalists. This review will focus on administrative and human factor interventions, such as intra-operative microbreaks and ergonomics training.

Study protocol - Interventions to reduce musculoskeletal occupational injury in surgeons and interventionalists: A systematic review.

Musculoskeletal occupational injury is prevalent within the surgical community. This is a multi-factorial issue, but is contributed to by physical posture, environmental hazards and administrative deficiency. There is growing awareness of this issue, with several behavioural, educational and administrative techniques being employed. The literature on this topic is, however, sporadic and difficult to access by healthcare practitioners. The primary aim of this systematic review is to evaluate the literature on the current interventions used to minimise musculoskeletal occupational injury in surgeons. This review will focus on administrative, human factor interventions and ergonomics training.

The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines.

INTRODUCTION: The SCARE Guidelines were published in 2016 to provide a structure for reporting surgical case reports. Since their publication, SCARE guidelines have been widely endorsed by authors, journal editors, and reviewers, and have helped to improve reporting transparency of case reports across a range of surgical specialties. In order to encourage further progress in reporting quality, the SCARE guidelines must themselves be kept up to date. We completed a Delphi consensus exercise to update the SCARE guidelines. METHODS: A Delphi consensus exercise was undertaken. All members of the previous Delphi group were invited to participate, in addition to researchers who have previously studied case reports, and editors from the International Journal of Surgery Case Reports. The expert group was sent an online questionnaire where they were asked to rate their agreement with proposed changes to each of the 24 items. RESULTS: 56 people agreed to participate and 45 (80%) invitees completed the survey which put forward modifications to the original guideline. The collated responses resulted in modifications. There was high agreement amongst the expert group. CONCLUSION: A modified and improved SCARE checklist is presented, after a Delphi consensus exercise was completed. The SCARE 2018 Statement: Updating Consensus Surgical CAse REport (SCARE) Guidelines.

The PROCESS 2018 statement: Updating Consensus Preferred Reporting Of CasE Series in Surgery (PROCESS) guidelines.

INTRODUCTION: The PROCESS guidelines were published in 2016 to provide a structure for reporting surgical case series. The PROCESS guidelines have since been widely endorsed by a number of journals. The requirement to report compliance with each item outlined in the PROCESS statement has improved the reporting transparency of case series across a number of surgical specialties. Here, we undertook a new Delphi consensus exercise to update the PROCESS guidelines. METHODS: All members of the previous Delphi group were invited to participate. In addition, researchers, editors, and reviewers who have previously published or reviewed case series with the International Journal of Surgery were invited to collaborate. An online questionnaire was sent to participants asking them to rate their agreement with amendments to each of the 29 items. RESULTS: 140 experts were invited to participate, 56 people agreed to participate, and 45 (80%) recipients completed the survey. There was a high level of agreement amongst the expert group, and unanimous consensus was reached in the first round. All except three proposed items were accepted, and the original guidelines were modified accordingly. CONCLUSION: A modified and improved PROCESS checklist is presented, after a Delphi consensus exercise was completed.

The Academic Surgical Collaborative: A three-year review of a trainee research collaborative.

INTRODUCTION: The Academic Surgical Collaborative (ASC) is a trainee research collaborative (TRC) formed in the UK in October 2014. Three years on, the achievements are presented along with advice for emerging and established TRCs. Methods: A retrospective review of internal, member-maintained ASC records was conducted. Membership numbers, PubMed indexed publications, presentations and prizes awarded were all calculated over time. Google Scholar was used to calculate citations per ASC publication. An online survey was distributed to members to ascertain member satisfaction. RESULTS: With 62 active members (predominantly medical students) the ASC has published 33 PubMed indexed papers over three years, with a mean of 21 citations per paper (SD 89, range 0-491). 54 presentations have been delivered and eight prizes have been awarded for ASC research projects. 60% of ASC members believe the ASC delivers research that improves patient care. Key learning points for the ASC have been the use of a set of resources distributed to new members, the value of regular meetings, close mentoring throughout research projects to develop the skills of junior researchers, encouragement for junior members to present at conferences, and an ongoing focus on research conduct and improving evidence based medicine. CONCLUSIONS: The ASC has fulfilled many of its goals set out at its inception. The ASCs subsequent aims are to enhance existing research training for junior members, advances in the field of core outcome development and also multi-collaborative research.

An Extensive Volar Forearm Laceration - The Spaghetti Wrist: A Systematic Review.

PURPOSE: 'Spaghetti wrist' is an extensive laceration that involves multiple structures in the volar wrist, including tendons, nerves and arteries. This injury is frequently encountered in trauma units, but despite its complex nature, management is often handled by junior surgeons.Furthermore, the guidance on how to approach these injuries is limited, with a relatively poor evidence base on management and outcomes. METHODS: In this article, we perform a systematic review of the literature on the management and outcomes of the spaghetti wrist injury. Patient demographics, definitions of spaghetti wrist, mechanism of injury, operative and rehabilitative techniques and surgical outcomes are discussed. RESULTS: Results from this study show significant physical, functional, psychological and financial impacts of spaghetti wrist injuries. Operative technique appears relatively consistent; even though reporting of injuries and outcomes was heterogeneous, no current classification system is in common usage. CONCLUSIONS: An increased focus on the standardisation of assessment, management and rehabilitation and on overcoming the obstacles to care will serve as a guidance to the operative and post-operative management of the spaghetti wrist injury. The use of a single definition and classification system has been proposed to standardise outcome measures and improve inter-observer reliability. TYPE OF STUDY/LEVEL OF EVIDENCE: Systematic Review: Level IIa evidence.

How to apply to a summer undergraduate research program.

Want to get more experience in research, but find it difficult as an undergraduate? A summer research project may be the answer and there are many ways to organize this. Various universities around the world offer summer undergraduate research programs. These tend to be very competitive; hundreds, even thousands of students can apply for only a handful of positions. However, with some proactivity and strong planning, diligent undergraduate students can get accepted onto these prestigious programs. In this article, we outline the steps involved in selecting and successfully applying to a summer undergraduate research program.

How to get shortlisted for medical jobs.

Progressing up the medical career ladder is a tough business. Most medical and surgical applications center the requirement for a holistic, balanced individual. As a result, there are usually specific marking criteria in predefined sections. This article provides a guide into what employers are looking for and how best to build your portfolio in these areas.

Reflective practice in health care and how to reflect effectively.

Reflective practice is a paper requirement of your career progression in health care. However, if done properly, it can greatly improve your skills as a health care provider. This article provides some structure to reflective practice to allow a health care provider to engage more with reflective practice and get more out of the experience.

How to succeed at medical interviews.

Few people truly relish being interviewed. But as a professional, you will go through a number of interviews in your life that will affect your career progression. In this article, we provide some tips on how best to prepare for a medical interview, both in terms of your portfolio and interview practice. Advice is also given on how to maximize performance during the interview and gain the most from reflection afterwards.

How to design and deliver a local teaching program.

Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this "How to" article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.