Improving the practice of the World Health Organisation's surgical pause checklist at a tertiary paediatric surgical unit.

BACKGROUND AND AIMS: The World Health Organisation (WHO) surgical checklist acts as a safety check before surgery. The three components are: sign in, surgical pause and sign out. This study aims to assess and improve the surgical pause at a tertiary paediatric surgical unit. METHODS AND RESULTS: Theatre nurses used as a standardised tool to record how the pause was carried out. All other theatre staff were blinded. Presentation of these data at departmental meetings allowed creation of a checklist poster which was placed in every theatre. Data collection was repeated five months later. Data on 114 operations were initially collected. Fifty-one per cent of operations completed all four steps to guideline. Introduction step met guideline in 61% of operations, identity and procedure in 90%, checklist in 98% and concerns in 71%. Following intervention, data were collected from 39 operations; 77% of operations completed all four steps to guideline. Introduction step met guideline in 87% of operations, identity and procedure in 100%, checklist in 100% and concerns in 90%. CONCLUSIONS: This study shows that by engaging with theatre staff to create an acceptable checklist poster, better standard of patient safety in the operating theatre can be achieved.

The benefits of a peer-assisted mock OSCE.

BACKGROUND: Objective structured clinical examinations (OSCEs) are associated with high stress and anxiety levels, which could have a negative impact on student performance. Students frequently have no opportunity to practise OSCEs other than in the high-stakes examination itself. This study describes the design and implementation of a peer-run mock OSCE exam for medical students, and the feasibility, acceptability and perceived impact of this educational initiative. METHODS: An OSCE training programme was designed by four fourth-year students. It involved the recruitment of 103 fourth-year tutors to facilitate the running and feedback of OSCE stations to 245 third-year medical students prior to their summative end-of-year exam. Tutees and tutors completed a questionnaire to assess the quality and perceptions of the benefits of this educational intervention. RESULTS: A total of 245 (85% of the year-3 group) tutee and 65 tutor surveys were completed over three evenings: 100 per cent of respondents classified the quality of the OSCE stations and resuscitation session as 'fantastic' or 'good'. The main themes from the tutee comments were: improved confidence and valued feedback. The main themes from the tutor comments were: motivation to continue with peer-assisted learning (PAL) projects and improved teaching skills. CONCLUSIONS: The peer-assisted mock OSCE improved tutee confidence and reduced the anxieties associated with OSCEs. Tutors gain valuable teaching skills. This PAL model is an acceptable, feasible and beneficial method of preparing students for this challenging style of health care examination.