The rise in trauma & orthopaedic trainee-led research and audit collaborative projects in the United Kingdom since the start of the COVID-19 pandemic.

Background and Objective: A significant increase has been observed globally in multi-centre trainee-led trauma & orthopaedic (T&O) research collaborative projects with more emphasis have been on tackling important research questions since the start of the COCID-19 pandemic. The objective of our analysis was to determine the number of trainee-led research collaborative projects in T&O in the United Kingdom that were started during the COVID-19 pandemic. Methods: A retrospective analysis was conducted to determine how many trainee-led national collaborative projects in T&O were conducted since the start of the COVID-19 pandemic lockdown (March 2020 to June 2021) and the number of projects identified were compared to the previous year (2019). Any regional collaborative projects, projects that were started before the onset of COVID and projects of other surgical specialities were not included in the study. Results: There were no projects identified in 2019 while in the Covid pandemic lockdown we identified 10 trainee-led collaborative trauma & orthopaedic projects with six of them being published with level of evidence from three to four. Conclusion: Covid was unprecedented and has placed considerable trials across healthcare. Our study highlights an increase in multi-centre trainee-led collaborative projects within the UK and it underlines the feasibility of such projects especially with the advent of social media and Redcap® which facilitate recruitment of new studies and data.

Establishment Of Virtual Fracture Clinic In Princess Royal Hospital Telford: Experience And Recommendations During The First 9 Months.

BACKGROUND: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. METHODS: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. RESULTS: In total 2489 patients were referred to VFC from internal and external sources. Seven hundred and thirty-four patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. Eighty-seven patients were triaged into subspecialty clinics. Thirty-seven patients were felt to have been referred inappropriately. Discussion: British Orthopaedic Association guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review; the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Addressing the failures of undergraduate anatomy education: Dissecting the issue and innovating a solution.

BACKGROUND: Reduced time allocation, changes in teaching methods and Covid-19 have resulted in undergraduate anatomy teaching being marginalised.This has implications on patient safety, litigation, student satisfaction and surgical workforce planning. AIMS: The aim of this study is to survey a cohort of recent English medical graduates to attain their perspective on anatomy training and to propose an innovative solution to solve existing problems in undergraduate anatomy training. METHODS: An online survey was sent out to 40 foundation doctors to offer insights into their undergraduate anatomy training. We asked participants to rate their perceived importance of anatomy, the importance offered to anatomy teaching at undergraduate level, preparation for clinical practice and future career plans. RESULTS: 22 participants responded to the online survey. All trained across England with equal spread between Northern and Southern medical schools. All participants perceived anatomy to be either important or very important in the survey. 20/22 felt that their undergraduate anatomy teaching was given very low to average importance by their institutions. 8/22 were confident or very confident with their anatomy knowledge on beginning clinical practice. Of the 22, 5 planned surgical careers, 10 did not know or gave other responses and 7 wanted to do General Practice. 16/22 said anatomy training had or will impact their decision on choosing a speciality. CONCLUSION: The current literature and above survey highlight the deficiencies that current doctors are facing.We suggest implementation of a standardised anatomy curriculum and the development of an online anatomy course.