Teaching to transform surgical culture: an educational programme and thematic analysis in a general surgery department.

INTRODUCTION: General surgery departments are busy, meaning educational opportunities may be sporadic. Clinical priorities can sometimes supersede teaching and trainees may feel alienated at the periphery of the working community. In this study, we demonstrate how a reflective, multidisciplinary general surgery teaching programme was established and use this to assess the impact of structured teaching on surgical doctors of all grades in the department. METHODS: Twelve semi-structured telephone interviews were conducted with participants of varying grades. Transcripts were analysed using a grounded theory thematic analysis, revealing four themes: the value of teaching; learning as a community; barriers to successful training; and culture of surgery. DISCUSSION: Teaching helped juniors construct healthy narratives around general surgery and encouraged a process of professional identity formation. Pairing junior and senior colleagues allowed both to develop their skills, and reflective learning revealed new learning opportunities. Transparency across the 'community of practice' was achieved and the programme helped juniors overcome negative stereotypes of intimidation embedded in the hidden surgical curriculum. CONCLUSION: Reflective, multidisciplinary learning can challenge the hidden curriculum and encourage team cohesion. A commitment to critical reflective teaching will be vital in cultivating surgeons of the future.

Teaching to transform surgical culture: An educational programme and thematic analysis in a general surgery department

Introduction General surgery departments are busy, meaning educational opportunities may be sporadic. Clinical priorities can sometimes supersede teaching and trainees may feel alienated at the periphery of the working community. In this study, we demonstrate how a reflective, multidisciplinary general surgery teaching programme was established and use this to assess the impact of structured teaching on surgical doctors of all grades in the department. Methods Twelve semi-structured telephone interviews were conducted with participants of varying grades. Transcripts were analysed using a grounded theory thematic analysis, revealing four themes: the value of teaching;learning as a community;barriers to successful training;and culture of surgery. Discussion Teaching helped juniors construct healthy narratives around general surgery and encouraged a process of professional identity formation. Pairing junior and senior colleagues allowed both to develop their skills, and reflective learning revealed new learning opportunities. Transparency across the ‘community of practice’ was achieved and the programme helped juniors overcome negative stereotypes of intimidation embedded in the hidden surgical curriculum. Conclusion Reflective, multidisciplinary learning can challenge the hidden curriculum and encourage team cohesion. A commitment to critical reflective teaching will be vital in cultivating surgeons of the future. NB: submitted to previous ASGBI congress 2020 but later withdrawn due to COVID-19 and congress being cancelled. We wish to re-present our work.

Service Evaluation Audit of Virtual Outpatient Clinics in the Post-COVID-19 era

Introduction The COVID-19 pandemic has significantly changed outpatient clinic services which now involve virtual (telephone/video) rather than face-to-face consultations. For both new clinic patients or follow-up patients after a recent emergency admission, these changes may impact on their perceptions and confidence in the outpatient service. The aim of this service provision audit is to ascertain both patient satisfaction and confidence in virtual consultations in our unit. Methods A retrospective evaluation of all General Surgery virtual clinic appointments between January and March 2021 was undertaken. Patients were contacted for feedback about their surgical consultation based on questions from the National Health Service Outpatient Department Survey (2011). Results In total, 151 patients were contacted. Overall satisfaction regarding telephone consultations was significantly higher when compared to survey results of face-to-face appointments in the pre-COVID era. The majority of patients were confident (51%) or confident to some extent (27%) of being listed for surgery without further examination. Only 8% of patients were not confident at the way surgery was explained and 10% were not confident of the risks of surgery. Finally, more than a third were not happy to be discharged from clinic following a telephone consultation. Conclusion Follow-up appointments are an integral part of the patient journey following an emergency admission. The COVID-19 recovery phase has necessitated a service reconfiguration towards virtual appointments. We show that patients were satisfied with virtual consultations, although further quality improvement should be undertaken to ensure outpatient discharge is satisfactory for all patients following an emergency admission.