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Article ; Online: Comments on: Novel use of infrared thermal imaging to predict arteriovenous fistula patency and maturation.

Hopkins, Luke / Khalid, Usman

2018 Volume 19, Issue 2, Page(s) 214

MeSH term(s)	Arteriovenous Fistula ; Arteriovenous Shunt, Surgical ; Humans ; Renal Dialysis ; Vascular Patency
Language	English
Publishing date	2018-02-19
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.5301/jva.5000786
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Article ; Online: Prognostic significance of drivers at work and learning styles in surgical training.

Mellor, Katie / Hopkins, Luke / Robinson, David Bryan Thomas / James, Osian Penri / Luton, Oliver / Brown, Chris / Egan, Richard John / Lewis, Wyn G

Postgraduate medical journal

2023 Volume 98, Issue 1165, Page(s) 855–859

Abstract: Purpose of the study: Drivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical ... ...

Abstract	Purpose of the study: Drivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical trainees' (CST) DW and LS on career progress. Study design: DW questionnaires and Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single-statutory education body. Primary outcome measures were membership of the Royal College of Surgeons (MRCS) examination and national training number (NTN) success. Results: Of 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p=0.003). DW spectrum was: please people (25.0%), be perfect (21.3%), hurry up (18.5%), be strong (13.9%) and try hard (0%, p<0.001). DW was either equivocal (n=14) or not provided (n=9) by 21.3% of CSTs. LS were: converging (34.3%), accommodating (28.7%), diverging (23.1%) and assimilating (13.9%, p=0.021). Men were more likely to be convergers (29/70, 41.4%), and women divergers (15/38, 39.5%, p=0.018) also preferring team-based LS (accommodating/diverging, 26/38 (68.4%) vs 30/70 (42.9%), p=0.010). MRCS success was not associated with DW (p=0.329) or LS (p=0.459). On multivariable analysis, NTN success was associated with LS (accommodators 64.5%, divergers 32.0%, OR 10.90, p=0.014), scholarly activity (OR 1.71, p=0.001), improving surgical training programme (OR 36.22, p=0.019) and universal ARCP 1 outcome (OR 183.77, p<0.001). Conclusions: LS are associated with important differences in career progress with accommodator twofold more likely than diverger to achieve NTN.
MeSH term(s)	Humans ; Male ; Female ; Learning ; Prognosis ; Educational Status ; Surveys and Questionnaires ; Surgeons
Language	English
Publishing date	2023-04-16
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2021-140930
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Article ; Online: Surgical training salvage during COVID-19: a hospital quality perspective.

Luton, Oliver / Mellor, Katie / Eley, Catherine / James, Osian / Robinson, David Brian Thomas / Hopkins, Luke / Lewis, Wyn Griffith / Egan, Richard John

BJS open

2022 Volume 6, Issue 2

MeSH term(s)	COVID-19 ; Hospitals ; Humans
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac019
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Article ; Online: Prognostic significance of competition ratios in surgical specialty training selection.

Mellor, Katie / Robinson, David B / Luton, Oliver / James, Osian P / Powell, Arfon G M T / Hopkins, Luke / Hemington-Gorse, Sarah / Egan, Richard J / Lewis, Wyn G

Postgraduate medical journal

2023 Volume 98, Issue 1163, Page(s) 700–704

Abstract: Background: A competition ratio (CR) indicates the ratio of total applications for a training post when compared with numbers of specialty posts available. This study aimed to evaluate CRs' influence on National Training Number (NTN) selection in a ... ...

Abstract	Background: A competition ratio (CR) indicates the ratio of total applications for a training post when compared with numbers of specialty posts available. This study aimed to evaluate CRs' influence on National Training Number (NTN) selection in a single UK Statutory Education Body. Methods: Consecutive core surgical trainees numbering 154 (105 men, 49 women; median years since graduation: four) were studied over a 6-year period. Annual specialty specific CRs were obtained from Health Education England's website, and primary outcome measure was UK NTN appointment. Results: Overall NTN appointment was 45.5%. Median CR was 2.36; range Oral & Maxillofacial Surgery 0.70 (2020) to Neurosurgery 22.0 (2020). Multivariable analysis revealed that NTN success was associated with: CR (OR 0.46, p=0.003), a single scientific publication (OR 6.25, p=0.001), cohort year (2019, OR 12.65, p=0.003) and Universal Annual Review of Competence Progression Outcome 1 (OR 45.24, p<0.001). CRs predicted NTN appointment with a Youden index defined critical ratio of 4.42; 28.6% (n=8) versus 49.2% (n=62), p=0.018. Conclusion: CRs displayed 30-fold variation, with CRs below 4.42 associated with twofold better NTN promotion, but strong clinical competence and academic reach again emerged as the principal drivers of career advancement.
MeSH term(s)	Male ; Humans ; Female ; Prognosis ; Specialties, Surgical/education ; Education, Medical, Graduate ; Educational Status ; Neurosurgery ; United Kingdom
Language	English
Publishing date	2023-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-139491
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Article ; Online: Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated.

Luton, Oliver W / James, Osian P / Mellor, Katie / Eley, Catherine / Hopkins, Luke / Robinson, David B T / Barlow, Emma / Lebares, Carter C / Lewis, Wyn G / Egan, Richard J

Journal of surgical education

2023 Volume 80, Issue 10, Page(s) 1395–1402

Abstract: Introduction: Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body.: Method: CSTs ... ...

Abstract	Introduction: Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body. Method: CSTs participated in 5-weeks of formal ESRT to address work stressors. The primary outcome measure was career progression related to curriculum metrics and National Training Number (NTN) appointment. Secondary measures related to burnout using validated psychological inventories. Results: Of 42 CSTs, 13 engaged fully with ESRT (31.0%; male 8, female 5, median age 28 year.), 11 engaged partially, and 18 did not. ESRT engagement was associated with better NTN appointment (ESRT 8/13 (61.5%) vs. not 1/18 (5.6%), p = 0.025), less burnout [aMBI; mean 5.14 (SD ± 2.35) vs. 3.14 (±2.25), F 6.637, p = 0.002, η Discussion: ESRT was associated with less stress and burnout, better mindfulness, and most importantly 13-fold better career progression.
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.07.017
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Article ; Online: Surgical curriculum concordance: requiem for the educational dream.

Luton, Oliver / James, Osian Penri / Mellor, Katie / Powell, Arfon / Hopkins, Luke / Robinson, David Bryan Thomas / Egan, Richard / Lewis, Wyn

Postgraduate medical journal

2021 Volume 98, Issue 1160, Page(s) 411–414

Abstract: This study aimed to analyse the degree of relative variation in speciality-specific competencies required for Certification of Completion of Training (CCT) set by the UK Joint Committee for Surgical Training (JCST) 2021 curriculum. Regulatory body ... ...

Abstract	This study aimed to analyse the degree of relative variation in speciality-specific competencies required for Certification of Completion of Training (CCT) set by the UK Joint Committee for Surgical Training (JCST) 2021 curriculum. Regulatory body guidance related to operative and non-operative surgical skill competencies required for CCT were analysed and compared. Wide inter-speciality variation was demonstrated in the minimum number of logbook cases (median 815; range 54 to 2100), indexed operations (8; 5 to 24) and procedure-based assessments (35; 6 to 110). Academic competencies related to peer-reviewed publications, communications to learned societies and audits were aligned at zero, zero and three across specialities, respectively. Mandatory courses have been standardised with Advanced Trauma Life Support being the sole pre-requisite CCT for all. JCST certification guidelines have broadly standardised competency domains, yet large discrepancies persist regarding operative indicative numbers and assessments. This article serves as a definitive CCT guide regarding prevailing changes.
MeSH term(s)	Certification ; Clinical Competence ; Curriculum ; Education, Medical, Graduate ; Educational Measurement ; Educational Status ; Humans
Language	English
Publishing date	2021-01-29
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-139385
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Article ; Online: Gongs galore: phaleristic study of the relative risk of a healing art related New Year Honour.

Mellor, Katie / Powell, Arfon Gmt / James, Osian P / Robinson, David B / Hopkins, Luke / Egan, Richard John / Lewis, Wyn G

Postgraduate medical journal

2021 Volume 98, Issue 1158, Page(s) 252–257

Abstract: Objectives: To compare proportional representation of healthcare specialty workers, in receipt of New Year Honours (NYHs) and examine system bias.: Design: Observational study of UK honours system including comparative analysis of proportional ... ...

Abstract	Objectives: To compare proportional representation of healthcare specialty workers, in receipt of New Year Honours (NYHs) and examine system bias. Design: Observational study of UK honours system including comparative analysis of proportional representation of the UK medical workforce. Participants: Recipients of NYHs from 2010 to 2019. Main outcome measures: Absolute risk of receiving an NYH, related to medical specialty, gender and geographical region. Relative risk (RR) of receiving an NYH for services to healthcare related to specialty. Results: 11 207 NYHs were bestowed, with 368 (3.3%) awarded to healthcare professionals: 212 (57.6%) women, 156 (42.4%) men. The RR of a healthcare professional receiving an NYH was 0.76 (95% CI 0.68 to 0.84, p<0.001) when compared with the remaining UK workforce. Doctors received most NYHs (n=181), with public health, clinical oncology and general medicine specialties most likely to be rewarded (RR 20.35 (95% CI 9.61 to 43.08, p<0.001), 8.43 (95% CI 2.70 to 26.30, p<0.001) and 8.22 (95% CI 6.22 to 10.86, p<0.001)), respectively; anaesthetists received fewest NYHs (RR 0.52 (95% CI 0.13 to 2.10), p=0.305). Men were more likely to receive NYHs than women (OR 0.44, 95% CI 0.36 to 0.54; p<0.001). Two hundred and fifty-four NYHs (69.0%) were bestowed on residents of England (60, 16.3% London), 49 (13.3%) Scotland (p=0.003), 39 (10.6%) Wales (p<0.001) and 26 (7.1%) Northern-Ireland (p<0.001). Conclusions: Relative risk of receiving an NYH varied over 150-fold by specialty, twofold by gender and threefold by geographical location. Public health physicians are perceived to be the pick of the parade.
MeSH term(s)	Awards and Prizes ; Female ; General Practice ; Humans ; Male ; Physicians ; Risk ; Workforce
Language	English
Publishing date	2021-02-09
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-139368
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Article ; Online: Trainee burnout: when does the fire start?

Robinson, David Bryan Thomas / James, Osian Penri / Hopkins, Luke / Brown, Chris / Powell, Arfon / Abdelrahman, Tarig / Egan, Richard John / Lewis, Wyn

Postgraduate medical journal

2020 Volume 98, Issue 1156, Page(s) 124–130

Abstract: Purpose of the study: Burnout is an increasingly recognised phenomenon in acute healthcare specialities and associated with depersonalisation, ill health and training programme attrition. This study aimed to quantify contributory physiological variables ...

Abstract	Purpose of the study: Burnout is an increasingly recognised phenomenon in acute healthcare specialities and associated with depersonalisation, ill health and training programme attrition. This study aimed to quantify contributory physiological variables that may indicate stress in newly qualified doctors. Study design: Post Graduate Year 1 doctors (n=13, 7 f, 6 m) were fitted with a VivaLNK wellness device during four prior induction days, followed by their first 14 days work as qualified doctors. Minute-by-minute Heart Rate (HR), Respiratory Rate (RR), and Stress Index (SI) data were correlated with Maslach Burnout Inventories, Short Grit Scales (SGS) and clinical rota duties: Induction vs Normal Working-Day (NWD) versus On-call shift. Results: In a total 125 recorded shift episodes, on comparing Induction versus NWD versus On-call shift work, no variation was observed in HR above baseline (25.47 vs 27.14 vs 24.34, p=0.240), RR above baseline (2.21 vs 1.86 vs 1.54, p=0.126) or SI (32.98 vs 38.02 vs 35.47, p=0.449). However, analysis of participant-specific temporal SIs correlated with shift-related clinical duties; that is, study participants who were most stressed during a NWD, were also more stressed during Induction (R Conclusion: Stress and burnout stimulus appear to start on day one of induction for susceptible PGY1 doctors, and continues into front-line clinical work irrespective of shift pattern. Short Grit Scale questionnaires appear an effective tool to facilitate targeted stress countermeasures.
MeSH term(s)	Adult ; Burnout, Professional/epidemiology ; Female ; Humans ; Internship and Residency ; Male ; Occupational Stress/psychology ; Physicians/psychology ; Surveys and Questionnaires ; Workload
Language	English
Publishing date	2020-11-04
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-137839
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Article ; Online: Consumer-grade biosensor validation for examining stress in healthcare professionals.

Hopkins, Luke / Stacey, Benjamin / Robinson, David B T / James, Osian P / Brown, Christopher / Egan, Richard J / Lewis, Wyn G / Bailey, Damian M

Physiological reports

2020 Volume 8, Issue 11, Page(s) e14454

Abstract: Introduction: A high prevalence of stress and burnout has been reported among healthcare professionals; however, the current tools utilized to quantify such metrics are not in keeping with doctors' busy lifestyles, and moreover do not comply with ... ...

Abstract	Introduction: A high prevalence of stress and burnout has been reported among healthcare professionals; however, the current tools utilized to quantify such metrics are not in keeping with doctors' busy lifestyles, and moreover do not comply with infection prevention policies. Given that increased stress can subsequently impact both the healthcare profession and the patient in care, this study aimed to assess the validity of a wearable biosensor to monitor and manage stress experienced by healthcare professionals. Methods: In all, 12 healthy, male volunteers completed an incremental exercise protocol to volitional exhaustion, which aimed to induce physiological stress in a graded manner. A wearable consumer-grade biosensor (Vital Scout, VivaLNK, Inc.) was used to measure stress, energy expenditure, respiration rate, and activity throughout the exercise protocol. These variables were validated against online breath-by-breath analysis (MedGraphics Ultima Series). Results: When compared against online "gold standard" measurements, the Vital Scout biosensor demonstrated a high level of accuracy to measure energy expenditure (r = .776, p < .001) and respiration rate (r = .744, p < .001). The Conclusion: The Vital Scout biosensor provided an accurate assessment of energy expenditure and respiration when compared to the "gold standard" assessment of these parameters. Biosensors have the potential to measure stress and deserve further research in the peri-hospital environment.
MeSH term(s)	Adult ; Biosensing Techniques/instrumentation ; Biosensing Techniques/methods ; Energy Metabolism ; Exercise/physiology ; Health Personnel ; Humans ; Male ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Respiratory Rate ; Stress, Physiological ; Stress, Psychological/diagnosis ; Wearable Electronic Devices
Language	English
Publishing date	2020-06-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Study
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.14454
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Article ; Online: Trauma and Orthopedic Surgery Curriculum Concordance: An Operative Learning Curve Trajectory Perspective.

Hopkins, Luke / Robinson, David B T / Brown, Christopher / Egan, Richard / Iorwerth, Awen / Holt, Mark / Lewis, Wyn G

Journal of surgical education

2019 Volume 76, Issue 6, Page(s) 1569–1578

Abstract: Introduction: Certification of completion of training in Trauma and Orthopedic (T&O) surgery in the UK requires the demonstration of operative competence in 12 index procedures, achieved through attaining a level 4 consultant-validated procedure-based ... ...

Abstract	Introduction: Certification of completion of training in Trauma and Orthopedic (T&O) surgery in the UK requires the demonstration of operative competence in 12 index procedures, achieved through attaining a level 4 consultant-validated procedure-based assessment (PBA). The aim of this study was to evaluate the trajectory of operative learning curves related to PBA performance with respect to operative caseload and training time. Design: Logbook data from consecutive 24 higher T&O trainees were compared with PBA evaluations to determine the relationship between PBA level, operative experience, training time, and indicative numbers. Learning curve gradients were calculated using trigonometry related to operative experience and training time. Setting: A higher surgical orthopedic training program serving a single UK (Wales) Deanery. Participants: Twenty-four consecutive higher T&O surgery trainees. Results: Median caseload to achieve level 4 competences ranged from 9 (interquartile range 6-12) for tension band wiring (olecranon or patella) to 101 (61-127) for arthroscopy, with significant variation between all 12 procedures (p < 0.001). Median number of PBAs to reach level 4 competences was 4 (2-6) with significant variation between procedures (p < 0.001). Median learning curve gradients to achieve level 4 competence for tension band wiring were 68.2° and 33.7° by caseload and training time respectively, compared with 12.2° and 45° for arthroscopy, with significant learning curve variation for all procedures related to caseload between first level 3 and first level 4 PBA (p < 0.001). Competence ratios were <1 (median 0.99, range 0.70-2.53) for 6 of the 12 indicative procedures. Conclusions: Significant learning curve trajectory variance was observed, with discrepancies between indicative operative numbers and the point at which competence was judged achieved. Numbers of index operations to achieve certification of completion of training warrant further examination.
MeSH term(s)	Certification ; Clinical Competence ; Curriculum ; Learning Curve ; Orthopedics/education ; Traumatology/education ; United Kingdom
Language	English
Publishing date	2019-05-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2019.05.009
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