Rolling data analysis will shape the development and delivery of regionalised surgical training, the Director of the National Surgical Training Programmes told a conference on the future of medical training.
Prof Kevin Barry was speaking on the RCSI’s work to regionalise surgical training at the conference organised by the Forum of Irish Postgraduate Medical Training Bodies on 31 May.
Prof Barry said there was an “appetite” for regionalisation among trainees and trainers. He said this would support surgical retention and minimise disruption and costs to trainees in future. Prof Barry said the reform must be targeted and focused, deliver on learning objectives, improve the quality of training, and be monitored using live training data.
Surgical trainees log information on about 360 operations per day onto the RCSI electronic logbook system, which currently has data on over 650,000 operations, Prof Barry told attendees.
This database allowed RCSI to examine the complexity of operations, involvement of trainees, level of supervision, and the numbers of trainees and operations per site, etc.
This information was “hugely powerful” in regard to designing clinical rotations, according to Prof Barry. He noted that collection and use of data to measure training and develop actionable insights to improve training and patient safety, was a key objective in the Forum’s Strategic Framework for Postgraduate Medical Training in Ireland 2021-2030.
“Fundamentally, I believe data can drive training and you can identify good training sites and less than good or suboptimal training sites and make corrective actions, and if you are going to organise regional rotations data is a very powerful way of ensuring the regional rotations work.”
RCSI has commenced the process of designing clinical rotations in general surgery in the Saolta University Health Care Group. It is also progressing regionalised implementation of training days, cadaveric dissection, train the trainer courses, trauma education and training, simulation, and a new robotic-assisted surgical training programme.
Prof Barry said that three “seminal” documents would influence the surgical workforce of the future, namely Sláintecare; the new surgical training curriculum; and the national trauma strategy.
“The surgical landscape is going to change radically and there will be a need for surgeons to work across multiple hospital sites in a much more coordinated fashion, so it makes sense that surgical training and surgical education should also follow the same pathway.”
In regard to the new curriculum issued in 2021, he said: “All of our surgical training programmes are competency-based and we look at capabilities in practice and the aim… is to ensure the training of a day-one consultant who, crucially, can successfully manage the undifferentiated emergency take. Regionalisation and the type of surgical experience, particularly in model 3 hospitals in the early phase of surgical training, has a huge role to play in ensuring that future surgeons are competent in emergency surgery.”
The three overarching priorities for surgical training were expansion of numbers in line with HSE targets; maintaining the quality of training; and ensuring surgeons were fit-for-purpose. Regionalisation of training was “an important strategy” in the context of these aims, according to Prof Barry.