Ingenuity from UK Trainee Surgeons Unveiled in Dragons’ Den-Style Competition
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An innovative Dragons’ Den-style competition held by Britain’s oldest surgical Royal College revealed fresh talent and creativity by trainee surgeons from all over the UK. Sponsored by the Royal College of Surgeons of Edinburgh (www.rcsed.ac.uk); which last month opened its first-ever base of operations in Birmingham to cater for the 80% of its UK membership based in England and Wales; the contest identified big yet practical ideas for learning resources and technical products, judged by a panel of four experienced ‘Dragon’ clinicians.
The competition, based on the popular TV series format, took place during the recent International Conference on Surgical Education and Training (ICOSET) which runs every two years and has taken place in Canada, Dublin and Australia. This year it was held in Harrogate, alongside the annual meeting of the Association of Surgeons of Great Britain and Ireland (ASGBI), and was attended by trainees, surgeons and lecturers from all over the world. The ‘Dragons’ themselves; some hailing from as far as South Africa, Australia and Inverness; came together to review the entries on the basis of educational value, technical merit and commercial support.
The shortlist included
o A video game to help clinicians make quick and accurate decisions (similar to ‘hazard perception’ in driving tests)
o A creative way of practising surgery using household items such as Tupperware and foodstuffs called the ‘Sandwich Box Trainer’
o Stemming from a married couple’s love of baking – an actual cake illustrating a hip fracture, with moveable joints so accurate it was used in hospitals as a training tool
THOSE WHO CAN, STITCH
Winning top position was a new app helping trainee surgeons track their own teaching experience online, an integral part of the preparation required in becoming consultants. Clinical Teaching Fellow Philip McElnay of University Hospitals Bristol scooped the prize of £500 having developed the web-based app called T-log, which not only enables medics to centrally file their teaching records but also allows feedback from their own students to be uploaded. The app was so successful that in six months it had over 850 episodes logged by over 150 users, and its popularity had spread to GPs and pharmacists in the region.
Philip, 26, is originally from Ireland but graduated from Glasgow University. He developed the app with a colleague to help trainees feel included and make a positive contribution towards their course. He says;
“One area which could definitely be improved was the evidence of the teaching they had delivered – they were turning up at interviews with reams of paper to demonstrate their achievements and passion for their subject.”
Of the ‘Dragons’ Den’ process Philip says “It was fun but also challenging. Just like on the TV programme there were four Dragons sitting in a row – there weren’t any huge piles of money, though! It was a good experience because some of their questions really made you think about how the app might be improved and developed. They were impressed that it had good educational value – and we could prove it. I’m delighted to have won this award.”
COME DISSECT WITH ME
Runner-up for the ICOSET Innovations prize was Tim Credland from Bradford Teaching Hospitals, who produced a ‘Surgical Sandwich Box’. The BUS(S)T – Bradford Universal Surgical (Sandwich box) Trainer, is a contraption made from a plastic sandwich box which supports a piece of pig skin - such as that on pork belly – over a balloon, and was originally designed to be an abdominal opening and closure trainer.
Tim, who has a background as a development technologist, developed the fixture (or ‘jig’) with his colleagues as they were unhappy with commercially available simulators. He says “Using a piece of pig skin gives a lifelike feel to procedures, the tissue layers cut, open and will hold sutures much better than the synthetic skin versions. We have found that we can use this trainer for a number of procedures and the tissue materials that we use are considerably cheaper than the commercially available alternatives.”
So far the BUS(S)T has been used as a training tool for hernia surgery, draining abdominal fluid (ascites), needle placement and a wide variety of procedures such as peritoneal lavage (a way of diagnosing intra-abdominal bleeding) and even appendectomy. Tim, who was born and brought up near Lincoln, continues;
“I was very pleased when my submission for entry for the Innovation Prize was accepted, especially as it is so simple and basic. When I saw the quality of the other shortlisted innovations presented at the Dragons’ Den in Harrogate, I was very surprised to be the runner up. I must say that the teaching app that won the prize was incredible.”
Tim, who joined Bradford Royal Infirmary as a Technician in the Education Service, was involved with the planning, building and equipping of the Simulation Centre and Technical Skills Laboratory within the Integrated Education, Simulation and Surgical Skills Centre, which opened 3 years ago, where he is now the Senior Technician.
CANNULA OF DUTY
A further runner-up was 36 year-old Muhammad Imran Aslam with his project ‘Serious Gaming for Surgical Education’. Mr Aslam is speciality registrar at University Hospitals of Leicester NHS Trust, who has a keen interest in surgical training and virtual simulation. He describes his project:
“Serious gaming (SG) is an innovative tool within medical education. SG allows decision-making to be rehearsed in a safe, virtual environment through different clinical scenarios to evaluate skills. These could include covering the provision of clinical care at night, management of patients with surgical emergencies in the acute admission unit, time management, communication and prioritisation of tasks generated from a surgical ward round. In the future, the game can be expanded to cover outpatient and acute care scenarios in various specialities in order to deliver the essential components of the surgical curriculum.”
The project was supervised by two surgical tutors; consultant colorectal surgeon John Jameson and consultant anaesthetist Danielle Bryden. According to Mr Jameson;
“Our vision is that the skills and experience gained through this project will be re-invested into further national development in this field. There is also potential for it to be applied to other groups undergoing multidisciplinary training.”
PAGING DR. KIPLING
Surgeon-in-training Samer Shamoon from Morriston Hospital in Swansea shares the hobby of baking with his wife Rana Bahoo, also an aspiring surgeon from Royal Gwent Hospital. They met in medical school and have been married five years. Whenever they finished each stint of their surgical ‘rotation’ (a period of their training at a particular department), they would bake a specially-themed cake related to that rotation to thank everybody in the department, and their latest creation – the ‘Neck of Femur repair’ was shortlisted for the Innovations prize.
Samer, who is 32 and was born in Ayrshire, says;
“Over time our creations became more complex; we moved from making simple anatomical demonstrations to more detailed models where surgical procedures could be performed on the cake ‘simulator’, with breadsticks for bones and red syrup for fake blood – everything edible, of course! For example, we made a brain cake for the Stroke department and an ‘AAA’ (Abdominal Aortic Aneurysm) one for the Vascular team. As an aspiring orthopaedic surgeon, I wanted to add extra detail to the hip fracture model, so it even had moveable joints. We were thrilled it was being used as a teaching tool for juniors.
“To enter the Innovations Prize, we had to fashion a more robust version that wouldn’t ‘melt’ on the way to Harrogate, and which could be commercially viable. So this was created using expanding foam and other DIY materials, but it stayed faithful to our original cake’s structure. We certainly didn't expect to be among the finalists. The Dragon’s Den ‘Innovation Prize’ was an amazing experience – these competitions are a great way of showcasing creativity and seeing what others can do/ We are very excited and have already started to think about what our next cake could be!”
The competition was chaired by Surgical Director of the RCSEd’s Faculty of Surgical Trainers Craig McIlhenny. The ‘dragons’ included Prof. Bob Baigrie, a vascular surgeon from South Africa; general surgeon from Australia Associate Prof. Stephen Tobin; colorectal surgeon from Inverness Prof. Ken Walker and Mr. Chris Munsch, a cardiac surgeon from Leeds.
According to Craig McIlhenny, who is a consultant urological surgeon;
“I am always thrilled to see the resourcefulness and creativity shining through the next generation of surgeons. They use materials in ingenious ways alongside their expertise in modern technology to create better educational tools that help the profession as a whole. I recently witnessed a fantastic microsurgery ‘practice’ model that a trainee had fashioned out of a hotel sewing kit! I’m delighted we were able to run this session at ICOSET and would like to thank Boston Scientific for contributing the prize. I have already been asked by other institutions if they could steal the idea!”
About The Royal College of Surgeons of Edinburgh
RCSEd (www.rcsed.ac.uk) was first incorporated as the Barber Surgeons of Edinburgh in 1505, and is the oldest surgical corporation in the world with a membership of over 23,000 professionals in over 100 countries worldwide. The College promotes the highest standards of surgical and dental practice through its interest in education, training and examinations, its liaison with external medical bodies and representation of the modern surgical and dental workforce. It is also home to the UK’s only Faculty of Surgical Trainers, open to all those with an interest in surgical training regardless of College affiliation. Find RCSEd on Twitter www.twitter.com/RCSEd and on Facebook www.facebook.com/rcsed
The College is based at Nicolson Street, Edinburgh, EH8 9DW and can be reached on (0)131 527 1600 or email@example.com. In March 2014, a new base opened in Birmingham, catering to the 80% of the College’s UK membership who are based in England and Wales.
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