BEST of Surgical Training: the pan-London Core Surgical Training induction programme

• Published in: The surgeon (Edinburgh) 2022-08, Vol.20 (4), p.e69-e77
• Main Authors: Stewart–Parker, Emma, Allan, Hayley, Vig, Stella
• Format: Article
• Language: English
• Subjects: Bootcamp; Collaboration; Induction; Resilience; Surgical training
• ISSN: 1479-666X; 2405-5840
• DOI: 10.1016/j.surge.2021.06.002

In the UK, Core Surgical Training (CST) marks the start of a surgical career, but previous experience and skills vary widely. Whilst Individual hospital Trusts offer local inductions, these are generally of a generic, administrative nature rather than advising trainees on how best to harness training opportunities. We designed a regional induction programme, ‘Building Excellence in Surgical Training’ (BEST) to address this, develop essential technical and non-technical skills, and engender support networks. All incoming London Core Surgical Trainees (annual cohort size 90) were invited to participate, during the week prior to commencement of training. Trainees undertook 3 modules (portfolio, surgical skills and human factors-based simulation) and a research paper presentation day. We collected qualitative and quantitative data through a structured evaluation form, pre and post course Likert-scale scores and self-assessment utilising the non-technical skills for surgeons (NOTSS) framework. 972 CSTs have completed BEST over the past 12 years. In 2019, significant improvements were seen in: confidence for starting CST, 45% (n = 22/49)-83% (n = 33/40,p = 0.00045); feeling the core programme cared about them, 55% (n = 27/49)-98% (n = 41/42, p =< 0.00001); getting to know peers 16% (n = 8/49)-88% (n = 35/40, p =< 0.00001); understanding human factors 82% (n = 40/49)-95% (n = 36/38, p = 0.00427); gaining confidence of trainers, 49% (n = 23/47)-86% (n = 31/36, p = 0.00114), and ability to speak out over patient safety concerns, 78% (n = 38/49)-97% (n = 37/38,p = 0.00019). NOTSS assessments showed significant improvement across all 4 criteria (n = 142, p =< 0.00001). BEST equips trainees with the fundamental skills and confidence to safely embark on surgical training and provides tools to navigate the challenges training presents. The ethos of collaboration and support will aid the development of more resilient and empowered surgeons, vital in this era. •Surgical trainees require support in acquiring skills and competencies efficiently.•Effective induction teaches how to harness opportunities and builds confidence.•Induction programmes have additional benefit of making trainees feel invested in.•Junior trainees are more vulnerable to burnout; support networks can mitigate this.•An atmosphere of collaboration not competition between peers engenders resilience.