title: Training in surgical outpatients.
abstract: The consultants in this department, where the trainees are predominantly SHOs, organise their outpatient clinics such that one consultant sees mainly new patients (A), another mainly follow-up patients (C) and the third a mixture (B). A prospective audit was conducted to assess the impact of these different arrangements on training. Details of the training received were recorded at 32 consecutive clinics. A training episode (TE) occurred if the trainee and consultant jointly reviewed, or directly discussed, the patient in the clinic. A total of 550 patients attended and trainees were involved with 254 (46 per cent). A TE occurred in only 88 (16 per cent). The 235 (43 per cent) new patients produced 66 (28 per cent) TE and the 315 follow-up patients 22 (7 per cent) TE. Seventeen of 46 (37 per cent) procedures were a TE. The TE for the individual consultants were (new and follow-up): A 0, 8 (7 per cent); B 19 (22 per cent), 7 (8 per cent); C 47 (57 per cent), 7 (6 per cent). Outpatient training was greatly influenced by clinic organisation. Follow-up patients, who often have complex problems, rarely generate a TE. Training in surgical outpatients has not received the same attention as operative training and this deficiency needs to be addressed.
authors.affiliation: Eastern General Hospital, Edinburgh.
authors.forename: C
authors.initials: C
authors.lastname: Raine
authors.forename: T J
authors.initials: TJ
authors.lastname: Crofts
authors.forename: J M
authors.initials: JM
authors.lastname: Griffiths
authors.forename: R J
authors.initials: RJ
authors.lastname: Aitken
mesh_terms: D003253:Consultants; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D013502:General Surgery / Q000193:education*; D006801:Humans; D008330:Management Audit; D008505:Medical Staff, Hospital / Q000193:education*; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D011446:Prospective Studies; D012606:Scotland