title: Improving core surgical training in a major trauma centre.
abstract: BACKGROUND
  English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres.
  
  
  OBJECTIVE
  To determine if T&O core surgical training in MTCs meets Joint Committee on Surgical Training (JCST) quality indicators including performance of T&O operative procedures and consultant supervised session attendance.
  
  
  METHODS
  An audit cycle assessing the impact of a weekly departmental core surgical trainee rota. The rota included allocated timetabled sessions that optimised clinical and surgical learning opportunities. Intercollegiate Surgical Curriculum Programme (ISCP) records for T&O core surgical trainees at a single MTC were analysed for 8 months pre and post rota introduction. Outcome measures were electronic surgical logbook evidence of leading T&O operative procedures and consultant validated work-based assessments (WBAs).
  
  
  RESULTS
  Nine core surgical trainees completed a 4 month MTC placement pre and post introduction of the core surgical trainee rota. Introduction of core surgical trainee rota significantly increased the mean number of T&O operative procedures led by a core surgical trainee during a 4 month MTC placement from 20.2 to 34.0 (p<0.05). The mean number of hip hemiarthroplasty procedures led by a core surgical trainee during a 4 month MTC placement was significantly increased (0.3 vs 2.4 [p=0.04]). Those of dynamic hip screw fixation (2.3 vs 3.6) and ankle fracture fixation (0.7 vs 1.6) were not. Introduction of a core surgical trainee rota significantly increased the mean number of consultant validated WBAs completed by a core surgical trainee during a 4 month MTC placement from 1.7 to 6.6 (p<0.0001).
  
  
  CONCLUSIONS
  Introduction of a departmental core surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs.
authors.affiliation: Specialty Registrar in Trauma and Orthopaedic Surgery Queen's Medical Centre, United Kingdom. Electronic address: daniel.morris1@nhs.net.
authors.forename: Daniel L J
authors.initials: DL
authors.lastname: Morris
authors.affiliation: Specialty Registrar in Trauma and Orthopaedic Surgery Queen's Medical Centre, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bryson
authors.affiliation: Orthopaedic Trauma Surgeon Queen's Medical Centre, United Kingdom.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Ollivere
authors.affiliation: Orthopaedic Trauma Surgeon Queen's Medical Centre, United Kingdom.
authors.forename: Daren P
authors.initials: DP
authors.lastname: Forward
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D006801:Humans; D009104:Multiple Trauma / Q000601:surgery*; D019637:Orthopedic Procedures / Q000193:education* / Q000592:standards; D009985:Orthopedics / Q000193:education* / Q000592:standards; D018794:Problem-Based Learning; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care; D014193:Trauma Centers; D006113:United Kingdom
keywords: Centre; Core; Major; Surgical; Training; Trauma