Aims. The COVID-19 pandemic has had a significant impact on the provision of orthopaedic care across the UK. During the pandemic orthopaedic specialist registrars were redeployed to “frontline” specialties occupying non-surgical roles. The impact of the COVID-19 pandemic on orthopaedic training in the UK is unknown. This paper sought to examine the role of orthopaedic trainees during the COVID-19 and the impact of COVID-19 pandemic on
The use of journal clubs and, more recently,
case-based discussions in order to stimulate debate among orthopaedic
surgeons lies at the heart of orthopaedic training and education. A
virtual learning environment can be used as a platform to host virtual
journal clubs and case-based discussions. This has many advantages
in the current climate of constrained time and diminishing trainee
and consultant participation in such activities. The virtual environment
model opens up participation and improves access to journal clubs
and case-based discussions, provides reusable educational content,
establishes an electronic record of participation for individuals,
makes use of multimedia material (including clinical imaging and
photographs) for discussion, and finally, allows participants to
link case-based discussions with relevant papers in the journal
club. The Leicester experience highlights the many advantages and some
of the potential difficulties in setting up such a virtual system
and provides useful guidance for those considering such a system
in their own training programme. As a result of the virtual learning
environment, trainee participation has increased and there is a
trend for increased consultant input in the virtual journal club
and case-based discussions. It is likely that the use of virtual environments will expand
to encompass newer technological approaches to personal learning
and professional development.
The imminent introduction of the new Trauma & Orthopaedic (T&O) curriculum, and the implementation of the Improving Surgical Training initiative, reflect yet another paradigm shift in the recent history of trauma and orthopaedic training. The move to outcome-based training without time constraints is a radical departure from the traditional time-based structure and represents an exciting new training frontier. This paper summarizes the history of T&O training reform, explains the rationale for change, and reflects on lessons learnt from the past. Cite this article:
We aimed to determine quality of life and burnout
among Dutch orthopaedic trainees following a modern orthopaedic
curriculum, with strict compliance to a 48-hour working week. We
also evaluated the effect of the clinical climate of learning on
their emotional well-being. We assessed burnout, quality of life and the clinical climate
of learning in 105 orthopaedic trainees using the Maslach Burnout
Inventory, linear analogue scale self-assessments, and Dutch Residency
Educational Climate Test (D-RECT), respectively. A total of 19 trainees (18%) had poor quality of life and 49
(47%) were dissatisfied with the balance between their personal
and professional life. Some symptoms of burnout were found in 29
trainees (28%). Higher D-RECT scores (indicating a better climate
of learning) were associated with a better quality of life (r =
0.31, p = 0.001), more work-life balance satisfaction (r = 0.31,
p = 0.002), fewer symptoms of emotional exhaustion (r = -0.21, p = 0.028)
and depersonalisation (r = -0,28, p = 0.04). A reduced quality of life with evidence of burnout were still
seen in a significant proportion of orthopaedic trainees despite
following a modern curriculum with strict compliance to a 48-hour
working week. It is vital that further work is undertaken to improve
the quality of life and reduce burnout in this cohort. Cite this article:
Quality assurance for training in trauma and orthopaedics was provided by the JCHST through the SAC for Trauma and Orthopaedics. To date there have been written SAC standards; some are compulsory and others advisory and will generate requirements or recommendations to change if unmet on inspection. There has been a major change in the way postgraduate training is monitored and quality assured, with the formation of the PMETB, which now has the combined responsibility for all postgraduate training. The aims and objectives of our study were to measure the effectiveness of the current quality assurance system for training in Trauma and Orthopaedics, and to determine the reduction in the number of unmet compulsory standards at the end of the visits process and how effectively these requirements were implemented. We also identified the deficiencies in each component of training and determined the current general profile of the quality of training in Trauma and Orthopaedics. The inspection visits, progress and revisit reports were collected from training regions that were visited after the standards were implemented. In 109 units, in the 3 years studied, the inspection process reduced the overall unmet standards from a mean of 14.8% (10.3-19.2%) to 8.9% (6.5%-12.7%). The number of unmet requirement per unit fell from 4.6 to 2.8 (p<0.05). 27% of units did not improve. Overall 15% of standards were deficient, least in Scottish units and most in Irish units. Currently registrars do 1.4 trauma lists, 2.8 elective lists, 1.3 fracture clinics and 2.1 elective clinics per week. This is the first multi-regional study of a national accreditation process. Quality assurance requires standards setting and rectification. These findings are important for the imminent restructuring by the
