Advanced teamworking in emergency surgical situations: Improving patient safety through the design of a multi-professional, multi-disciplinary course focusing on non-technical skills

s / International Journal of Surgery 12 (2014) S13eS117 S86 has been set to 35%. The data from the EWS audit for December 2013 in our hospital demonstrated a compliance rate of 51%. This is a significant increase from the previous four months of 15, 17, 25 and 18%. Conclusions: Timely medical escalation has a major clinical impact and financial implications to the trust. The EWS podcast on our trust website was the main intervention in the beginning of December and has made a massive impact on our patient care. 1220: EVALUATING AND ADDRESSING MODERN UNDERGRADUATE SURGICAL EDUCATIONAL NEEDS Daniel Moffat , Ahmed Karim , Ian Gooding . Department of Surgery, Birmingham Heartlands Hospital, UK; Department of Gastroenterology, Colchester Hospital, UK. Introduction: An imperative part of surgical training has been the passing on of technical skills to junior colleagues. Surgery was learnt by repeatedly performing operations on patients, under supervision. Junior doctors often feeling ill-prepared for surgical foundation training. Methods: A national medical student survey was electronically conducted to investigate how effective surgical teaching is on the modern undergraduate course. 187 clinical year medical students participated in the survey. Results: 51% of students rarely had formal surgical skill teaching with 77% never receiving formal skill assessment by supervisors. 82% have never been examined on knot tying or suturing. 47% of students had never had the opportunity to practice surgical skills, and 49% felt they would not be confident to close an open wound. 96.8% were not satisfied with surgical simulation training at medical school. A 2-day course was devised to address deficiencies in surgical skill teaching, resulting in a minimum average improvement of 42% of open surgical skills and 36% of laparoscopic skills. Conclusions: Our study has identified a substantial shortfall in the teaching of surgical skills. We have shown this deficit can be addressed by implementing a surgical skills course, demonstrating a significant improvement in student skills. 1237: ADVANCED TEAMWORKING IN EMERGENCY SURGICAL SITUATIONS: IMPROVING PATIENT SAFETY THROUGH THE DESIGN OF A MULTI-PROFESSIONAL, MULTI-DISCIPLINARY COURSE FOCUSING ON NON-TECHNICAL SKILLS Emma Stewart-Parker , Rob Galloway , Simon Finn , Varadarajan Kalidasan , Stella Vig . Croydon University Hospital, London, UK; Brighton and Sussex University Hospitals, Brighton, UK. Introduction: Non-technical skills are vital to surgeons, yet they are rarely formally taught. Teams of healthcare professionals make human errors despite technical expertise and knowledge, compromising patient safety. Our aim was to design a one-day, multi-professional, multidisciplinary course to practice non-technical and team-working skills in emergency situations through simulation. Methods: The course comprised a morning of interactive lectures and team-working exercises, and an afternoon of simulated scenarios. For the latter, the group divided into teams made up of an anaesthetist, ODP, surgical trainee/ emergency medic and nurse. During the scenarios, teams focused on communication strategies, situational awareness and prompts such as checklists. A thorough debrief with experienced clinicians followed. Results: Over 100 healthcare professionals have completed the course. All reported finding the course useful and would recommend it to their colleagues. 95% felt the scenarios had good or excellent relevance to clinical practice, and longer-term data (up to 1 year post course completion) revealed 98% continued to use the skills taught. Conclusions: There is a real enthusiasm for developing non-technical skills within modern surgical training. A course which includes simulation in a multi-professional and multidisciplinary environment will improve not only teamworking, but the culture in general and, ultimately, patient safety. 1249: PRESERVING ARTERIOVENOUS FISTULA OUTCOMES DURING SURGICAL TRAINING Damian McGrogan , Melanie Field , Alexander Maxwell , Hari Krishnan , Nicholas Inston . Department of Vascular Access and Renal Transplantation, University Hospitals Birmingham, Queen Elizabeth Hospital, Birmingham, UK; Regional Nephrology Unit, Belfast Health and Social Care Trust, Belfast City Hospital, Belfast, UK. Introduction: Arteriovenous fistulae (AVFs) are the preferred option for vascular access as they are associated with lower mortality in haemodialysis patients compared to arteriovenous grafts (AVGs) or central venous catheters (CVCs). Methods: We assessed whether vascular access outcomes for surgical trainees are comparable to consultants or associate specialists. A prospective database was created and information collected regarding patient demographics, past medical history, pre-operative investigations, grade of operating surgeon, type of AVF formed, primary AVF patency rate and the 4 year cumulative AVF survival. Results: 143 vascular access patients were identified for inclusion during the 6-month study period. Primary AVF patency was established in 123 (86%). There was no significant difference in survival of AVFs according to grade of surgeon (consultants and associate specialists versus trainee surgeons; log rank x2 0.984 p 1⁄4 0.61) or type of AVF (radiocephalic versus brachiocephalic AVF; log rank x2 0.472 p 1⁄4 0.79). Patency rates of successful AVFs at one and two years were 60.9% and 47.9% respectively. Conclusions: We have demonstrated no significant differences in outcomes of primary AVFs formed by trained versus trainee surgeons. Creation of a primary AVF represents an excellent training platform for intermediate stage surgeons across general and vascular surgical specialties. 1276: STARSURGUK: IMPROVINGMEDICAL STUDENT'S PERCEPTIONS OF SURGICAL ACADEMIA THROUGH PARTICIPATION IN A COLLABORATIVE, MULTI-CENTRE, NATIONAL COHORT STUDY STARSurg Collaborative . STARSurg, Nationwide, UK. Introduction: Medical students can struggle to engage in high-quality research and audit outside of formal programmes, such as intercalated degrees. STARSurgUK is the world's first student-led collaborative network in surgery, completing its first national study in 2013. This parallel study assessed the educational impact of participation. Methods: Practical experience within STARSurgUK was supplemented with a 1-day training meeting, e-learning modules and YouTube presentations. Paired, self-reported electronic surveys were issued preand post-participation. Likert scales were used to assess collaborators' understanding and perceptions of research, audit, academic careers and the collaborative research model. Paired differences were assessed using Wilcoxon signed rank tests (alpha1⁄40.05). Results: 55 paired pre-post responses (23%) were received (M:F 58:42; median age1⁄423). Participation led to increased confidence in key academic activities including: data collection in a clinical setting (p<0.001), presentation of scientific results (p<0.013) and communication with local governance bodies (p<0.001). Collaborators described an increased appreciation of research, audit and study design (p1⁄40.001). The majority of collaborators (98%) disclosed 'no previous interaction' with trainee-led networks, however 95% were more likely to engage following participation. Conclusions: STARSurgUK empowered students to engage with surgical academia and promoted integration into trainee-led research networks. Collaborators reported increased confidence in generic academic skills. 1291: ENHANCING CORE SURGICAL TRAINING: A SUSTAINABLE MODEL FOR SIMULATED OPERATIONS ON WHOLE FRESH FROZEN CADAVERS Peter Coe , Laura Derbyshire, James Pollard, Aqsa Siddiqui, Angela Bell, David Jones. University Hospital South Manchester, Manchester, UK. Introduction: Better Training Better Care (BTBC) pilots are a Health Education England initiative to maximise learning opportunities during training. We report on the cost, development and educational benefit of a BTBC pilot of simulated operations on whole fresh frozen cadavers (FFC) for Core Surgical Trainees (CSTs). Methods: Evaluation from a first workshop informed design of a second. The safety checklist, a simulated sterile field and parallel training of Operating Department Practitioner Trainees allowed operative environment simulation. Consultant Supervisors attended during Supporting Professional Activities time. Educational evaluation was by a designed questionnaire and modified Dundee Ready Educational Environment Measure (DREEM). Abstracts / International Journal of Surgery 12 (2014) S13eS117 S87s / International Journal of Surgery 12 (2014) S13eS117 S87 Results: Alterations to timetablingmaximised cadaver use, and trainer and trainee time. Twenty-two CSTs attended the second workshop. 50 operations with workplace based assessments were completed. Costs were £166 per operation (initial workshop, £203). All participants found FFC tissue ‘similar or very similar’ to live tissue and the course ‘useful or very useful’ to improve skills and confidence. A modified DREEM score of 142/184 is an ‘excellent educational experience’. Conclusions: Whole FFC can provide simulation of operative procedures in a safe environment. Maximising FFCs means costs compare favourably to lower fidelity models. The model has potential for wider adoption. 1322: HEALTHCARE STAFF NUMBERS INVOLVED IN PATIENT-CARE IN AN ACUTE SURGICAL PATIENT Abhishek Sharma , Duff Bruce , Manoj Kumar . Aberdeen Royal Infirmary, Aberdeen, UK; North Cumbria University Hospital NHS Trust,