Orthopaedic Trainees in the Northeast are lucky enough to benefit from the Surgical Skills Training Programme run by the Newcastle Surgical Training Centre (NSTC). This comprises of 4 separate days of cadaveric training with the aims of developing surgical and non-technical skills so that new ST3 trainees can cope with most emergency orthopaedic operations. This also integrates simulation into the orthopaedic curriculum.
Sessions are split up to cover a particular area of the body each time and pre-reading is provided so that trainees can revise the relevant case scenarios, anatomy and approaches beforehand. The structure of the course is designed to mirror the orthopaedic curriculum and supplement the training we receive in our usual practice. It also allows opportunity to perform certain important procedures which are less commonly encountered such as fasciotomies or the anterior approach to a septic hip.
Each session starts with a discussion of the common injuries that are relevant to this body area and the pertinent parts of the history, examination and emergency management to be aware of. Trainees are encouraged to come up with the options for treatment and relevant literature to support their treatment choices.
Moving into the simulated theatre environment each consultant trainer supervises 2-3 trainees working with one fresh frozen cadaver. Trainees discuss the best way to orientate the patient and image intensifier in theatre for each procedure and how best to position and restrain the patient. The cadaver is then draped and the trainees perform all the common approaches for that area, with the trainer ensuring good surgical technique and awareness of the structures at risk. Often there are two limbs so both trainees get to perform each approach with the other assisting and discussing tips and tricks with the consultant.
Complex cases with X-rays are included in the pre-course reading and allow the trainers to check the trainees’ understanding and management plans. Trainees complete ISCP case based discussions or simulated DOPS for each of these cases. Certain procedures such as carpal tunnel decompression or tendon transfer allow a full PBA to be completed and others such as total hip replacement allow the approach component of the PBA to be completed. Trainers evaluate each trainees surgical skill acquisition and their ISCP assessments reflect this.
The NSTC is a cadaveric training centre that has been set up by Newcastle Hospitals and runs both industry and deanery courses in all surgical specialities. In conjunction with the Health Education England working across the Northeast a similar programme of cross speciality cadaveric training days are provided for Core Surgical Trainees. The Orthopaedic ST3 programme has been set up by the experienced orthopaedic trauma consultant Mr Paul Fearon and recruits consultant faculty for the training days from throughout the Northern region, which gives trainees who are new to the region opportunity to build relationships with other trainers. The 4 training days are funded by top slicing the the trainees’ study budget for each trainee by £550, this represents phenomenal value for money to trainees with a similar cadaveric courses costing trainees in the region of £2,000.
The feedback from trainees is predictably glowing, the opportunity to do so much supervised operating in a controlled environment is unparalleled. Trainees particularly enjoy the opportunity explore anatomy outside the standard surgical field and perform less common high risk approaches. Examples of these would include posterior approaches to the knee and approaches for distal humerus fracture fixation. Another favourite is the dissection of the course of certain commonly injured nerves such as the radial and common peroneal nerve, to gain an understanding of just how close certain neurovascular structures are to the approaches.