Athar Sheikh

Surgical e-learning: validation of multimedia web-based lectures

Background  Distance learning has been advocated increasingly as a modern efficient method of teaching surgery. Efficiency of knowledge transfer and validity of web‐based courses have not been subjected to rigorous study to date.

Improving surgical outpatient efficiency through mobile phone text messaging.

Introduction. Currently, 175 000 people are on outpatient waiting lists in Irish hospitals. Many clinic slots are taken by patients returning for routine review postoperatively. Methods. A Nokia mobile phone was used to send an outpatient text (OPT) to patients 2 weeks postdischarge. Patients replying that they were well were discharged. If no reply after 2 attempts was received, they were scheduled for the next outpatient clinic. Results. Overall, 55 patients were offered the service over a 4-month period. Of these, 74.5% of patients were discharged from follow-up using text message surveillance. Patients were surveyed regarding their perception of the surveillance model, with all respondents ranking OPT surveillance as their preferred method of follow-up. There was a 13.6% decrease in outpatient visits over the study period. In addition, 6 emergency department visits were also avoided. Conclusion. Text message surveillance decreases outpatient waiting times and increases quality of care.

Surgent University: the establishment and evaluation of a national online clinical teaching repository for surgical trainees and students.

Introduction. The aim of this study was to develop a new teaching strategy for medical students while creating a national online repository system (Surgent University). Then, the potential of this e-learning modality to facilitate learning of clinical surgery was evaluated. Methods. An online repository and Internet-based interface was designed and hosted on the medical education Web site, www.surgent.ie. Participation was by medical students across 3 Irish universities. Student use of the repository was quantitatively assessed over an 8-week period. They were then invited to complete an anonymous survey assessing the effectiveness of the online repository. Statistical analysis was performed using SPSS version 15, with P < .05 considered significant. Results. Over the study period, the online repository received 6105 uploaded facts by 182 final-year medical students from 3 different universities. The repository Web pages were accessed 54 061 times with 4609 individual searches of the repository. Of the 60 participating students invited to provide survey-based feedback, there were 40 respondents, giving a 66.7% response rate. Of those surveyed, 70% (n = 28) rated the online repository as highly beneficial and 75% (n = 30) as highly relevant. Overall, 87.5% (n = 35) felt that it should be continued, and 70% (n = 28) felt that it should be expanded beyond surgery to include other hospital specialties. Those finding the program interface user-friendly were more likely to find it beneficial (P = .031) and relevant to their ongoing education (P = .002). Conclusions. A user-friendly interface allows for high levels of usage, whereas a “student-centered” structure ensures that the facts uploaded are beneficial and relevant to medical students’ education.

Patientsmate©: the implementation and evaluation of an online prospective audit system

INTRODUCTION Inaccuracy in Hospital Inpatient Enquiry (HIPE)/Casemix-based data has been reported as high as 26%. This results in financial waste and makes effective audit impossible. We aimed to develop a novel web-based outcome audit system. METHODS A web-based online audit system, Patientsmate©, was developed using an integrated database system written in the programme language PHP. Data were inputted by the surgical team responsible for the patients care. A prospective comparison study of the new Patientsmate© and the standard HIPE systems, was performed over a 1-month period and involving two general surgical teams in April 2010. In addition, a Likert-scale based questionnaire was designed and hosted within the Patientsmate© system. A focus group of those clinicians directly involved in data accessing and input were then invited to complete the questionnaire in order to assess usability of the system. RESULTS During the study period there were a total of 108 patients and 88 procedures. Our study confirms the accuracy of clinician derived data, with the Patientsmate© system more accurately recording number of patients (83% vs. 80.6%), number of procedures (85.2% vs. 68.1%) and hospital day case rate (52% vs. 47.1%). Inputting data using Patientsmate© for a single patient took 6-7 minutes. Of those using the system, 75% reported feeling comfortable after using it once only and 100% were satisfied with the layout of the online interface. CONCLUSION The Patientsmate© system allows for increased accuracy in outcome-based data as compared with the HIPE system, facilitating audit, financial savings and the appropriate allocation of services.

An evaluation of Irish general surgical research publications from 2000 to 2009.

BACKGROUND Maintaining a high standard of research, and being competitive in the funding application process requires a coordinated and focused research strategy. The first step in the formulation of such a strategy is the identification of those centres, and specifically those areas of study, in which Irish surgical research has previously performed strongly. The aim of this paper was to evaluate all surgical research produced in the Republic of Ireland in the first ten years of the new millennium. METHODS All publications originating from adult Irish general surgical units between the years 2000-2009 were identified from Pubmed and Medline databases. All publications were examined for senior author, originating institute, theme, research model and publishing journal. RESULTS There were a total of 590 publications in Irish general surgical units during the study period. The top publishing hospitals were Institution 1 (129:21%), Institution 2 (82:13.9%) and Institution 3 (81:13.7%). One hundred and thirty three papers were published in journals with impact factors > 4.5. Papers were more likely to be published in journals with impact factors > 4.5 if they came from Institution 1 (38 papers) p = 0.001, published on breast (50 papers) p < 0.001 or upper gastrointestinal topics (35 papers) p < 0.001, or published on bench research (76 papers) p < 0.001. Publications increased from the first half of the decade to the second, with the largest increases seen in Institution 1 (40-89), Institution 4 (21-42) and Institution 6 (11-37). CONCLUSIONS Ireland continues to produce high quality surgical research, characterised by number of articles produced per 10⁶ inhabitants. This study shows that the number of articles published in the second half of the decade almost doubled from 221 to 369 and that the mean journal impact factor for all articles published was 2.87.

Reply to Memon and Memon: Surgical e-learning: validation of multi-media, web-based lectures

hybrid programmes would be of major benefit, especially in countries where there are shortages of instructors and instructional material (provided they are not too expensive!). Improvements in audio and video technologies have certainly revolutionised the way teaching is now conducted and such methods will continue to evolve. This article demonstrates the use of hybrid methodology to improve learning outcomes and student satisfaction and we thank the authors for their insightful study. REFERENCE