BackgroundAdequate training and assessment of competency in surgical trainees are important in minimizing adverse events and achieving good patient outcomes. The purpose was to investigate the current literature on digitally supported methods of facilitating work‐based competency assessment of surgical trainees.MethodsTwo concurrent literature searches were performed by two independent researchers using three databases: MEDLINE, Embase and Education Resources Information Center. Eligible studies reported on digitally supported tools for assessing surgical competency in a work‐based setting for interns, residents or trainees of a post‐graduate surgical programme. Studies focusing primarily on training courses, simulations or other tools for assessing surgical skills in a setting outside of work were excluded. Articles published as abstracts only, articles not published in English and review articles that did not contain original data were excluded.ResultsA total of 11 eligible studies were included, with six of these implementing smartphone application‐based programmes, and five utilizing web‐based programmes. Five studies implemented the ‘System for Improving and Measuring Procedural Learning’ smartphone application. Studies were based predominantly on general surgery residents, and were limited to the North American context. There was significant variability between studies regarding methodology, including the scoring system used to assess competency.ConclusionThis review confirms that digitally supported competency assessment of surgical trainees in a work‐based setting is both feasible and effective. Digital platforms allow evaluations to be performed in a timely fashion without significant disturbance to workflow.

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This paper reports on a survey of carer satisfaction with telephone consultations with doctors in a community service for people with intellectual disability (also known as learning disability in the UK health services). A 10-item anonymized carer satisfaction questionnaire was sent out following telephone consultations over a 4 week period with questions about suitability, effectiveness, efficiency and appropriateness of telephone consultations. Out of 13 questionnaires sent, 11 were returned. There was a high level of satisfaction with accessibility, effectiveness and suitability. Similar numbers felt that telephone consultations were an efficient use of time. However more than one-third of carers said they would have preferred a face-to-face consultation with the doctor. Telephone consultations, although routine practice in psychiatry, need further research to establish them as a viable alternative to face-to-face consultations.

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The management of appendicitis with appendicectomy is very common in surgical practice. A recognised complication of appendicitis and appendicectomy is the formation of an enterocutaneous fistula. We present the case of a seventy-five-year-old woman who presented with an appendicocutaneous fistula on the background of an open appendicectomy performed sixty years prior to presentation.