Introduction Intraoperative feedback can be associated with improved surgical performance. Quality feedback can reduce the time required by trainees to achieve proficiency in psychomotor skills. Operative training time has become increasingly limited, and it has become imperative to use surgical training time effectively. Aim In this survey, we assessed trainees’ perspectives of intraoperative feedback. We included several aspects of feedback including its occurrence, quality, and potential barriers. Methods All surgical trainees in a single centre were invited to complete an electronic questionnaire. Participants were anonymised. We summarised data using descriptive statistics. Results Most trainees (85%) reported they had the opportunity to share their training goals with trainers. Just under three-quarters of trainees felt they always or sometimes got timely feedback. Only half of the trainees were signposted to feedback and 23% felt feedback was not part of their department's culture. Half of the trainees did not always feel comfortable asking for feedback from their trainers stating their reasons as fear of criticism, lack of time and competing clinical commitments. Conclusion There is no denying the importance of feedback on operative performance, however, this survey shows that many of the pillars of quality feedback are poorly adhered to.
ObjectivesRecurrent lumbar spine surgery due to disc herniation is a contributor to debilitating pain, disability, and carries a high patient morbidity rate1 We identified risk factors for recurrent lumbar disc herniation post-surgical intervention.DesignRetrospective Cohort Study.SubjectsAll adult lumbar spine revisions for disc herniation performed in the Neurosurgical Department at Ninewells Hospital.MethodsThe number of revisions from 2013 to 2017 for each patient was recorded and two groups were identified. The first group consisted of patients who had one revision and the second group consisted of patients who had recurrent revisions (more than one) Possible factors influencing the likelihood of recurrent revisions were also noted, including age, gender, BMI, operation length, level of surgery, time from primary surgery to revision, smoking and diabetes status.Results140 patients had revision surgeries, of which 87 (62.1%) had one revision while 53 (37.1%) had recurrent operations. Younger patients (p=0.025) and patients with higher BMI (p=0.01) were more likely to have a higher number of revisions. Patients with DM (p=0.015) were associated with a higher likelihood of recurrent revisions. Other factors had little effect on the likelihood of recurrent revisions (p>0.05).ConclusionsIdentifying risk factors that influence the recurrence of lumbar revisions helps improve patient outcome and decrease incidence of revisions.
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