Publications (205) View all
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Article: Reply: Academic jobs for surgical education
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ABSTRACT: Response to the letter to the editor: A Goel, S Goel. Article: Khan N, Khan MS, Dasgupta P, Ahmed K. The surgeon as educator: fundamentals of faculty training in surgical specialties. BJU Int. 2013 Jan;111(1):171-8. We appreciate that the authors highlighted one of the main points of the article: academic clinicians who take time or interest in medical education research and teaching are not receiving enough reward and recognition. Institutions usually place higher merit on research and publications in other areas. To answer the question about any existing reward systems in the field of medicine: in the UK, clinicians who take the highly competitive academic career path are rewarded with protected time for teaching and research, but no extra monetary incentive (1). Some centres will offer academic posts with specific focus on medical education. However, in most cases, the protected time is mostly shared between clinical activities, teaching and research activities. These academic posts are also very competitive (roughly 5% of newly qualified UK doctors will occupy these posts)(2). Therefore, the incentive to teach (apart from personal interest) is usually to further support a portfolio to progress into an academic career. In the UK, there are dedicated "teaching hospitals" - a hospital that provides medical education and training to future and existing healthcare professionals, alongside patient care. These hospitals receive extra funding from their affiliated medical school (through taxpayer contribution), but individual academics of the teaching hospitals do not receive any extra financial reward. Some teaching hospitals and medical schools have student nominated teacher award schemes, where exceptional teaching activity is recognised (3). However, this is not universally applied. Our recommendations for objective and universally recognised reward systems for teaching excellence: • Protected time: although academic clinicians receive protected time, this is usually not specifically allocated to teaching activity. It may be helpful to evenly distribute time for both teaching and research with equal recognition for both. • Monetary incentive: For teaching hospitals that receive extra funding (from either the public or private sector), some of this financial contribution for teaching should reach the individual academics who actually provide the teaching and research. • Incentive for career progression: Teaching excellence should receive equal weighting to research with regards to career progression (both academic and non-academic). An ideal system would be to outline a separate and objective points based criteria specifically for teaching in job applications, but this may be difficult and resource consuming. • Funding for teaching fellowships or teacher training courses: Institutions should fund attendance to training courses or run their own courses by academics who have gained background to educational theory. Academics should be encouraged to take teaching fellowships. • More teaching based academic posts - Academic posts with increased or sole focus on medical education should be created.BJU International 05/2013; 111(5):E266-7. · 2.84 Impact Factor -
Article: Bringing science closer to urologists.
BJU International 05/2013; 111(5):689. · 2.84 Impact Factor -
Article: Development and content validation of a surgical safety checklist for operating theatres that use robotic technology.
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ABSTRACT: OBJECTIVES: To identify and assess potential hazards in robot-assisted urological surgery. To develop a comprehensive checklist to be used in operating theatres with robotic technology. METHODS: Healthcare Failure Mode and Effects Analysis (HFMEA), a risk assessment tool, was used in a urology operating theatre with innovative robotic technology in a UK teaching hospital between June and December 2011. A 15-member multidisciplinary team identified 'failure modes' through process mapping and flow diagrams. Potential hazards were rated according to severity and frequency and scored using a 'hazard score matrix'. All hazards scoring ≥8 were considered for 'decision tree' analysis, which produced a list of hazards to be included in a surgical safety checklist. RESULTS: Process mapping highlighted three main phases: the anaesthesia phase, the operating phase and the postoperative handover to recovery phase. A total of 51 failure modes were identified, 61% of which had a hazard score ≥8. A total of 22 hazards were finalised via decision tree analysis and were included in the checklist. The focus was on hazards specific to robotic urological procedures such as patient positioning (hazard score 12), port placement (hazard score 9) and robot docking/de-docking (hazard score 12). CONCLUSIONS: HFMEA identified hazards in an operating theatre with innovative robotic technologies which has led to the development of a surgical safety checklist. Further work will involve validation and implementation of the checklist.BJU International 04/2013; · 2.84 Impact Factor -
Article: Introducing The Productive Operating Theatre Programme in Urology Theatre Suites
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ABSTRACT: Background: The Productive Operating Theatre (TPOT) is a theatre improvement programme designed by the UK National Health Service. The aim of this study was to evaluate the implementation of TPOT in urology operating theatres and identify obstacles to running an ideal operating list. Method: TPOT was introduced in two urology operating theatres in September 2010. A multidisciplinary team identified and audited obstacles to the running of an ideal operating list. A brief/debrief system was introduced and patient satisfaction was recorded via a structured questionnaire. The primary outcome measure was the effect of TPOT on start and overrun times. Results: Start times: 39-41% increase in operating lists starting on time from September 2010 to June 2011, involving 1,365 cases. Overrun times: Declined by 832 min between March 2010 and March 2011. The cost of monthly overrun decreased from September 2010 to June 2011 by GBP 510-3,030. Patient experience: A high degree of satisfaction regarding level of care (77%), staff hygiene (71%) and information provided (72%), while negative comments regarding staff shortages and environment/facilities were recorded. Conclusions: TPOT has helped identify key obstacles and shown improvements in efficiency measures such as start/overrun times.Urologia Internationalis 04/2013; · 0.99 Impact Factor -
Article: Robotic surgical technology is here to stay and evolve
Trends in Urology and Mens Health. 03/2013;
