Kapil Sugand

Kapil Sugand
Imperial College London | Imperial

PGCert HBE BSc PhD MBBS MRCS MCCT MSET MICR FRSA FRSPH OMT AICSM

About

90
Publications
11,663
Reads
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1,389
Citations
Additional affiliations
October 2017 - present
North West London Rotation
Position
  • Trauma & Orthopaedic Surgical Registrar
October 2014 - present
St George's, University of London
Position
  • Core Surgical Trainee
June 2013 - present
Imperial College London
Position
  • Surgical Fellow
Description
  • Specialising in education technology and simulation

Publications

Publications (90)
Article
Full-text available
Objective This is the first British multicentre study observing the impact of the COVID-19 pandemic on orthopaedic trauma with respect to referrals, operative caseload and mortality during its peak. Design A longitudinal, multicentre, retrospective, observational, cohort study was conducted during the peak 6 weeks of the first wave from 17 March 2...
Article
Full-text available
Background: This study assessed the impact of the COVID-19 pandemic on acute upper limb referrals and operative case-mix at the beginning and ease of British lockdown. Methods: A longitudinal multicentre observational cohort study was conducted for both upper limb trauma referrals and operative case-mix over a 12-week period (6 weeks from the be...
Article
Full-text available
Purpose The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3 to 4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 infection. Typically, death from COVID-19 infection occurs between 15-22 days after the onset of symptoms, but this period can extend up to 8 weeks. This stud...
Article
Full-text available
Introduction COVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database...
Article
Introduction : Working time regulations, senior led service delivery and increasing complexity of surgical technology has led to significant strains in surgical training. Additionally, the current COVID-19 pandemic has placed substantial limitations on surgical training worldwide. Contact free, remote, web-based, validated learning tools which are...
Article
Background To investigate discrepancies, if any, between the complications that patients report on the patient-reported outcome measures (PROMs) questionnaire and what is formally recorded in their medical records. Methodology A retrospective analysis of PROMs-reported complications was performed at a single elective center for all patients who had...
Article
The published online version contains mistake, as the Fig. 1 legend should read "Kaplan-Meier survival curve for 30-day survival for 2020 cohort COVID-19 positive vs COVID-19 negative" whilst the Fig. 2 legend should read "Kaplan-Meier survival curve for 30-day survival 2020 COVID-19 negative group vs 2019 cohort".
Article
Full-text available
Purpose: Thirty-day mortality of patients with hip fracture is well researched and predictive; validated scoring tools have been developed (Nottingham Hip Fracture Score, NHFS). COVID-19 has significantly greater mortality in the elderly and comorbid patients which includes hip fracture patients. Non-operative treatment is not appropriate due to s...
Article
Full-text available
Background and purpose — The COVID-19 pandemic has been recognised as an unprecedented global health crisis. This study assesses the impact on a large acute paediatric hospital service in London, evaluating the trends in the acute paediatric orthopaedic trauma referral caseload and operative casemix before (2019) and during (2020) COVID-19 lockdown...
Preprint
Objectives: This is the first national study observing the impact of the COVID-19 pandemic on orthopaedic trauma with respect to referrals, operative caseload and mortality during the first six weeks (namely the "golden peak weeks") following the introduction of the national social distancing and lockdown measures from mid-March 2020. Design: A lon...
Article
Full-text available
Background and purpose — The COVID-19 pandemic has been recognized as an unprecedented global health crisis. This is the first observational study to evaluate its impact on the orthopedic workload in a London level 1 trauma center (i.e., a major trauma center [MTC]) before (2019) and during (2020) the “golden month” post-COVID-19 lockdown. Patients...
Article
Full-text available
Background Laparoscopic surgery has become the gold standard for many operations with significant benefits in morbidity and hospital recovery time. One such procedure is appendicectomy, which is overwhelmingly performed using the laparoscopic approach in the modern era. This has also meant that the number of cases involving traditional open appendi...
Article
Background: FluoroSim, a novel fluoroscopic simulator, can be used to practice dynamic hip screw (DHS) guidewire insertion in a high-fidelity clinical scenario. Our aim was to demonstrate a training effect in undergraduate medical students who are not familiar with this operation and its simulation. Methods: Forty-five undergraduate medical stud...
Book
Medical school is full of unfamiliar and often frightening experiences for students. In the first year, a student must move away from home, balance personal finances, assimilate large volumes of information, learn practical skills, pass high-stakes exams, and face a range of unique experiences. The Oxford Handbook for Medical School provides an ess...
Article
Background: Patient satisfaction in consenting is a major pillar of clinical governance and healthcare quality assessment. The purpose was to observe the effect of using 3D anatomical models of knee and shoulder joints on patient satisfaction during informed consent in the largest single-blinded randomised controlled trial in this field. Methods:...
Article
Full-text available
Purpose Surgical education videos currently all use a single point of view (POV) with the trainee locked onto a fixed viewpoint, which may not deliver sufficient information for complex procedures. We developed a novel multiple POV video system and evaluated its training outcome compared with traditional single POV. Methods We filmed a hip resurfa...
Data
Questionnaire to evaluate surgical video system. This questionnaire evaluates the surgical video system. (DOCX)
Data
Questionnaire on knowledge of a hip resurfacing procedure. This questionnaire evaluates the knowledge of a hip resurfacing procedure. (DOCX)
Data
Modified GRS. This questionnaire allows expert to evaluate the participants’ performance using the modified global rating scale, which was designed using a modified Delphi technique, after watching their performance recorded in the video. (DOCX)
Data
Dataset. This file contains the dataset of the study. (DOCX)
Article
Acetabular fractures are a real challenge for junior doctors as well as experienced orthopedic surgeons. Correct fracture classification is crucial for appreciating the fracture type, surgical planning and predicting prognosis. Although three‐dimensional (3D) tutorial is believed to improve understanding of complex anatomy structure, there have bee...
Article
Full-text available
Background and purpose — Cognitive task analysis (CTA) has been used extensively to train pilots and in other surgical specialties. However, the use of CTA within orthopedics is in its infancy. We evaluated the effectiveness of a novel CTA tool to improve understanding of the procedural steps in antegrade femoral intramedullary nailing. Material an...
Article
Full-text available
Background: Virtual reality and cadaveric simulations are expensive and not readily accessible1. Innovative and accessible training adjuncts are required to help meet training needs. Cognitive task analysis (CTA) has been used extensively to train pilots and surgeons in other surgical specialties2-6. However, the use of CTA tools within orthopaedi...
Article
Full-text available
Background and purpose — Simulation is an adjunct to surgical education. However, nothing can accurately simulate fluoroscopic procedures in orthopedic trauma. Current options for training with fluoroscopy are either intraoperative, which risks radiation, or use of expensive and unrealistic virtual reality simulators. We introduce FluoroSim, an ine...
Article
Full-text available
Background: Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of fe...
Conference Paper
Background Surgical training is evolving, with a reduction in theatre time and case complexity for current trainees. Additionally, surgical training programmes are moving to competency based models, where technical skills and knowledge are assessed for progression. Trainees need new adjuncts to theatre to learn complex procedures. The dynamic hip s...
Article
Full-text available
Background: Virtual-reality and cadaveric simulations are expensive and not readily accessible. Innovative and accessible training adjuncts are required to help to meet training needs. Cognitive task analysis has been used extensively to train pilots and in other surgical specialties. However, the use of cognitive task analyses within orthopaedics...
Conference Paper
Digital fluoroscopy for dynamic hip screw surgical training: a proof of concept study
Conference Paper
Digital fluoroscopy for dynamic hip screw surgical training: the training effect of a novel orthopaedic simulator
Conference Paper
Digital fluoroscopy for dynamic hip screw surgical training: the construct validity of a novel orthopaedic simulator
Poster
Digital fluoroscopy for dynamic hip screw surgical training: the concurrent validity of a novel orthopaedic simulator
Poster
A Novel Affordable Augmented Reality Simulation Of The Guide-Wire Insertion In DHS/CHS Surgery.
Poster
Outcomes of Medial Patellofemoral Ligament Reconstruction For Patellar Dislocation
Article
Introduction Because of the low cost and easy access, surgical video has become a popular method of acquiring surgical skills outside operating rooms without disrupting normal surgical flow. However, currently existing video systems all use a single point of view (POV). Some complex orthopedic procedures, such as joint replacement, require a level...
Article
Full-text available
Objective: The primary objective was observing transferability of minimally invasive surgical skills between virtual reality simulators for laparoscopy and arthroscopy. Secondary objectives were to assess face validity and acceptability. Design: Prospective single-blinded crossover randomized controlled trial. Setting: MSk Laboratory, Imperial...
Article
Full-text available
Background and purpose — Virtual reality (VR) simulation offers a safe, controlled, and effective environment to complement training but requires extensive validation before it can be implemented within the curriculum. The main objective was to assess whether VR dynamic hip screw (DHS) simulation has a training effect to improve objective performan...
Article
Full-text available
The role of simulation in orthopaedic surgical training is becoming increasingly evident, as simulation allows repeated sustained practice in an environment that does not harm the patient. Previous studies have shown that the cognitive aspects of surgery are of equal if not greater importance in developing decision making than the practical aspects...
Article
Full-text available
The aim of this study was to describe the presentation of patients with ruptured abdominal aortic aneurysm (rAAA) and identify factors contributing toward misdiagnosis. This was an observational study of cases with a final diagnosis of rAAA assessed at nine Emergency Departments and managed at one of two regional vascular centres in the UK. Eighty-...
Article
Full-text available
Background and purpose Virtual-reality (VR) simulation in orthopedic training is still in its infancy, and much of the work has been focused on arthroscopy. We evaluated the construct validity of a new VR trauma simulator for performing dynamic hip screw (DHS) fixation of a trochanteric femoral fracture. Patients and methods 30 volunteers were div...
Article
Full-text available
Simulation allows training without posing risk to patient safety. It has developed in response to the demand for patient safety and the reduced training times for surgeons. Whilst there is an increasing role of simulation in orthopaedic training, the perception of patients and the general public of this novel method is yet unknown. Patients and the...
Article
Full-text available
A 75-year-old woman who had undergone hybrid metal-on-metal hip resurfacing 8 years earlier underwent revision arthroplasty because of hip, groin and lateral thigh pain. The main differential was aseptic loosening; however, serum cobalt and chromium levels were normal. Multiple imaging modalities revealed a periprosthetic, cystic soft tissue mass a...
Article
Introduction Orthopaedic training comprises of unstandardised subjective feedback. Trainees rely on personal reflection and self-assessment to gauge performance and to improve future practice. An objective and standardised means of measuring performance metrics to achieve competency is required. Objectives To correlate the accuracy of subjective se...
Article
Background The worldwide incidence of trauma is increasing and the World Health Organisation has identified it as a major cause of clinical burden globally. Intramedullary nailing is a common orthopaedic procedure and is one of the definitive surgical treatments for open fractures of the lower limb. We piloted the first intraoperative intramedullar...
Article
Full-text available
Background Trainees are now facing reduced dedicated time in the operating theatre with expectation to reach the same level of competency and proficiency as their predecessors. We assessed whether a commercially available virtual reality dynamic hip screw (DHS) fixation (for an extracapsular fracture of the left neck of femur) simulation had a trai...
Article
Full-text available
Introduction Currently there is little evidence on the role of virtual reality (VR) simulators for orthopaedic trauma simulation due to lack of validated commercially available platforms. We determined face validity and acceptability of the only VR haptic-enabled DHS fixation simulator as a potential training tool. Methods 52 medical students (naïv...
Article
Full-text available
Background Studies have postulated the extent of video gaming exposure and the correlation with surgical skills acquisition and visuospatial awareness. No study has examined the link between extent of video-gaming and performance on a orthopaedic trauma simulator. Objectives To assess whether video-gaming improves performance on a virtual-reality...
Article
Background/context With improving technology, virtual worlds (VWs) are increasingly playing a part in providing online simulation to supplement traditional teaching in medical education. Orthopaedics often receives little formal teaching. A novel VW training and assessment programme has been developed to cover the management of an open fracture of...
Article
Background/context Simulation is increasingly being used in medical education to supplement traditional teaching. With improving technology, virtual worlds (VWs) are increasingly playing a part in providing online simulation. Orthopaedics often receives little formal teaching. A novel VW training and assessment programme has been developed to cover...
Article
Full-text available
Introduction Current training in trauma and orthopaedics is facing challenges due to limited operating time, a rising trend in medical lawsuits and fierce promotion of patient safety. Objectives To observe the perception of simulation in orthopaedic trauma training and whether there is a change in perception related to level of exposure to the VR s...
Article
Full-text available
Introduction The role of gender to achieve competency, if not proficiency, has been a contentious issue in all surgical specialities but more so within orthopaedics which is usually male-dominated. Current literature suggests gender differences in surgical skill acquisition. Such performance metrics can be easily measured in one of the commonest or...
Article
Full-text available
Introduction The role of self-assessment has been questioned in relation to the inaccuracy of overestimating ability within surgical disciplines. With the emergence of virtual-reality (VR) simulation as an effective method of acquiring technical surgical skills, the ability of surgical trainees to independently use this technology without the need...
Article
Full-text available
Introduction: Previous studies have suggested that there is a positive correlation between the extent of video gaming and efficiency of surgical skill acquisition on laparoscopic and endovascular surgical simulators amongst trainees. However, the link between video gaming and orthopaedic trauma simulation remains unexamined, in particular dynamic...
Conference Paper
Methods A cohort of 50 medical students were recruited and exposed to presentations on neurological topics such as stroke, neuronal degeneration and brain physiology following injuries. Primary outcomes consisted of subjective metrics on education impact by (i) answering a 10-point questionnaire on a 7-point Likert scale (ii) undergoing a 5-minute...
Article
Full-text available
Stress fractures commonly occur in athletes and military cadets due to repetitive stress on the bony cortex. Stress fractures of the tibia are commonly localized proximally and occur during aerobic weightbearing exercises. This is an unusual case of bilateral simultaneous distal tibial stress fracture in a young homemaker.
Article
Full-text available
The medical profession consistently strives to uphold patient empowerment, equality and safety. It is ironic that now, at a time where advances in technology and knowledge have given us an increased capacity to preserve and prolong life, we find ourselves increasingly asking questions about the value of the lives we are saving. A recent editorial b...
Article
Pituitary apoplexy is an uncommon syndrome typically resulting from ischaemic or haemorrhagic necrosis of an existing pituitary adenoma. Patients classically present with sudden-onset severe headache, reduced consciousness, and meningeal irritation. For this reason, the clinical picture is frequently mistaken as being caused by aneurysmal subarachn...
Article
AimTo explore and discuss the necessity of integrating the history of medicine within the medical curriculum. Methods International peer-reviewed academic journals, PubMed and MedLine databases and secondary sources were explored to review historical events that revolutionalized the practice of medicine, surgery, pharmaceuticals and robotics, among...