199 Teaching Basic Surgical Skills Using a More Frugal, Near-Peer, and Environmentally Sustainable Way: Mixed Methods Study

Abstract Aim To evaluate the impact of a novel program of weekly, lunchtime BSS sessions on quantitative and qualitative factors. Method A weekly, lunchtime BSS course was designed to achieve the outcomes of the Royal College of Surgeons BSS course over one foundation doctor rotation. Sessions included knot tying, suturing, abscess drainage, application of plaster of Paris, joint aspirations and reductions, abdominal wall closure, and basic laparoscopic skills. The hospital canteen sourced unwanted pig skin and belly from the local butcher. Out-of-date surgical equipment was used. Pre- and post-session feedback was assessed for perceived increase in confidence. Thematic analysis of voluntary semi structured interview transcripts were performed to understand the impact of the course on perceived well-being, quality of training, and interest in a surgical career. Results There were 64 responses. Confidence was significantly improved from 47% to 73% (95% CI 15%-27%; P.001; t13=5.3117) across all surgical skills over 4 iterations. In 7 semi-structured interviews, 100% of the participants reported improved perceived well-being, value added to training, and positivity toward near-peer teaching and 71% preferred local weekly teaching. Interest in a surgical career was unchanged. Conclusions This course was feasible around clinical workloads, resourced locally at next to no cost, environmentally sustainable, and free to attend. The course offered junior doctors not only a weekly opportunity to learn but also to teach. Peer-led, decentralized surgical education increases confidence and has a positive effect on perceptions about well-being and training. We hope to disseminate this course, leading to reproduction in other centres, refinement, and wide implementation.