Simulation as a tool for learning surgical craft in Covid-19 era

Since our last Scottish Medical Journal (SMJ) issue, the world has changed. We are faced with a unique and unprecedented challenge of COVID-19 (coronavirus) challenge. ¹ It has touched our lives in many ways and in some areas has caught us unprepared. Healthcare sector remains central to delivering much needed care to those affected by this panendemic and has- for right reason, come under sharp focus. ² We have seen some great examples of spontaneous altruism across the globe both at community and individual level, but much more is needed to be done to build our capacity for the present and the future. This needs careful planning and preparations including upskilling and training our workforce.

In this issue of SMJ, there are two articles addressing training of future workforce, although at different levels of training in Medicine. Yiasemidou et al. ³ describe a cost-effective training model for a common surgical procedure of appendicectomy. More than 350,000 surgical procedures are performed by surgeons across America and Europe annually to remove suspected inflamed appendices.^4,5 Shear number of procedures and surgical workforce required to deliver this care requires a validated training curriculum. A cost-effective model described here would significantly enhance our capacity and future simulation research. At an undergraduate level and for more generic learning amongst medical students, Richard et al. ⁶ describe Balint-style reflective group practice learning amongst medical students during General Practice placement. The style was described by Michael Balint in his book “The Doctor, his Patient and the Illness” in 1957 ⁷ and method had achieved a wider recognition in General Practice immediately. With no fear of a particular practice getting assessed as “good or “bad”, this style provides a unique opportunity of assessing and reflecting on patient-doctor interactions by practioners including self-directed improvement, if needed. The method has significant potential of learning from our experience of doctor patient interactions.

We continue to highlight experience of clinical practioners through opportunity to publish in SMJ of rare diseases and rare case reports. Lim et al. ⁸ present experience of dealing with a rare primary thyroid cancer from Scotland-squamous cell histology. The case series of three patients in a large cohort of 2724 cases 3/2724;01%) of primary thyroid cancers in Scotland over period of 10 years reminds us of the fact that most colleagues in this craft may not see a case of Primary squamous cell carcinoma in their life-time. Sadly, prognosis in these cases remains poor and further research is needed to underpin improved management of these cases in the future.