Introduction of an ENT emergency—safe boot camp into postgraduate surgical training in the Republic of Ireland

Abstract

Background: Otolaryngology (ENT) is a craft surgical specialty, which presents significant challenges for the novice surgical trainee (NST), when managing patients with potentially life-threatening conditions. We assess current evidence behind intensive, simulation-rich training programmes or “boot camps”. We outline an ENT emergency-safe boot camp for NSTs and the impact this can have on trainees’ competence when dealing with ENT emergencies. Methods: We designed a standardized “ENT emergency-safe boot camp”, aimed at NSTs with a view to up-skilling them in the management of 3 critical clinical scenarios namely post-thyroidectomy haematoma, post-tonsillectomy haemorrhage and epistaxis. All core surgical trainees (CSTs) (n = 54) on the National Surgical Training programme at the Royal College of Surgeons (RCSI) were enrolled on the boot camp. A pre- and post-boot camp anonymised self-assessment was completed by all participants. Results: Trainees’ self-assessment demonstrated an increase in median competence scores from 3/5 to 4/5 for management of post-thyroidectomy haematoma and epistaxis. There was a greater increase in self-assessed competence scores from 2/5 to 4/5 for the management of post-tonsillectomy haemorrhage. Ninety-two percent of respondents said the course added to their previous knowledge, 70% of respondents said it improved their technical skills and 85% of participants said the course gave them more confidence with handling ENT related on-call problems. Conclusion: Study participants expressed an increase in confidence when dealing with specific ENT emergencies, following boot camp training. This correlates with published data. Patient safety should be enhanced, as a result of participation in this dedicated ENT emergency-safe boot camp.