91 results on '"McIlhenny C"'
Search Results
2. Nomogram predicting the probability of spontaneous stone passage in patients presenting with acute ureteric colic
- Author
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Gao, C, Peters, M, Kurver, P, Anbarasan, T, Jayaraajan, K, Manning, T, Cashman, S, Nambiar, A, Cumberbatch, M, Lamb, BW, Pickard, R, Erotocritou, P, Smith, D, Kasivisvanathan, V, Shah, TT, Abboudi, H, Abdelmoteleb, H, Abu Yousif, M, Acher, P, Adams, R, Ager, M, Ahmed, I, Ajayi, L, Akintimehin, A, Akman, J, Al Hayek, S, Al‐Dhahir, W, Al‐Qassim, Z, Al‐Shakhshir, S, Alberto, M, Ali Abdaal, C, Arya, M, Assaf, N, Ayres, B, Badgery, H, Bateman, K, Bdesha, A, Bedi, N, Begum, R, Belal, M, Biyani, CS, Bolton, D, Bultitude, M, Burge, F, Bycroft, J, Cameron, F, Campbell, A, Cannon, A, Carrie, A, Chappell, B, Chin, AOL, Chow, K, Christidis, D, Clements, J, Coode‐Bate, J, Cronbach, P, Curry, D, Dasgupta, R, Demirel, S, Derbyshire, L, Din, W, Docherty, E, Edison, E, Eldred‐Evans, D, Ellis, G, Evans, S, Foley, R, Frymann, R, Gallagher, M, Gowardhan, B, Graham, J, Graham, S, Gray, S, Grice, P, Gupta, S, Hamad, S, Hann, G, Harris, A, Hatem, E, Hawary, A, Hayat, Z, Hayne, D, Hegazy, M, Henderson, J, Hendry, J, Ho, C, Hughes‐Hallet, A, Hussain, A, Hussain, Z, Ibrahim, H, Irving, S, Ivin, N, Jaffer, A, Jalil, R, Kashora, F, Kavia, R, Kerr, L, Khadouri, S, Khan, A, Khan, M, Khan, S, Koschel, S, Kozan, AA, Kum, F, Kynaston, H, Laird, A, Lavan, L, Lawrentschuk, N, Lee, JCM, Lee, S, Liew, M, Mackenzie, K, Malki, M, Manson‐Bahr, D, Mason, H, Matanhelia, M, Maw, J, Mbuvi, J, Mc Cauley, N, Mc Grath, S, Mc Kay, AC, Mcilhenny, C, Miakhil, I, Miller, M, Mirza, AB, Morrison‐Jones, V, Morrow, J, Mosey, R, Murtagh, K, Natarajan, M, Nehikhare, Y, Ness, D, Ng, A, Ngweso, S, Nkwam, N, Nyandoro, M, Nzenza, T, O’ Brien, J, O’ Rourke, J, Olaniyi, P, Olivier, J, Osman, B, Oyekan, A, Pang, K, Pankhania, R, Parwaiz, I, Parys, B, Patterson, J, Pearce, I, Phipps, S, Premakumar, Y, Probert, JL, Quinlan, D, Ratan, H, Reid, K, Rezacova, M, Rezvani, S, Rodger, F, Rogers, A, Ross, D, Rowbotham, C, Rujancich, P, Ruljancich, P, Sadien, I, Sakthivel, A, Saleemi, A, Samsudin, A, Sandhu, S, Seaward, L, Sharma, A, Sharma, S, Shergill, I, Shetty, A, Shingles, C, Simmons, L, Simpson, R, Simson, N, Singh, H, Sriprasad, S, Stammeijer, R, Steen, C, Stewart, H, Stonier, T, Suraparaj, L, Swallow, D, Symes, A, Symes, R, Tailor, K, Tait, C, Tam, JP, Tay, J, Tay, LJ, Tregunna, R, Tudor, E, Udovichich, C, Umez‐Eronini, N, Wang, L, Ward, A, Weeratunga, G, Withington, J, Wong, C, Wozniak, S, Yassaie, O, and Young, M
- Abstract
Objectives\ud \ud To develop a nomogram that could predict spontaneous stone passage (SSP) in patients presenting with acute ureteric colic who are suitable for conservative management.\ud \ud \ud \ud Patients and Methods\ud \ud A 2517 patient dataset was utilised from an international multicentre cohort study (MIMIC, A Multi-centre Cohort Study Evaluating the role of Inflammatory Markers In Patients Presenting with Acute Ureteric Colic) of patients presenting with acute ureteric colic across 71 secondary care hospitals in the UK, Ireland, Australia, and New Zealand. Inclusion criteria mandated a non-contrast computed tomography of the kidneys, ureters, and bladder. SSP was defined as the ‘absence of the need for intervention’. The model was developed using logistic regression and backwards selection (to achieve lowest Akaike's information criterion) in a subset from 2009–2015 (n = 1728) and temporally validated on a subset from 2016–2017 (n = 789).\ud \ud \ud \ud Results\ud \ud Of the 2517 patients, 1874 had SSP (74.5%). The mean (SD) age was 47 (14.7) years and 1892 were male (75.2%). At the end of the modelling process, gender: male (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.64–1.01, P = 0.07), neutrophil count (OR 1.03, 95% CI 1.00–1.06, P = 0.08), hydronephrosis (OR 0.79, 95% CI 0.59–1.05, P = 0.1), hydroureter (OR 1.3, 95% CI 0.97–1.75, P = 0.08), stone size >5–7 mm (OR 0.2, 95% CI 0.16–0.25, P 7 mm (OR 0.11, 95% CI 0.08–0.15, P
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- 2022
3. Training and assessing technical and non-technical skills for uretersocopy within a simulation-based curriculum - a randomised control trial: O135
- Author
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Brunckhorst, O., Shahid, S., Aydin, A., McIlhenny, C., Khan, S., Syed, J. R., Sahai, A., Brewin, J., Bello, F., Kneebone, R., Khan, M. S., Dasgupta, P., and Ahmed, K.
- Published
- 2015
4. Validity assessment of the Non-Technical Skills for Urological Surgeons (NoTSUS) curriculum and assessment scale
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Aydin, A., primary, Griffin, C., additional, Brunckhorst, O., additional, Mcilhenny, C., additional, Brewin, J., additional, Raison, N., additional, Al-Jabir, A., additional, Shabbir, M., additional, Palou Redorta, J., additional, Khan, M.S., additional, Dasgupta, P., additional, and Ahmed, K., additional
- Published
- 2020
- Full Text
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5. Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic: results from the Multi-centre cohort study evaluating the role of Inflammatory Markers In patients presenting with acute ureteric Colic (MIMIC) study
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Shah, TT, Gao, C, Peters, M, Manning, T, Cashman, S, Nambiar, A, Cumberbatch, M, Lamb, B, Peacock, A, Van Son, MJ, van Rossum, PSN, Pickard, R, Erotocritou, P, Smith, D, Kasivisvanathan, V, Abboudi, H, Abdelmoteleb, H, Abu Yousif, M, Acher, P, Adams, R, Ager, M, Ahmed, I, Ajayi, L, Akintimehin, A, Akman, J, Al Hayek, S, Al-Dhahir, W, Al-Qassim, Z, Al-Shakhshir, S, Alberto, M, Abdaal, AC, Arya, M, Assaf, N, Ayres, B, Badgery, H, Bateman, K, Bdesha, A, Bedi, N, Begum, R, Belal, M, Biyani, CS, Bolton, D, Bultitude, M, Burge, F, Bycroft, J, Cameron, F, Campbell, A, Cannon, A, Carrie, A, Chappell, B, Chin, AOL, Chow, K, Christidis, D, Clements, J, Coode-Bate, J, Cronbach, P, Curry, D, Dasgupta, R, Demirel, S, Derbyshire, L, Din, W, Docherty, E, Edison, E, Eldred-Evans, D, Ellis, G, Evans, S, Foley, R, Frymann, R, Gallagher, M, Gowardhan, B, Graham, J, Graham, S, Gray, S, Grice, P, Gupta, S, Hamad, S, Hann, GA, Hussain, Z, Ibrahim, H, Irving, S, Ivin, N, Jaffer, A, Jalil, R, Kashora, F, Kavia, R, Kerr, L, Khadouri, S, Khan, A, Khan, M, Khan, S, Koschel, S, Kozan, AA, Kum, F, Kynaston, H, Laird, A, Lavan, L, Lawrentschuk, N, Lee, JCM, Lee, S, Liew, M, Mackenzie, K, Malki, M, Manson-Bahr, D, Mason, H, Matanhelia, M, Maw, J, Mbuvi, J, Mc Cauley, N, McGrath, S, Mc Kay, AC, Mcilhenny, C, Miakhil, I, Miller, M, Mirza, AB, Morrison-Jones, V, Morrow, J, Mosey, R, Murtagh, K, Natarajan, M, Nehikhare, Y, Ness, D, Ng, A, Ngweso, S, Nkwam, N, Nyandoro, M, Nzenza, T, O'Brien, J, O'Rourke, J, Olaniyi, P, Olivier, J, Osman, B, Oyekan, A, Pang, K, Pankhania, R, Parwaiz, I, Parys, B, Patterson, J, Pearce, I, Phipps, S, Premakumar, Y, Probert, JL, Quinlan, D, Ratan, H, Reid, K, Rezacova, M, Rezvani, S, Rodger, F, Rogers, A, Ross, D, Rowbotham, C, Rujancich, P, Ruljancich, P, Sadien, I, Sakthivel, A, Saleemi, A, Samsudin, A, Sandhu, S, Seaward, L, Sharma, A, Sharma, S, Shergill, I, Shetty, A, Shingles, C, Simmons, L, Simpson, R, Simson, N, Singh, H, Sriprasad, S, Stammeijer, R, Steen, C, Stewart, H, Stonier, T, Suraparaj, L, Swallow, D, Symes, A, Symes, R, Tailor, K, Tait, C, Tam, JP, Tay, J, Tay, LJ, Tregunna, R, Tudor, E, Udovicich, C, Umez-Eronini, N, Wang, L, Ward, A, Weeratunga, G, Withington, J, Wong, C, Wozniak, S, Yassaie, O, Young, M, Shah, TT, Gao, C, Peters, M, Manning, T, Cashman, S, Nambiar, A, Cumberbatch, M, Lamb, B, Peacock, A, Van Son, MJ, van Rossum, PSN, Pickard, R, Erotocritou, P, Smith, D, Kasivisvanathan, V, Abboudi, H, Abdelmoteleb, H, Abu Yousif, M, Acher, P, Adams, R, Ager, M, Ahmed, I, Ajayi, L, Akintimehin, A, Akman, J, Al Hayek, S, Al-Dhahir, W, Al-Qassim, Z, Al-Shakhshir, S, Alberto, M, Abdaal, AC, Arya, M, Assaf, N, Ayres, B, Badgery, H, Bateman, K, Bdesha, A, Bedi, N, Begum, R, Belal, M, Biyani, CS, Bolton, D, Bultitude, M, Burge, F, Bycroft, J, Cameron, F, Campbell, A, Cannon, A, Carrie, A, Chappell, B, Chin, AOL, Chow, K, Christidis, D, Clements, J, Coode-Bate, J, Cronbach, P, Curry, D, Dasgupta, R, Demirel, S, Derbyshire, L, Din, W, Docherty, E, Edison, E, Eldred-Evans, D, Ellis, G, Evans, S, Foley, R, Frymann, R, Gallagher, M, Gowardhan, B, Graham, J, Graham, S, Gray, S, Grice, P, Gupta, S, Hamad, S, Hann, GA, Hussain, Z, Ibrahim, H, Irving, S, Ivin, N, Jaffer, A, Jalil, R, Kashora, F, Kavia, R, Kerr, L, Khadouri, S, Khan, A, Khan, M, Khan, S, Koschel, S, Kozan, AA, Kum, F, Kynaston, H, Laird, A, Lavan, L, Lawrentschuk, N, Lee, JCM, Lee, S, Liew, M, Mackenzie, K, Malki, M, Manson-Bahr, D, Mason, H, Matanhelia, M, Maw, J, Mbuvi, J, Mc Cauley, N, McGrath, S, Mc Kay, AC, Mcilhenny, C, Miakhil, I, Miller, M, Mirza, AB, Morrison-Jones, V, Morrow, J, Mosey, R, Murtagh, K, Natarajan, M, Nehikhare, Y, Ness, D, Ng, A, Ngweso, S, Nkwam, N, Nyandoro, M, Nzenza, T, O'Brien, J, O'Rourke, J, Olaniyi, P, Olivier, J, Osman, B, Oyekan, A, Pang, K, Pankhania, R, Parwaiz, I, Parys, B, Patterson, J, Pearce, I, Phipps, S, Premakumar, Y, Probert, JL, Quinlan, D, Ratan, H, Reid, K, Rezacova, M, Rezvani, S, Rodger, F, Rogers, A, Ross, D, Rowbotham, C, Rujancich, P, Ruljancich, P, Sadien, I, Sakthivel, A, Saleemi, A, Samsudin, A, Sandhu, S, Seaward, L, Sharma, A, Sharma, S, Shergill, I, Shetty, A, Shingles, C, Simmons, L, Simpson, R, Simson, N, Singh, H, Sriprasad, S, Stammeijer, R, Steen, C, Stewart, H, Stonier, T, Suraparaj, L, Swallow, D, Symes, A, Symes, R, Tailor, K, Tait, C, Tam, JP, Tay, J, Tay, LJ, Tregunna, R, Tudor, E, Udovicich, C, Umez-Eronini, N, Wang, L, Ward, A, Weeratunga, G, Withington, J, Wong, C, Wozniak, S, Yassaie, O, and Young, M
- Abstract
OBJECTIVES: To assess the relationship of white blood cell count (WBC) and other routinely collected inflammatory and clinical markers including stone size, stone position, and medical expulsive therapy use (MET), with spontaneous stone passage (SSP) in a large contemporary cohort of patients with acute ureteric colic, as there are conflicting data on the role of WBC and other inflammatory markers in SSP in patients with acute ureteric colic. PATIENTS AND METHODS: Multicentre retrospective cohort study coordinated by the British Urology Researchers in Surgical Training (BURST) Research Collaborative at 71 secondary care hospitals across four countries (UK, Republic of Ireland, Australia, and New Zealand). In all, 4170 patients presented with acute ureteric colic and a computed tomography confirmed single ureteric stone. Our primary outcome measure was SSP, as defined by the absence of need for intervention to assist stone passage (SP). Multivariable mixed effects logistic regression was used to explore the relationship between key patient factors and SSP. RESULTS: In all, 2518 patients were discharged with conservative management and had further follow-up with a SSP rate of 74% (n = 1874/2518). Sepsis after discharge with conservative management was reported in 0.6% (n = 16/2518). On multivariable analysis neither WBC, neutrophils count, nor C-reactive protein (CRP) predicted SSP, with an adjusted odds ratio (OR) of 0.97 (95% confidence interval [CI] 0.91-1.04, P = 0.38), 1.06 (95% CI 0.99-1.13, P = 0.1) and 1.00 (95% CI 0.99-1.00, P = 0.17), respectively. MET also did not predict SSP (adjusted OR 1.11, 95% CI 0.76-1.61). However, stone size and stone position were significant predictors. SSP for stones <5 mm was 89% (95% CI 87-90) compared to 49% (95% CI 44-53) for stones ≥5-7 mm, and 29% (95% CI 23-36) for stones >7 mm. For stones in the upper ureter the SSP rate was 52% (95% CI 48-56), middle ureter was 70% (95% CI 64-76), and lower ureter was 83% (95% CI 81-85).
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- 2019
6. 637 - Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP) in patients presenting with acute ureteric colic: Results from the MIMIC study
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Shah, T.T., Gao, C., O’Keefe, A., Manning, T., Peacocke, A., Cashman, S., Nambiar, A., Ben, L., Cumberbatch, M., Ivin, N., Maw, J., Ali Abdaal, C., Al Hayek, S., Christidis, D., Bolton, D., Lawrentschuk, N., Khan, S., Demirel, S., Graham, S., Lee, J.C.M., Evans, S., Koschel, S., Badgery, H., Wang, L., Nzenza, T., Ruljancich, P., Begum, R., Hamad, S., Shetty, A., Swallow, D., Morrow, J., Curry, D., Young, M., Abboudi, H., Jalil, R., Dasgupta, R., Cameron, F., Shingles, C., Ho, C., Parwaiz, I., Henderson, J., Mackenzie, K., Reid, K., Umez-Eronini, N., Assaf, N., Oyekan, A., Sriprasad, S., Hayat, Z., Morrison-Jones, V., Steen, C., Alberto, M., Rujancich, P., Laird, A., Sharma, A., Phipps, S., Harris, A., Rogers, A., Ngweso, S., Nyandoro, M., Hayne, D., Hendry, J., Kerr, L., Mcilhenny, C., Rodger, F., Docherty, E., Ng, A., Seaward, L., Eldred-Evans, D., Bultitude, M., Abdelmoteleb, H., Hawary, A., Tregunna, R., Ibrahim, H., Mc Grath, S., O’Brien, J., Campbell, A., Cronbach, P., Bdesha, A., Suraparaj, L., Gupta, S., Tait, C., Sakthivel, A., Pankhania, R., Al-Qassim, Z., Rezacova, M., Edison, E., Sandhu, S., Foley, R., Akintimehin, A., Khan, A., Nkwam, N., Grice, P., Khan, M., Kashora, F., Manson-Bahr, D., Mc Cauley, N., Nehikhare, Y., Bycroft, J., Tailor, K., Saleemi, A., Al-Dhahir, W., Abu Yousif, M., O’Rourke, J., Chin, A.O.L., Pearce, I., Olivier, J., Tay, J., Cannon, A., Akman, J., Hussain, Z., Coode-Bate, J., Natarajan, M., Irving, S., Murtagh, K., Carrie, A., Miller, M., Malki, M., Burge, F., Ratan, H., Bedi, N., Kavia, R., Stonier, T., Simson, N., Singh, H., Hatem, E., Arya, M., Sadien, I., Miakhil, I., Sharma, S., Olaniyi, P., Stammeijer, R., Mason, H., Symes, A., Lavan, L., Rowbotham, C., Wong, C., Al-Shakhshir, S., Belal, M., Mc Kay, A.C., Graham, J., Simmons, L., Khadouri, S., Withington, J., Ajayi, L., Tay, L.J., Ward, A., Parys, B., Liew, M., Simpson, R., Ross, D., Adams, R., Mirza, A.B., Acher, P., Gallagher, M., Premakumar, Y., Ager, M., Ayres, B., Pang, K., Patterson, J., Kozan, A.A., Jaffer, A., Din, W., Biyani, C.S., Tam, J.P., Tudor, E., Probert, J.L., Matanhelia, M., Hegazy, M., Quinlan, D., Ness, D., Gowardhan, B., Bateman, K., Wozniak, S., Ellis, G., Smith, D., Derbyshire, L., Chow, K., Mosey, R., Osman, B., Kynaston, H., Clements, J., Hann, G., Gray, S., Yassaie, O., Weeratunga, G., Udovichich, C., Mbuvi, J., Stewart, H., Samsudin, A., Hughes-Hallet, A., Kum, F., Symes, R., Frymann, R., Chappell, B., Rezvani, S., Ahmed, I., Shergill, I., Lee, S., Hussain, A., Pickard, R., Erotocritou, P., and Kasivisvanathan, V.
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- 2018
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7. Optimum number of core biopsies for accurate assessment of histological grade in breast cancer
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McIlhenny, C., Doughty, J. C., George, W. D., and Mallon, E. A.
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- 2002
8. Management of aortic aneurysm in the presence of a horseshoe kidney (Br J Surg 2001; 88: 500-9)
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McIlhenny, C. and Scott, R. N.
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- 2001
9. Foundation Year 1 doctors’ experience and confidence in catheterisation: A multicentre survey
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Grimes, NG, primary, Leask, J, additional, McKay, AC, additional, and McIlhenny, C, additional
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- 2019
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10. Construct and criterion validity testing of the Non-Technical Skills for Surgeons (NOTSS) behaviour assessment tool using videos of simulated operations
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Yule, S, primary, Gupta, A, additional, Gazarian, D, additional, Geraghty, A, additional, Smink, D S, additional, Beard, J, additional, Sundt, T, additional, Youngson, G, additional, McIlhenny, C, additional, and Paterson-Brown, S, additional
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- 2018
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11. Quality of life and satisfaction in a virtual stone clinic: A pilot study
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Hendry, J., primary, Kerr, L., additional, and Mcilhenny, C., additional
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- 2018
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12. Development and validation of the non-technical skills for urological surgeons (NoTSUS) ureteroscopy scenario curriculum
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Aydin, A., primary, Brunckhorst, O., additional, Raison, N., additional, Brewin, J., additional, Mcilhenny, C., additional, Al-Jabir, A., additional, Aya, H., additional, Dar, F., additional, Iqbal, M., additional, Lovegrove, C., additional, Shabbir, M., additional, Brouwers, T., additional, Palou Redorta, J., additional, Khan, M., additional, Dasgupta, P., additional, and Ahmed, K., additional
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- 2018
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13. Cognitive training for technical and non-technical skills in robotic surgery: A randomised controlled trial
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Raison, N., primary, Ahmed, K., additional, Abe, T., additional, Brunckhorst, O., additional, Novara, G., additional, Buffi, N., additional, Mcilhenny, C., additional, Van Der Poel, H., additional, Van Hemelrijck, M., additional, Gavazzi, A., additional, and Dasgupta, P., additional
- Published
- 2018
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14. Medically expulsive therapy (MET) has no benefit in improving spontaneous stone passage (SSP) in patients presenting with acute ureteric colic: Results from the MIMIC study
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Shah, T.T., primary, Gao, C., additional, O’Keefe, A., additional, Manning, T., additional, Peacocke, A., additional, Cashman, S., additional, Nambiar, A., additional, Ben, L., additional, Cumberbatch, M., additional, Ivin, N., additional, Maw, J., additional, Ali Abdaal, C., additional, Al Hayek, S., additional, Christidis, D., additional, Bolton, D., additional, Lawrentschuk, N., additional, Khan, S., additional, Demirel, S., additional, Graham, S., additional, Lee, J.C.M., additional, Evans, S., additional, Koschel, S., additional, Badgery, H., additional, Wang, L., additional, Nzenza, T., additional, Ruljancich, P., additional, Begum, R., additional, Hamad, S., additional, Shetty, A., additional, Swallow, D., additional, Morrow, J., additional, Curry, D., additional, Young, M., additional, Abboudi, H., additional, Jalil, R., additional, Dasgupta, R., additional, Cameron, F., additional, Shingles, C., additional, Ho, C., additional, Parwaiz, I., additional, Henderson, J., additional, Mackenzie, K., additional, Reid, K., additional, Umez-Eronini, N., additional, Assaf, N., additional, Oyekan, A., additional, Sriprasad, S., additional, Hayat, Z., additional, Morrison-Jones, V., additional, Steen, C., additional, Alberto, M., additional, Rujancich, P., additional, Laird, A., additional, Sharma, A., additional, Phipps, S., additional, Harris, A., additional, Rogers, A., additional, Ngweso, S., additional, Nyandoro, M., additional, Hayne, D., additional, Hendry, J., additional, Kerr, L., additional, Mcilhenny, C., additional, Rodger, F., additional, Docherty, E., additional, Ng, A., additional, Seaward, L., additional, Eldred-Evans, D., additional, Bultitude, M., additional, Abdelmoteleb, H., additional, Hawary, A., additional, Tregunna, R., additional, Ibrahim, H., additional, Mc Grath, S., additional, O’Brien, J., additional, Campbell, A., additional, Cronbach, P., additional, Bdesha, A., additional, Suraparaj, L., additional, Gupta, S., additional, Tait, C., additional, Sakthivel, A., additional, Pankhania, R., additional, Al-Qassim, Z., additional, Rezacova, M., additional, Edison, E., additional, Sandhu, S., additional, Foley, R., additional, Akintimehin, A., additional, Khan, A., additional, Nkwam, N., additional, Grice, P., additional, Khan, M., additional, Kashora, F., additional, Manson-Bahr, D., additional, Mc Cauley, N., additional, Nehikhare, Y., additional, Bycroft, J., additional, Tailor, K., additional, Saleemi, A., additional, Al-Dhahir, W., additional, Abu Yousif, M., additional, O’Rourke, J., additional, Chin, A.O.L., additional, Pearce, I., additional, Olivier, J., additional, Tay, J., additional, Cannon, A., additional, Akman, J., additional, Hussain, Z., additional, Coode-Bate, J., additional, Natarajan, M., additional, Irving, S., additional, Murtagh, K., additional, Carrie, A., additional, Miller, M., additional, Malki, M., additional, Burge, F., additional, Ratan, H., additional, Bedi, N., additional, Kavia, R., additional, Stonier, T., additional, Simson, N., additional, Singh, H., additional, Hatem, E., additional, Arya, M., additional, Sadien, I., additional, Miakhil, I., additional, Sharma, S., additional, Olaniyi, P., additional, Stammeijer, R., additional, Mason, H., additional, Symes, A., additional, Lavan, L., additional, Rowbotham, C., additional, Wong, C., additional, Al-Shakhshir, S., additional, Belal, M., additional, Mc Kay, A.C., additional, Graham, J., additional, Simmons, L., additional, Khadouri, S., additional, Withington, J., additional, Ajayi, L., additional, Tay, L.J., additional, Ward, A., additional, Parys, B., additional, Liew, M., additional, Simpson, R., additional, Ross, D., additional, Adams, R., additional, Mirza, A.B., additional, Acher, P., additional, Gallagher, M., additional, Premakumar, Y., additional, Ager, M., additional, Ayres, B., additional, Pang, K., additional, Patterson, J., additional, Kozan, A.A., additional, Jaffer, A., additional, Din, W., additional, Biyani, C.S., additional, Tam, J.P., additional, Tudor, E., additional, Probert, J.L., additional, Matanhelia, M., additional, Hegazy, M., additional, Quinlan, D., additional, Ness, D., additional, Gowardhan, B., additional, Bateman, K., additional, Wozniak, S., additional, Ellis, G., additional, Smith, D., additional, Derbyshire, L., additional, Chow, K., additional, Mosey, R., additional, Osman, B., additional, Kynaston, H., additional, Clements, J., additional, Hann, G., additional, Gray, S., additional, Yassaie, O., additional, Weeratunga, G., additional, Udovichich, C., additional, Mbuvi, J., additional, Stewart, H., additional, Samsudin, A., additional, Hughes-Hallet, A., additional, Kum, F., additional, Symes, R., additional, Frymann, R., additional, Chappell, B., additional, Rezvani, S., additional, Ahmed, I., additional, Shergill, I., additional, Lee, S., additional, Hussain, A., additional, Pickard, R., additional, Erotocritou, P., additional, and Kasivisvanathan, V., additional
- Published
- 2018
- Full Text
- View/download PDF
15. PT199 - Validity assessment of the Non-Technical Skills for Urological Surgeons (NoTSUS) curriculum and assessment scale
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Aydin, A., Griffin, C., Brunckhorst, O., Mcilhenny, C., Brewin, J., Raison, N., Al-Jabir, A., Shabbir, M., Palou Redorta, J., Khan, M.S., Dasgupta, P., and Ahmed, K.
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- 2020
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16. Validation of the European SIMULATE ureterorenoscopy training curriculum
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Aydin, A., primary, Ahmed, K., additional, Abe, T., additional, Raison, N., additional, Kunit, T., additional, Brunckhorst, O., additional, Ross, T., additional, Wood, T., additional, Al-Jabir, A., additional, Iqbal, M., additional, Aya, H., additional, Brewin, J., additional, McIlhenny, C., additional, McCabe, J., additional, Rukin, N., additional, Patterson, J., additional, Marsh, H., additional, Dasgupta, R., additional, Samsuddin, A., additional, Khan, A., additional, Sievert, K.-D., additional, Khan, M.S., additional, and Dasgupta, P., additional
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- 2017
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17. Training tools for non-technical skills in robotic surgery
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Wood, T., primary, Raison, N., additional, Haldar, S., additional, Brunckhorst, O., additional, Mcilhenny, C., additional, Dasgupta, P., additional, and Ahmed, K., additional
- Published
- 2016
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18. Development and validation of a tool for training and assessment of non-technical skills in robot assisted surgery
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Wood, T., primary, Raison, N., additional, Brunckhorst, O., additional, Ross, T., additional, Wallace, L., additional, Challacombe, B., additional, Callaghan, C., additional, Thurairaja, R., additional, Catterwell, R., additional, Kessaris, N., additional, Khan, S., additional, Loukopoulos, I., additional, Van Rij, S., additional, Blecher, G., additional, Wong, K., additional, Van Der Poel, H., additional, Buffi, N., additional, Murphy, D., additional, Gavazzi, A., additional, Mcilhenny, C., additional, Dasgupta, P., additional, and Ahmed, K., additional
- Published
- 2016
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19. Patient safety attitudes in core surgical trainees
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Geraghty, A., primary, Renwick, A., additional, Yalamarthi, S., additional, and McIlhenny, C., additional
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- 2015
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20. PT047 - Quality of life and satisfaction in a virtual stone clinic: A pilot study
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Hendry, J., Kerr, L., and Mcilhenny, C.
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- 2018
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21. 477 - Cognitive training for technical and non-technical skills in robotic surgery: A randomised controlled trial
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Raison, N., Ahmed, K., Abe, T., Brunckhorst, O., Novara, G., Buffi, N., Mcilhenny, C., Van Der Poel, H., Van Hemelrijck, M., Gavazzi, A., and Dasgupta, P.
- Published
- 2018
- Full Text
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22. 470 - Development and validation of the non-technical skills for urological surgeons (NoTSUS) ureteroscopy scenario curriculum
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Aydin, A., Brunckhorst, O., Raison, N., Brewin, J., Mcilhenny, C., Al-Jabir, A., Aya, H., Dar, F., Iqbal, M., Lovegrove, C., Shabbir, M., Brouwers, T., Palou Redorta, J., Khan, M., Dasgupta, P., and Ahmed, K.
- Published
- 2018
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23. 489 Combining technical and non-technical skills training within a simulation-based ureteroscopy curriculum – a randomised controlled trial
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Brunckhorst, O., primary, Shahid, S., additional, Aydin, A., additional, Mcilhenny, C., additional, Khan, S., additional, Raza, S.J., additional, Sahai, A., additional, Brewin, J., additional, Bello, F., additional, Kneebone, R., additional, Khan, M.S., additional, Dasgupta, P., additional, and Ahmed, K., additional
- Published
- 2015
- Full Text
- View/download PDF
24. 723 - Validation of the European SIMULATE ureterorenoscopy training curriculum
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Aydin, A., Ahmed, K., Abe, T., Raison, N., Kunit, T., Brunckhorst, O., Ross, T., Wood, T., Al-Jabir, A., Iqbal, M., Aya, H., Brewin, J., McIlhenny, C., McCabe, J., Rukin, N., Patterson, J., Marsh, H., Dasgupta, R., Samsuddin, A., Khan, A., Sievert, K.-D., Khan, M.S., and Dasgupta, P.
- Published
- 2017
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25. 1021 Factors determining the feasibility of day-case upper tract endoscopy: A prospective study
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Malki, M., primary and McIlhenny, C., additional
- Published
- 2014
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26. PJY04 - Development and validation of a tool for training and assessment of non-technical skills in robot assisted surgery
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Wood, T., Raison, N., Brunckhorst, O., Ross, T., Wallace, L., Challacombe, B., Callaghan, C., Thurairaja, R., Catterwell, R., Kessaris, N., Khan, S., Loukopoulos, I., Van Rij, S., Blecher, G., Wong, K., Van Der Poel, H., Buffi, N., Murphy, D., Gavazzi, A., Mcilhenny, C., Dasgupta, P., and Ahmed, K.
- Published
- 2016
- Full Text
- View/download PDF
27. PJY05 - Training tools for non-technical skills in robotic surgery
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Wood, T., Raison, N., Haldar, S., Brunckhorst, O., Mcilhenny, C., Dasgupta, P., and Ahmed, K.
- Published
- 2016
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28. E57 Predictive factors for readmission following flexible and semirigid ureteroscopy
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Malki, M., primary and Mcilhenny, C., additional
- Published
- 2013
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29. Evidence-based management of upper tract urolithiasis in the spinal cord-injured patient
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Ramsey, S, primary and McIlhenny, C, additional
- Published
- 2011
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30. Chronic pelvic pain syndrome — How well do we manage it?
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McIlhenny, C, primary and Jones, G.J, additional
- Published
- 2003
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31. Abdominal Aortic Aneurysm in Association with Horseshoe Kidney
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McIlhenny, C., primary and Scott, R.N., additional
- Published
- 2002
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32. A comparison of serum and plasma levels of vascular endothelial growth factor during the menstrual cycle in healthy female volunteers
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McIlhenny, C, primary, George, W D, additional, and Doughty, J C, additional
- Published
- 2002
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33. Letter 2
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McIlhenny, C, primary and Scott, R N, additional
- Published
- 2001
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34. A breast complication of intravenous drug abuse
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McIlhenny, C., primary, George, W.D., additional, and Doughty, J.C., additional
- Published
- 2000
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35. Standard setting in an objective structured clinical examination: use of global ratings of borderline performance to determine the passing score.
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Mcilhenny C and Orr G
- Published
- 2002
36. Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale.
- Author
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Aydın A, Griffin CM, Brunckhorst O, Al-Jabir A, Raison N, Aya H, McIlhenny C, Brewin J, Shabbir M, Palou Redorta J, Khan MS, Dasgupta P, and Ahmed K
- Subjects
- Longitudinal Studies, Simulation Training, Clinical Competence, Curriculum, Urology education
- Abstract
Objective: In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale., Methods: This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed., Results: 62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability., Conclusions: The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.
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- 2021
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37. Incidence of Wrong-Site Surgery List Errors for a 2-Year Period in a Single National Health Service Board.
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Geraghty A, Ferguson L, McIlhenny C, and Bowie P
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- Female, Humans, Incidence, Male, State Medicine, Time Factors, Medical Errors statistics & numerical data
- Abstract
Introduction: Wrong-site/side surgical "never events" continue to cause considerable harm to patients, healthcare professionals, and organizations within the United Kingdom. Incidence has remained static despite the mandatory introduction of surgical checklists. Operating theater list errors have been identified as a regular contributor to these never events. The aims of the study were to identify and to learn from the incidence of wrong-site/side list errors in a single National Health Service board., Methods: The study was conducted in a single National Health Service board serving a population of approximately 300,000. All theater teams systematically recorded errors identified at the morning theater brief or checklist pause as part of a board-wide quality improvement project. Data were reviewed for a 2-year period from May 2013 to April 2015, and all episodes of wrong-site/side list errors were identified for analysis., Results: No episodes of wrong-site/side surgery were recorded for the study period. A total of 86 wrong-site/side list errors were identified in 29,480 cases (0.29%). There was considerable variation in incidence between surgical specialties with ophthalmology recording the largest proportion of errors per number of surgical cases performed (1 in 87 cases) and gynecology recording the smallest proportion (1 in 2671 cases). The commonest errors to occur were "wrong-side" list errors (62/86, 72.1%)., Discussion: This is the first study to identify incidence of wrong-site/site list errors in the United Kingdom. Reducing list errors should form part of a wider risk reduction strategy to reduce wrong-site/side never events. Human factors barrier management analysis may help identify the most effective checks and controls to reduce list errors incidence, whereas resilience engineering approaches should help develop understanding of how to best capture and neutralize errors.
- Published
- 2020
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38. Raising awareness of non-technical skills in operating theatres.
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Paterson-Brown S, Youngson G, McIlhenny C, Maran N, Flin R, and Yule S
- Subjects
- Awareness, Operating Rooms, Surgeons
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2019
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39. Cognitive training for technical and non-technical skills in robotic surgery: a randomised controlled trial.
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Raison N, Ahmed K, Abe T, Brunckhorst O, Novara G, Buffi N, McIlhenny C, van der Poel H, van Hemelrijck M, Gavazzi A, and Dasgupta P
- Subjects
- Anastomosis, Surgical standards, Cognition, Education, Medical, Continuing, Educational Measurement, Humans, Minimally Invasive Surgical Procedures standards, Program Evaluation, Reproducibility of Results, Robotic Surgical Procedures standards, Task Performance and Analysis, Anastomosis, Surgical education, Clinical Competence, Computer Simulation, Minimally Invasive Surgical Procedures education, Robotic Surgical Procedures education, Surgeons education
- Abstract
Objective: To investigate the effectiveness of motor imagery (MI) for technical skill and non-technical skill (NTS) training in minimally invasive surgery (MIS)., Subjects and Methods: A single-blind, parallel-group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non-Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ)., Results: In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04)., Conclusions: Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found., (© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.)
- Published
- 2018
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40. Simulation in urology to train non-technical skills in ward rounds.
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Somasundram K, Spence H, Colquhoun AJ, Mcilhenny C, Biyani CS, and Jain S
- Subjects
- Communication, Decision Making, Educational Measurement, Group Processes, Humans, Internship and Residency, Leadership, Patient Care Team, Problem-Based Learning, Qualitative Research, Urology standards, Clinical Competence standards, Simulation Training, Urology education
- Abstract
Objective: To report our experience of an exercise designed to train newly appointed urology trainees in non-technical skills on ward rounds as a part of a simulation 'boot camp', through a qualitative analysis of participant feedback on the utility of this method of training., Patients and Methods: The simulations took place in a high-fidelity simulated ward bay. Forty-eight doctors with formal urology training ranging between 2 and 60 months (mean 19.1 ± 11.6 months) took part. Thirty-one participants were on a formal urology specialty training pathway. The remaining participants were core (pre-specialty) surgical trainees. The entry requirement was that participants must be junior-level urologists, ideally at the beginning of specialty training. Participants individually led a simulated ward round, which was devised using actors to play patients and a simulated 'switchboard' for telephone conversations. Distractions were introduced deliberately for participants to manage an emergent urology-related scenario. 'Freeze-frames' were used to 'pause' the ward round, whereby observing consultants provided feedback on performance. After the simulated exercises, a whole-group structured debriefing took place. Non-Technical Skills for Surgeons (NOTSS) scores were generated for participants by seven consultant urologists. Participants completed a two-part feedback form. Part one involved nine questions scored on a Likert scale, and part two required free-text responses., Results: The mean (±sd) itemized NOTSS scores for situational awareness, decision-making, communication and teamwork, and leadership were 3.01 (±0.15), 2.95 (±0.16), 3.05 (±0.19), and 2.98 (±0.15), respectively. From the thematic analysis, participants commented positively on the number of scenarios per participant, the use of actors as patients and real staff, and the use of freeze-frames for immediate feedback. Residents also provided suggestions for distractions to be considered in the future., Conclusions: This simulated ward round was generally well received by participants, and the obtained feedback provides an insight into how this can be adapted to maximize the benefits for new specialty residents. The mean NOTSS scores indicated that non-technical skills performances could be improved. This supports our rationale to train non-technical skills in a safe environment to bolster career transition into positions of greater decision-making autonomy., (© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.)
- Published
- 2018
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41. General surgery education across three continents.
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McIlhenny C, Kurashima Y, Chan C, Hirano S, Domínguez-Rosado I, and Stefanidis D
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- Competency-Based Education trends, Education, Medical, Graduate trends, General Surgery trends, Humans, Japan, Mexico, United Kingdom, United States, Competency-Based Education methods, Education, Medical, Graduate methods, General Surgery education
- Abstract
Surgical education has seen tremendous changes in the US over the past decade. The Halstedian training model of see one, do one, teach one that governed surgical training for almost 100 years has been replaced by the achievement of the ACGME competencies, milestones, entrustable professional activities (EPAs), and acquisition of surgical skill outside the operating room on simulators. Several of these changes in American medical education have been influenced by educators and training paradigms abroad. In this paper, we review the training paradigms for surgeons in the UK, Japan, and Mexico to allow comparisons with the US training paradigm and promote the exchange of ideas., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
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- View/download PDF
42. Development and validation of a tool for non-technical skills evaluation in robotic surgery-the ICARS system.
- Author
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Raison N, Wood T, Brunckhorst O, Abe T, Ross T, Challacombe B, Khan MS, Novara G, Buffi N, Van Der Poel H, McIlhenny C, Dasgupta P, and Ahmed K
- Subjects
- Curriculum, Educational Measurement, Humans, Operating Rooms, Program Evaluation, Robotic Surgical Procedures standards, Video Recording, Clinical Competence standards, Robotic Surgical Procedures education, Surgeons education
- Abstract
Background: Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery., Methods: A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons. Using a Delphi methodology, a panel of 16 expert surgeons was consulted to identify behaviours important to NTS assessment. These behaviours were organised into an appropriate assessment template. Experts were consulted on the feasibility, applicability and educational impact of ICARS. An observational trial was used to validate ICARS. 73 novice, intermediate and expert robotic surgeons completed a urethrovesical anastomosis within a simulated operating room. NTS were tested using four scripted scenarios of increasing difficulty. Performances were video recorded. Robotic and NTS experts assessed the videos post hoc using ICARS and the standard behavioural rating system, NOn-Technical Skills for Surgeons (NOTSS)., Results: 28 key non-technical behaviours were identified by the expert panel. The finalised behavioural rating system was organised into four principle domains and seven categories. Expert opinion strongly supported its implementation. ICARS was found to be equivalent to NOTSS on Bland-Altman analysis and accurately differentiated between novice, intermediate and expert participants, p = 0.01. Moderate agreement was found between raters, Krippendorff's alpha = 0.4. The internal structure of ICARS was shown to be consistent and reliable (median Cronbach alpha = 0.92, range 0.85-0.94)., Conclusion: ICARS is the first NTS behavioural rating system developed for robotic surgery. Initial validation has shown it to be an effective and reliable tool. Implementation of ICARS will supported structured training and assessment of NTS within the robotic surgical curriculum.
- Published
- 2017
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43. Outcomes of Ureterorenoscopic Stone Treatment in 301 Patients with a Solitary Kidney.
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Legemate JD, Marchant F, Bouzouita A, Li S, McIlhenny C, Miller NL, Saita A, and de la Rosette JJ
- Abstract
Objectives: To determine the stone-free rates and intra- and postoperative complication rates and grades of ureterorenoscopic stone treatment in patients with a solitary kidney. Methods: This study is a subanalysis of the Clinical Research Office of the Endourological Society (CROES) ureterorenoscopy (URS) study, which is a prospective international multicenter observational study. Over a 1-year period, consecutive patients treated with ureterorenoscopy for urinary stones were included. Patients entered in this analysis were those with a solitary functioning kidney. Descriptive data on patient characteristics, stone-free rates, complication rates, and grades were evaluated for three separate groups: patients treated with ureteroscopy for ureteral stones, for renal stones, and a combination of renal and ureteral stones. Results: A total of 301 patients were treated for stones in a solitary kidney; 219 were treated for ureteral stones. In this group, the stone-free rate was 88.6%, with an intraoperative complication rate of 7.4% and postoperative complication rate of 4.1%. Totally, 57 patients were treated for renal stones. In this group, the stone-free rate was 56.4%, with an intraoperative complication rate of 7.0% and postoperative complication rate of 10.5%. There were 25 patients who were treated for renal stones in combination with ureter stones. In this group, the stone-free rate was 60.0%, with an intraoperative complication rate of 12.0% and postoperative complication rate of 10.5%. Within the three groups, 72% of the postoperative complications were classified as Clavien I and II. Conclusions: Ureteroscopy is an effective and safe treatment modality for the removal of ureteral and renal stones in patients with a solitary kidney. Stone location as well as total stone burden seems to be important factors influencing the ability to render patients stone free. Moreover, single session ureteroscopic stone removal was less effective for the treatment of larger renal stones or renal stones in combination with ureteral stones.
- Published
- 2017
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44. Training Tools for Nontechnical Skills for Surgeons-A Systematic Review.
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Wood TC, Raison N, Haldar S, Brunckhorst O, McIlhenny C, Dasgupta P, and Ahmed K
- Subjects
- Curriculum, Education, Medical, Graduate, Educational Measurement, Humans, Clinical Competence, Surgeons education
- Abstract
Objective: Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools., Design: A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria., Setting: Systematic review was performed fully at King's College London., Results: A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question., Conclusions: Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program., (Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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45. Analysis of Factors' Association with Risk of Postoperative Urosepsis in Patients Undergoing Ureteroscopy for Treatment of Stone Disease.
- Author
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Blackmur JP, Maitra NU, Marri RR, Housami F, Malki M, and McIlhenny C
- Subjects
- Adult, Aged, Anti-Bacterial Agents therapeutic use, Female, Humans, Length of Stay statistics & numerical data, Logistic Models, Male, Matched-Pair Analysis, Middle Aged, Postoperative Period, Risk Factors, Stents statistics & numerical data, Urinary Tract Infections drug therapy, Urinary Tract Infections microbiology, Urine microbiology, Kidney Calculi surgery, Postoperative Complications etiology, Sepsis etiology, Ureteroscopy adverse effects, Urinary Tract Infections etiology
- Abstract
Introduction: To investigate which patient, stone, infective, and surgical factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation for ureteral or renal stones., Methods: Data were collected prospectively in a single National Health Service institution. A logistic regression model was used to assess the association of factors with postoperative urosepsis. Two matched-pair analyses were used to assess the risk of postoperative urosepsis in patients with (a) an emergency presentation to hospital with urosepsis in the 90 days preceding URS and (b) a positive midstream sample of urine (MSSU) identified, but who were asymptomatic at preoperative assessment, who then received an appropriate course of antibiotics., Results: Four hundred sixty-two consecutive patients were included in the study. Thirty-four patients (7.4%) had an episode of urosepsis within 28 days of their operation. A positive preoperative MSSU was significantly associated with postoperative urosepsis on multivariable analysis, despite appropriate treatment with a preoperative course of antibiotics: odds ratio (OR) 4.88, 95% confidence interval (CI) 2.11, 11.31, p < 0.001. The presence of diabetes mellitus, presence of ischemic heart disease, patient American Society of Anesthesiologists score, same-session bilateral URS, and stone volume were the other variables significantly associated with postoperative infection on univariable analysis, but these ceased to be significantly associated on multivariable analysis. Subgroup analysis found that a positive MSSU in both patients with a preoperative ureteral stent and those without was significantly associated with postoperative urosepsis, however, the OR was much lower for the stented group (OR 3.23 vs OR 16.67). On matched-pair analysis, patients with a positive preoperative MSSU were significantly more likely to have postoperative urosepsis compared to controls (OR 17.46, 95% CI 2.18, 139.80, p = 0.007). There was no significant difference in the OR of postoperative urosepsis in patients who had a preceding urine infection requiring hospital admission in the 90 days preceding URS (OR 0.60, 95% CI 0.19, 1.92, p = 0.39)., Conclusions: Positive preoperative MSSU was significantly associated with postoperative urosepsis by logistic regression and matched-pair analysis. These higher risk patients should be counseled appropriately before surgery, and should be the focus of vigilant postoperative monitoring. The study suggests particular caution in patients with a positive preoperative MSSU without a preoperative ureteral stent.
- Published
- 2016
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- View/download PDF
46. Human factor skills in the surgical environment.
- Author
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Geraghty A and McIlhenny C
- Subjects
- Communication, Decision Making, Humans, Leadership, Patient Care Team, Medical Errors prevention & control, Surgical Procedures, Operative methods
- Published
- 2016
- Full Text
- View/download PDF
47. Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial.
- Author
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Brunckhorst O, Shahid S, Aydin A, McIlhenny C, Khan S, Raza SJ, Sahai A, Brewin J, Bello F, Kneebone R, Khan MS, Dasgupta P, and Ahmed K
- Subjects
- Adult, Clinical Competence, Cohort Studies, Curriculum, Educational Measurement, Female, Humans, Male, Surveys and Questionnaires, Young Adult, Education, Medical, Continuing methods, Simulation Training methods, Ureteroscopy education
- Abstract
Background: Current training modalities within ureteroscopy have been extensively validated and must now be integrated within a comprehensive curriculum. Additionally, non-technical skills often cause surgical error and little research has been conducted to combine this with technical skills teaching. This study therefore aimed to develop and validate a curriculum for semi-rigid ureteroscopy, integrating both technical and non-technical skills teaching within the programme., Methods: Delphi methodology was utilised for curriculum development and content validation, with a randomised trial then conducted (n = 32) for curriculum evaluation. The developed curriculum consisted of four modules; initially developing basic technical skills and subsequently integrating non-technical skills teaching. Sixteen participants underwent the simulation-based curriculum and were subsequently assessed, together with the control cohort (n = 16) within a full immersion environment. Both technical (Time to completion, OSATS and a task specific checklist) and non-technical (NOTSS) outcome measures were recorded with parametric and non-parametric analyses used depending on the distribution of our data as evaluated by a Shapiro-Wilk test., Results: Improvements within the intervention cohort demonstrated educational value across all technical and non-technical parameters recorded, including time to completion (p < 0.01), OSATS scores (p < 0.001), task specific checklist scores (p = 0.011) and NOTSS scores (p < 0.001). Content validity, feasibility and acceptability were all demonstrated through curriculum development and post-study questionnaire results., Conclusions: The current developed curriculum demonstrates that integrating both technical and non-technical skills teaching is both educationally valuable and feasible. Additionally, the curriculum offers a validated simulation-based training modality within ureteroscopy and a framework for the development of other simulation-based programmes.
- Published
- 2015
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48. The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment.
- Author
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Brunckhorst O, Shahid S, Aydin A, Khan S, McIlhenny C, Brewin J, Sahai A, Bello F, Kneebone R, Shamim Khan M, Dasgupta P, and Ahmed K
- Subjects
- Communication, Curriculum, Decision Making, Educational Measurement, Humans, Leadership, London, Patient Care Team, Prospective Studies, Clinical Competence, Simulation Training methods, Ureteroscopy education
- Abstract
Objective: Little integration of technical and nontechnical skills (e.g., situational awareness, communication, decision making, teamwork, and leadership) teaching exists within surgery. We therefore aimed to (1) evaluate the relationship between these 2 skill sets within a simulation-based environment and (2) assess if certain nontechnical skill components are of particular relevance to technical performance., Design: A prospective analysis of data acquired from a comparative study of simulation vs nonsimulation training was conducted. Half of the participants underwent training of technical and nontechnical skills within ureteroscopy, with the remaining half undergoing no training. All were assessed within a full immersion environment against both technical (time to completion, Objective Structured Assessment of Technical Skills, and task-specific checklist scores) and nontechnical parameters (Nontechnical Skills for Surgeons [NOTSS] rating scale). The data of whole and individual cohorts were analyzed using Pearson correlation coefficient., Setting: The trial took place within the Simulation and Interactive Learning Centre at Guy's Hospital, London, UK., Participants: In total, 32 novice participants with no prior practical ureteroscopy experience were included within the data analysis., Results: A correlation was found within all outcome measures analyzed. For the whole cohort, a strong negative correlation was found between time to completion and NOTSS scores (r = -0.75, p < 0.001), with strong positive correlations identified when NOTSS scores were compared with Objective Structured Assessment of Technical Skills (r = 0.89, p < 0.001) and task-specific checklist scores (r = 0.91, p < 0.001). Similar results were observed when each cohort was analyzed separately. Finally, all individual nontechnical skill components demonstrated a strong correlation with all technical skill parameters, regardless of training., Conclusions: A strong correlation between technical and nontechnical performance exists, which was demonstrated to be irrespective of training received. This may suggest an inherent link between skill sets. Furthermore, all nontechnical skill sets are important in technical performance. This supports the notion that both of these skills should be trained and assessed together within 1 curriculum., (Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
49. The dilemma of post-ureteroscopy stenting.
- Author
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Hughes B, Wiseman OJ, Thompson T, Masood J, Smith RD, McIlhenny C, Irving S, Dasgupta R, and Bultitude MF
- Subjects
- Device Removal, Female, Humans, Male, Postoperative Care, Practice Guidelines as Topic, Cystoscopy adverse effects, Prosthesis Implantation methods, Stents, Unnecessary Procedures, Ureteral Diseases surgery, Ureteroscopy
- Published
- 2014
- Full Text
- View/download PDF
50. Contralateral renal cell carcinoma ureteric metastases can arise on tyrosine kinase adjuvant therapy and be effectively treated by endoscopic laser excision and ablation.
- Author
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Reid SL, Arestis NJ, McIlhenny C, and Lamb GW
- Abstract
Renal cell carcinoma (RCC) uncommonly metastasizes to the ureter and rarely to the contralateral ureter. We describe the presentation of 2 successive contralateral ureteric metastases from RCC in our institution. The first represents the only reported metachronous ureteric deposit on adjuvant sorafenib after laparoscopic radical nephrectomy for RCC. The other presented with a synchronous lesion after radiological work-up. Both lesions were treated with endoscopic excision and laser ablation with preservation of the renal unit and no local recurrence. We report these cases and discuss the literature.
- Published
- 2014
- Full Text
- View/download PDF
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