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Attitudes to Surgical Trainee-Led Research Collaboratives – ReSurgEnt SurveyA collaboration between the NWRC, SPARCS and the University of Bristol

Questionnaire based study of surgical trainees in the UK

2ReSurgEnt Survey Protocol Version 3

Protocol Version 3

Steering GroupNick Heywood – General Surgical Registrar, University Hospital of South Manchester

Natalie Blencowe – NIHR Clinical Lecturer in Surgery, University of Bristol and SPARCS

Hema Sekhar – General Surgical Registrar and Christie Research Fellow, Northwest Deanery

Athene Lane – Trials and methodology research, University of Bristol

Rachel Foster – Core Surgical Trainee, Northwest Deanery

Clare Clement Qualitative Research & Trials Methodology, University of Bristol

Karen Coulman – Questionnaire and Trials Methodology, University of Bristol

James Glasbey – NIHR Academic Clinical Fellow

Helen Mohan – General Surgical Registrar and President of the Assosciation of Surgeons in Training

Jane Blazeby – Professor of Surgery, University of Bristol


Table of Contents1. Background....................................................................................................................................4

2. Aim................................................................................................................................................5

3. Methods & study design................................................................................................................5

4. Questionnaire - Surgical Trainee Views on Surgical Research Collaboratives................................6


1. Background

After the first of the trainee led surgical research collaboratives was established in 2007, their

number has seen a rapid growth between 2010 and 2015 and are now well established in the UK.

Both regional and national collaboratives encompass various surgical subspecialties with general

surgery the predominant speciality[1]. They provide the opportunity for large-scale multicentre

studies to be performed in a relatively short time-frame, enhancing recruitment and involving

trainees at all grades, from medical student through to senior registrar[2]. Furthermore, a recent

study of 241 general surgical centres in the UK found 99% cumulative participation in trainee

collaborative studies in 2015-16, with an increase from 44% in 2012. This was higher than the 79%

which participated in NIHR studies, and included 15 observational studies and 3 randomised

controlled trials[3].

Despite the success of trainee-led surgical research collaboratives, there are still ongoing discussions

about the recognition of trainee contributions by surgical training committees and the UK

Foundation Programme. Currently, each surgical speciality has its own requirements for gaining the

certificate of completion of training (CCT), often including first author publications, however, there is

no framework in place for recognizing individual contributions to collaborative research. Although,

involvement in research may be mandatory for some CCT’s, collaborative research is not, and, where

there has been widespread involvement in studies, not all trainees have been involved.

Each individual will have their own reasons for participating, and although one may postulate that

this may be for patient benefit or to improve their academic CV, reasons for non-participation are

likely to be speculation. Some trainees may have no involvement, are currently involved, or have

been involved at some stage in the past, but have now left. It is important for the collaborative

networks to understand all these reasons and to identify what encourages participation, and what

inhibits it. Further appreciation of these factors would help to develop a framework for recognition

of the hard work and contribution trainees make to high-quality surgical research studies.


2. AimThe aims of the study are to assess the following:

What factors encourage trainees to get involved in surgical trainee research collaboratives?

What factors discourage trainees from getting involved in surgical trainee research

collaboratives?

Is there a relationship between number of publications and the involvement in surgical

trainee research collaboratives?

Does involvement in surgical trainee research collaboratives differ depending on baseline

demographics?

3. Methods & study designA specially designed questionnaire (Section 4) will be circulated to core and specialist trainees of all

surgical specialties. This will be done by emailing the relevant trainee administrator at each deanery

with a link to the questions which will be hosted on Bristol Online Surveys (BOS)

There are 17 Deaneries, each of which have responsibility for the delivery of surgical training for the

specialities in their region. Each of these specialities, for both core surgical training and higher

surgical training, normally have a designated administrator that looks after the teaching and training

and the distribution of email and training information. It is common to be contacted by trainees

performing research via this mailing list as it does not require sharing of contact information in each

region. No personally identifiable data will be obtained. The contact details of these administrators

are readily available in the public domain and each will receive a deanery and speciality specific

email.

Responses will be collated and analysed using a statistical software package. Information regarding

the number of trainees in each deanery and for each specialty will be requested in order to identify a

response rate. All responses will be anonymised.

Inclusion CriteriaAll trainees currently in surgical specialty training in the UK between Core training year 1 and the

final year of Higher Specialist training.

Exclusion CriteriaAll others

6ReSurgEnt Survey Protocol Version 3Email invitation wording for ReSurgEnT surveyThe following email will be sent out to the email contact for the administrator of each speciality surgical training in each deanery. Speciality will be defined as per email contact.

Dear Programme Administrator,

We would appreciate if you could forward the following email to the trainees in [insert speciality] in

your region. Also, could you please tell us the total number of trainees in [insert speciality] for core

training and higher training.

Thank you

Mr Nick Heywood, Miss Natalie Blencowe, and Professor Jane Blazeby

On Behalf of the ReSurgEnt Survery collaboration

Dear Trainee,

We would appreciate your views on surgical trainee collaborative research through completion of a questionnaire survey, available at the following link: [insert link]. This should take no more than 10 minutes of your time. Participants who complete the survey by [insert date] can choose to be entered into a prize draw to win one of three Love2shop gift vouchers (each £50 value).

Since 2006, surgical trainee research collaboratives have grown across all surgical specialities in the UK and have reached up to 99% of hospital sites. They have provided high quality trainee-led projects including several randomised controlled trials and multiple observational cohort studies. There has been great enthusiasm for collaborative research, however, we are aware that not all trainees have been involved. We are keen to explore the reasons that may have encouraged you to participate (and to what extent) and those that may have discouraged you. Understanding this would provide the collaborative research networks with much needed information about how to improve engagement with trainees and to address concerns and apprehensions.

Thank You

Mr Nick Heywood, Miss Natalie Blencowe, and Professor Jane BlazebyDissemination of resultsResults will be collated with the aim to be presented at the National Research Collaborative Meeting

in late 2017. A manuscript will be prepared with the aim to be published in a peer reviewed journal.

References[1] A. A. B. Jamjoom, P. N. H. Phan, P. J. Hutchinson, and A. G. Kolias, “Surgical trainee research

collaboratives in the UK: an observational study of research activity and publication productivity,” BMJ Open, vol. 6, no. 2, Feb. 2016.

[2] A. Bhangu, A. G. Kolias, T. Pinkney, N. J. Hall, and J. E. Fitzgerald, “Surgical research collaboratives in the UK,” The Lancet, vol. 382, no. 9898. pp. 1091–1092, 2013.

[3] D. Nepogodiev, S. J. Chapman, A. G. Kolias, J. E. Fitzgerald, M. Lee, and N. S. Blencowe, “The effect of trainee research collaboratives in the UK.,” The lancet. Gastroenterology & hepatology, vol. 2, no. 4. Netherlands, pp. 247–248, Apr-2017.


4. Questionnaire - Trainee Views on Surgical Trainee-led Research CollaborativesPlease answer the following questions about yourself and your views on surgical research collaboratives. For most answers, check the box(es) most applicable to you or fill in the blanks.

About You1. Your Age…………………years

2. Your Gender (Select only one) Female Male

3. Your Grade CT1

CT2

ST3

ST4

ST5

ST6

ST7

ST8

Trust grade (please specify level)………….

Other (please specify)………………

4. Your Speciality (Select all that apply) Cardiothoracic

General Surgery

Neurosurgery

Oral & Maxillofacial Surgery

Otolaryngology

Paediatric Surgery

Plastics Surgery

Trauma & Orthopaedic Surgery

Urology

Vascular

Undecided

Other

8ReSurgEnt Survey Protocol Version 35. To which region do you belong (i.e. deanery affiliation): Eastern

Kent, Sussex & Surrey

Leicestershire, Northamptonshire & Rutland

London

Mersey

Northern

Northern Ireland

North West

Trent

Oxford

Scotland

Southwestern

South Yorkshire and South Humber

Wales

West Midlands

Wessex

Yorkshire

6. Are you full-time or part-time Full-time

Part-time

7. Have you ever undertaken a formal period of research (Select all that apply)

MRes

MPhil

MD

PhD

Other (please specify)……….

No

8.Are you an Academic Trainee? Academic Trainee (current)

Academic Trainee (previous)

No


About Your Publications9a. In the following table, please state the number of PubMed citable publications you have at each type of authorship, for either trainee-led research collaborative studies or other research

(i) Trainee-led collaborative study (please state the Journals for each and if you paid to publish)

(ii) Other research study (please state the Journals for each and if you paid to publish)

a. First authorb. Co-author(named appears on PubMed alongside title and other part of citation)c. Corporate authorship( i.e. as part of a larger group with which the study group itself is the named author)d. ‘Other’ (i.e citable contributor)


About Surgical Research Collaboratives10. Are you currently involved in any studies through a surgical research collaborative? No

Yes

11. Have you previously been involved in any studies through a surgical research collaborative? No

Yes

12. If you have been involved in surgical research collaborative research projects, what has your contribution been to these projects? Please select the appropriate category(ies) for your contributions and state the number for each. .

Contribution Previously Involved Currently Involved(i.) Regional (Involves hospitals within one collaborative)

(ii.) National or international (Involves hospitals across two or more collaboratives)

(iii.) Regional (Involves hospitals within one collaborative)

(iv.) National or International (Involves hospitals across two or more collaboratives)

a. Steering Committee (i.e. project development and running of studies)b. Writing Group (i.e. contribution to writing manuscript)c. Regional Lead (i.e. coordinating project at regional hospital sites)d. Local Lead (i.e. coordinating project at local hospital site)e. Local Collaborator (i.e. data collection)f. Data Validation (i.e. validation of selected patients)g. Advisory Group (i.e. mentored a project with expert advice either in design or writing phase)


13a. For each of the roles listed below please indicate how likely you would be to get involved in a future trainee-led surgical collaborative study?

Steering Committee (i.e. project development and running of studies)

Very Unlikely Unlikely

Neither Likely or Unlikely

Likely Very Likely

Writing Group (i.e. contribution to manuscript) Very

Unlikely UnlikelyNeither Likely or Unlikely

Likely Very Likely

Regional Lead(i.e. coordinating project at regional hospital sites)



Likely Very Likely

Local Lead (i.e. local hospital lead) Very


Likely Very Likely

Local Collaborator (i.e. data collection) Very


Likely Very Likely

Data Validation (i.e. validation of data previously collected for a study )



Likely Very Likely

Advisory Group(i.e. mentored a project with expert advice either in design or writing phase)



Likely Very Likely

13b. Please use the free text space below for any comments for your answers to the above questions………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

14a. If you have been involved in a surgical collaborative research project, what was/were the reason(s) you got involved? (please select all that apply) I have an interest in surgical research

I wanted to improve patient care

I wanted to increase my number of publications

For networking

I was encouraged to by programme director

To educate myself about research and governance

12ReSurgEnt Survey Protocol Version 3 To satisfy ARCP requirements

Other………………………………..

14b. What was the main reason you got involved (please select one) I have an interest in surgical research

I wanted to improve patient care

I wanted to increase my number of publications

For networking

I was encouraged to by programme director

To educate myself about research and governance

To satisfy ARCP requirements

Other………………………………..

14c. Please Provide further details about your answer ………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………..…………………………………………………………………….

15a. If you have never been involved, or have decided not to participate in further surgical collaborative research projects, what reason(s) prevented you from taking part? (select all that apply) I am not interested in collaborative research

I do not have time

There is no surgical research collaborative in my region

It is not recognized at CCT (certificate of completion of training)

The location of the meeting is too far away

The time of the meeting means I cannot attend

The projects are not of interest to me

I do not feel welcome at the collaborative

I feel I am too junior to be part of the collaborative

I have issues with authorship of collaborative research

Other (please specify)…………………………………………………….

13ReSurgEnt Survey Protocol Version 315b. Any further comments, including any other barriers to your involvement:…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

16. Do you think trainee-led research collaboratives have a place in surgical training? Yes – Why……………………………………………………………………………………

No – Why not…………………………………………………………………………….

17a. How should CCT requirements recognize involvement in trainee-led research collaboratives? (select all that apply) Number of projects involved with

Number of publications

Number of first author publications

A points based system based on contribution

Merit judgement by the Speciality Advisory Committee (SAC)

Other, please specify:……………………………………………………………………………………………………………………..

Should not be recognized at CCT (please go to question 18)

17b. What specific aspects of the research process should be recognized? (Select all that apply) Steering Committee (i.e. project development and running of studies)

Writing Group (i.e. contribution to manuscript)

Regional Lead (i.e. coordinating project at regional hospital sites)

Local Lead (i.e. coordinating project at local hospital site)

Local Collaborator (i.e. data collection)

Data Validation (i.e. validation of selected patients)

Advisory Group (i.e. mentored a project with expert advice either in design or writing phase)

Other, please specify:……………………………………………………………………………………………………………………..

17c. For publication purposes, how should authorship contribution of trainee-led research collaborative projects be recognised? Steering committee as named Co-authors with Contributors citable

Single Corporate Authorship – Steering group and all contributors citable together

Other (please specify)………………….

18. Do you think involvement in surgical research collaboratives should be recognized by….? (select all that apply) UK Foundation Programme (UKFPO)

14ReSurgEnt Survey Protocol Version 3 Core Trainee interview process

Higher surgical training interview process

Academic training posts

Certificate of Completion of Training (CCT)

None of the above (Why?) ..................................................................................................................

Thank you for completing the questionnaire. We are also undertaking a study where we are interviewing trainees about their experiences of being involved in surgical research collaboratives (the ReSurgEnT study). If you would be interested in hearing more about this study, please provide your email address………………………………………………………………. Alternatively, you can contact Clare Clement (researcher at the University of Bristol) at [email protected] or 0117 928 7272 to find out more about the study.

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