https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/64 2026-05-23T06:04:52Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/741 Title: Holding a Mirror to Ourselves: Remediation Policy in Surgical Training in Australia and Aotearoa New Zealand Authors: McLeod, K.; Woodward-Kron, R.; Rashid, Prem; Nestel, D. Abstract: ABSTRACT Introduction: Remediation is a critical component of surgical training, designed to support trainees who are not progressing as expected and to ensure they reach the standards required. Despite its importance, remediation practices remain poorly un derstood. A clearer understanding of current remediation practices is essential if training bodies are to better support trainees, protect patient safety, and strengthen the integrity of training programs. The aim of this study was to examine the current reme diation policies affecting surgical trainees in Australia and Aotearoa New Zealand (ANZ). Methods: We undertook a systematic approach for document analysis in health policy research of publicly available docu ments from the regulators and accrediting professional bodies relating to underperformance and remediation within the Surgical Education and Training (SET) program in ANZ. Results: In total, 47 documents were reviewed in relation to the management of underperformance and remediation within surgical training. Four themes were identified: when policy shapes remediation; similarity of remediation processes; inconsistent terminology and focus on due process. Conclusion: This study examined the current remediation policy affecting surgical trainees in ANZ, which is shaped from standards and regulations set by multiple organizations. Although this creates similar regulatory processes across training pro grams, it results in a strong focus on due process rather than the educational aspects of remediation. Inconsistent terminology around assessment and remediation further impedes effective comparison and data collection. Addressing these concerns will allow opportunities for improving future remediation processes. 2026-02-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/695 Title: General Surgical Management of Lower Gastrointestinal Bleeding in a Rural Setting-A Case for Establishing a Local Management Guidelin Authors: Sundaram, P.; Zalums, A.; Sabat, N.; Rahman, R.; Dissanayake, M.; Emeto, T. I. Abstract: Background: Acute lower gastrointestinal bleeding (LGIB) presents a management challenge in regional and rural hospitals due to limited resources and potential delays in accessing specialist care. This study aimed to assess the performance of general surgeons in a rural general hospital in managing patients with acute LGIB using a quality indicator framework. Methods: A single-center retrospective study reviewed the records of adult patients presenting to the emergency department with acute LGIB between January 2017 and June 2022. Data on demographics, clinical and laboratory findings, initial management strategies, and patient outcomes were extracted from electronic medical records (EMR). Results: A total of 145 patients were included. Key findings revealed underutilization of the Oakland score system, inconsistencies in blood product transfusion practices, and inappropriate management of antiplatelet medications. Notably, there was an observed overuse of computed tomography angiography (CTA) despite limited access to interventional radiology services. Endoscopic interventions, however, demonstrated effectiveness in managing acute LGIB at the hospital. Conclusion: This study highlights the need for a locally developed clinical guideline tailored to the specific resource constraints of the hospital. The findings further emphasize the importance of proficiency in endoscopic techniques for rural general surgeons managing patients with acute LGIB. This study can serve as a foundation for the development of a local guideline to optimize the management of acute LGIB in this setting. 2025-10-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/686 Title: "We Don't Want You to Be Dismissed": Perspectives of Remediation From Surgical Education and Training Managers Authors: McLeod, K.; Woodward-Kron, R.; Rashid, P.; Nestel, D. Abstract: Background: While education and training managers are key personnel within surgical training programs regarding management of trainee performance including remediation, there is a lack of research concerning their perspectives. For improvements in remediation at a systems level, insight to their perspectives and experiences is essential. Methods: This qualitative study explored the perspectives of 12 education and training managers of surgical societies/associations/colleges in Australia and Aotearoa New Zealand. Purposive and snowball sampling was utilized for data collection in semi-structured interviews. Following an interpretivist approach, transcribed interviews were analyzed using reflexive thematic analysis. Results: Four themes and 10 subthemes were identified: "a guiding role"; remediation is a "well-oiled machine"; remediation is "not punitive"; and room for improvement. Conclusion: Educational managers hold a pivotal role in guiding trainees and supervisors throughout the remediation process. From their perspective, remediation is considered well managed, with nearly all trainees successfully completing remediation. Although they recommend further resources and additional support for supervisors, their focus on improvement centers on tightening governance and reducing the risk of trainee litigation. Including the perspectives of managers in the remediation process will aid in its successful implementation. 2025-09-04T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/663 Title: Early complications after penile prosthesis surgery: findings from the PHOENIX multicenter registry Authors: van Renterghem, K.; de Bruyn, H.; Yebes, A.; Calopedos, R.; Deho, F.; Torremade, J.; D'Anna, M.; Bettocchi, C.; Garcia Gomez, B.; Caris, C.; Witjes, W.; Moncada, Ralph; EAU Research Foundation PHOENIX Study Group Abstract: Erectile dysfunction is a prevalent condition that may impact psychosocial health and quality of life. While various treatment modalities exist, penile prosthesis implantation offers a permanent solution. Surgery, however, carries inherent risks and potential complications. The aim of this study was to determine the incidence and risk factors of early postoperative complications after penile prosthesis surgery in a large, multicenter, prospective, cohort study. Data was analyzed from patients participating in the PHOENIX registry, an international study on penile prosthesis surgery conducted by the EAU Research Foundation. Patients were operated on from November 2021 until august 2024 in 30 centers from 8 countries. Our study was not limited to one device or brand, all available inflatable and malleable devices were eligible for inclusion. Postoperative complications were registered at different time points, up to 2 years post-surgery. For this analysis we studied complications that occurred within 2 weeks after surgery. Data on early complications after penile prosthesis surgery of 1072 patients were analyzed. Median age was 62 (range 24-88) years old at time of surgery. A total of 639 (59.6%) patients received a drain perioperatively. A total of 49 patients (4.6%) reported complications within 2 weeks after surgery. Infection occurred in 4 patients and penoscrotal hematoma occurred in 6 patients within 2 weeks post-surgery. A total of 5 patients underwent early revision surgery. There was no significant effect of diabetes mellitus on development of an early postoperative infection (0.4% vs. 0.4%, p = 1.00). We found no significant impact of drain placement on hematoma development (0.3% vs. 0.3%, p = 0.69). We did find that early hematoma occurred more frequently in low-volume versus high-volume centers (1.3% vs. 0.1%, p = 0.02). This large international study confirms that penile prosthesis surgery is a safe procedure with a low rate of early postoperative complications. 2025-05-01T00:00:00Z