Surgical projects

VOLUME: Validation of Operative Logbooks for Understanding Milestone Excellence

What is the number of operative procedures needed to achieve competency in T&O index procedures?

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Supervisors

Mr James Tomlinson (jamestomlinson1@nhs.net)

Mr Cronan Kerin (cronan.kerin@nhs.net)

Abstract and methodology

This project will use logbook and ISCP data to define learning curves in common index procedures in trauma and orthopaedic training. This work will build an evidence base for how many procedures are needed to achieve competence, and potentially inform changes to the training curriculum across the four nations in the UK. 

The post holder will work with a local surgeon and the SAC chair to analyse existing data sets and answer a question that is one of the most important outstanding issues in UK orthopaedic training.

Type of project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional training or teaching

No further training will be needed but the support of Professor Richard Jacques and team has been secured given the complexity of the modelling. You will be trained in these techniques.

Ethics requirements

Secondary data or tissue samples that was not originally collected for research - UREC or NHS REC approval required

Reboot: The surgical bootcamp revisited

What do trainees learn at a surgical bootcamp, and do they still have a role in transition points?

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Supervisors

Mr James Tomlinson (jamestomlinson1@nhs.net)

Miss Zaha Siddiqui (z.kamransiddiqui@gmail.com)

Abstract and methodology

Surgical training involves navigating uncertainty, from unfamiliar professional expectations to increasing clinical responsibility and operative independence. Contemporary models of uncertainty tolerance suggest that responses to uncertainty are shaped by prior experiences, perceived stakes and training culture. These factors may also influence how trainees perceive bootcamp and understand and apply NOTSS.

This project will explore these questions through interviews with trainees from the 2020–2027 bootcamp cohorts, capturing perspectives from different stages of orthopaedic training. This project will use qualitative research to explore the continuing relevance of bootcamps and explore the longitudinal impact, building on previously published work from this group.

Type of project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional training or teaching

Training in qual research techniques and data analysis will be given - all three supervisors have expertise in this field and all have published qualitative research. There will be training available with one of the School of Education faculty (Dr Tim Herrick).

Ethics requirements

Study in Trust involving NHS staff working methods only – no NHS ethics approval required (although this should still be agreed by the relevant Trust R&D department). However as a medical student is completing the study, please contact Carolyn Staton about putting the study through UREC

An investigation into the surveillance and outcomes for visceral aneurysms

What is the optimal surveillance interval for visceral aneurysms? 

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Supervisors

Saima Ehsan (saima.ehsan@nhs.net)

Stephen Goode (stephen.goode3@nhs.net)

Abstract and methodology

Visceral aneurysms are usually incidental findings noted on scans carried out for other indications. The incidence varies from 0.5 to 2%. The natural history is thought to be different for men and women of childbearing age. There is significant variation in clinical management which means that different areas adopt different protocols for surveillance and intervention. 

The aim of this study is to look at the natural history of visceral aneurysms detected at STH, observe the rate of growth and outcomes of intervention. This will allow the development of a better informed and evidence based surveillance and intervention strategy.

Retrospective analysis of visceral aneurysms detected and manged at STH observing the rate of growth and outcomes of intervention. This will involve analysis using CT and ultrasound imaging and interrogating local databases. 

An informed and evidence based approach for the management of visceral aneurysms is needed. This study could lead to a change in surveillance intervals and modalities used. Some current evidence suggest that surveillance intervals can be safely increased but there have been no coordinated large-scale studies. Standardization of management could lead to better use of resources (scans/ appointments and intervention) and improve patient experience. 

Type of project

Clinical or Surgical project - based in the clinical environment with patients/including service evaluation

Additional training or teaching

n/a

Ethics requirements

Service Evaluation - NHS Service Evaluation number required - UoS Ethics will additionally be required

Sternal healing after median sternotomy: correlation between symptoms and radiology

What is the symptomatic recovery after median sternotomy, and how does this correlate with radiology?

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Supervisors

John Edwards (john.edwards3@nhs.net)

Luigi Ventura (Luigi.ventura@nhs.net)

Abstract and methodology

Painful non-united sternotomy carries a high symptomatic burden and is a surgical challenge to correct. We have developed a management algorithm for this condition, and have a series of patients, some of whom have had surgery. 

In a observational study, we wish to

• characterise the Sternal Healing Score for patients who undergo a CT scan for any indication
• assess the symptoms in those patients displaying radiologic evidence of non-union
• in a prospective cohort, document the symptomatic recovery after median sternotomy

Type of project

Clinical or Surgical project - based in the clinical environment with patients/including service evaluation

Additional training or teaching

Implementation of appropriate data collection, radiological interpretation and statistical methods

Ethics requirements

Service Evaluation - NHS Service Evaluation number required - UoS Ethics will additionally be required

TRANSIT — Trainee Networks, Socio-economic Interactions, and Transitions: Assessing Equity and Barriers in Progression to Trauma and Orthopaedic ST3 Training

How are applicant characteristics, personal circumstances and access to professional opportunities and networks associated with preparedness for and progression into UK Trauma and Orthopaedic ST3 training?

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Supervisors

Nicholas Uren (n.uren@sheffield.ac.uk)

Professor Pirashanthie Vivekananda-Schmidt (p.vivekananda-schmidt@sheffield.ac.uk)

Abstract and methodology

TRANSIT (Trainee Networks, Socio-economic Interactions, and Transitions) is a national explanatory sequential mixed-methods study investigating inequalities in access to opportunities and progression into Trauma and Orthopaedic (T&O) ST3 training in the United Kingdom.

The study examines how applicant characteristics, socioeconomic circumstances, access to clinical and academic opportunities, mentorship, sponsorship, professional networks and institutional support are associated with preparedness for and outcomes of national ST3 recruitment.

The study will be established before the student commences, with ethical approval secured, the national survey disseminated, the interview framework developed and qualitative interviews underway.

The student will join an active national research collaboration and contribute to a clearly defined component of the wider study. Activities will include reviewing the literature, analysing national survey data, participating in semi-structured interviews and undertaking qualitative thematic analysis. The student will also contribute to integrating quantitative and qualitative findings and preparing a manuscript for peer-reviewed publication.

Through collaboration with the British Orthopaedic Trainees Association (BOTA) commitee, the student will gain insight into surgical training, national recruitment processes and the challenges facing aspiring surgeons.

The project offers practical experience in quantitative and qualitative research methods, structured academic supervision and opportunities for co-authorship on a peer-reviewed publication.

Type of project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional training or teaching

The student will receive structured training in mixed-methods research, including literature searching, critical appraisal, survey development and dissemination, quantitative statistical analysis, semi-structured interviewing and reflexive thematic analysis.

The student will be signposted to appropriate statistical support and training in SPSS, alongside hands-on supervision in qualitative interviewing, coding, thematic analysis, and the integration of findings.

Regular supervisory meetings will support methodological development, academic writing, conference submissions and manuscript preparation. Collaboration with the BOTA committee will also provide insight into surgical training, national recruitment and professional organisations.

Ethics requirements

Original research involving human tissues/human participants and/or patient details and information - UREC or NHS REC ethics approval needed

Gastrointestinal BSc projects

Clinical coeliac disease or endoscopy

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Supervisors

Professor David Sanders (david.sanders1@nhs.net)     

Dr Imran Aziz (imran.aziz1@nhs.net) 

Abstract

There are numerous research projects to choose from in different areas: endoscopy, capsule endoscopy, inflammatory bowel disease, functional gut disorders, coeliac disease and many, many more. Every BSc student to date has published (with a PubMed ID – useful for points in future applications after foundation years). There have been 14x 1st class with honors 

Objectives

We wish to give you 

• a broad base of research learning in a friendly department with excellent support
• fantastic research opportunities and exposure to clinical practice
• clinical confidence from talking to and recruiting patients

During the intercalation application process, you will have the chance to meet with the consultant supervisors within our department who are offering upcoming projects. You may be working with a database or clinical letters, you may have the opportunity to get involved with departmental recruiting (if you wish) for other studies, you will work alongside our nursing and medical team and will gain clinical skills whilst supporting an endoscopy list. 

Type of project

Clinical or surgical project: based in the clinical environment with patients/including service evaluation

Additional training or teaching

You will have excellent in-house methodological support from your supervisor and clinical fellows (doctors who are registrars training to become gastroenterology consultants but undertaking extra research training for an MD) within the department. 

The unique clinical studies that you will have the opportunity to undertake often lead to changes in clinical practice. You will be well supported in a thriving NHS GI research environment. You may be taking bloods, putting cannulas in, watching gastroscopies or colonoscopies. There is plenty of patient contact and you will feel that you are contributing to the team.

Ethics requirements

Secondary data or tissue samples:UREC or NHS REC ethics approval already received for the intended research project

Effect of direct oral anticoagulants on hip fracture surgery

What is the effect of direct oral anticoagulants on hip fracture surgery?

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Supervisors

Dr Matt Wiles (matthew.wiles1@nhs.net)     

Dr Paul Bramley (paul.bramley2@nhs.net) 

Aims

To determine if direct oral anticoagulants (DOACs) impact on hip fracture surgery in the following areas:

• Time to surgery.
• Anaesthetic technique.
• Blood loss and transfusion requirements.
• Incidence of complications (including mortality).

Methodology

Students will undertake database/notes review of all patients who underwent hip fracture surgery at Sheffield Teaching Hospitals (2021-2024) and who were on a DOAC on admission. The following data will be collected:

• Baseline demographics (age/sex/ethnicity/renal function)
• Haemoglobin on admission, day 1 and day 2 postoperatively
• Mode of anaesthesia
• Number of units of RBCs transfuse
• Time to surgery
• Intra-operative blood loss
• Duration of stay
• Incidence of complications (including death)
• Nottingham Hip Fracture Score

This study will determine the effect of surgical delay on mode of anaesthesia and outcomes. Sheffield has a protocol for deferral of surgery for 24 hours in patients on DOACs (which is not present in other centres). There is a paucity of data on the correct time for delay (especially in patients with low eGFR) and the results of this study will be of interest nationally.

Type of project

Clinical project: based in the clinical environment with patients/including service evaluation

Additional training or teaching

Students will be trained to access all relevant databases and in data analysis (including statistical tests).

Ethics requirements

Original research involving human tissues/human participants and/or patient details and information: UREC or NHS REC ethics approval needed

Thermography and hyperspectral Imaging in critical limb ischaemia (CLI) – observational feasibility study

To evaluate the feasibility, diagnostic consistency, and clinical potential of thermal and hyperspectral imaging for assessing tissue perfusion and viability in patients with Critical Limb Ischaemia (CLI).

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Supervisors

Dr Stephen Goode (stephen.goode3@nhs.net)     

Miss Saima Ehsan (Saima.ehsan@nhs.net) 

Background

Accurate assessment of tissue perfusion is crucial in CLI for guiding revascularisation and predicting wound healing and amputation risk. Traditional imaging modalities (angiography, duplex ultrasound) primarily assess macrovessel flow but provide limited insight into microvascular tissue perfusion. Emerging optical techniques such as infrared thermography and hyperspectral imaging (HSI) offer non-invasive, rapid, and quantitative assessment of skin temperature and oxygenation patterns. These technologies may complement existing vascular imaging and provide new biomarkers for tissue viability.

Project overview

This is a mixed methods observational study combining quantitative imaging analysis and qualitative clinical correlation. The student will participate in data collection from patients with CLI undergoing endovascular (1 student) or surgical revascularisation (1x student). Thermal and hyperspectral images will be obtained pre- and post-intervention and compared with standard clinical outcomes and imaging findings (angiography, ABPI, wound scores).

The project will assess:

• Feasibility of thermographic and hyperspectral imaging in the vascular setting.
• Correlation between imaging metrics and clinical outcome measures (tissue loss, healing, amputation-free survival).
• Interobserver reproducibility and technical limitations.

Type of project

Clinical or Surgical project: based in the clinical environment with patients/including service evaluation

Additional training or teaching

Students will receive training in vascular physiology, optical imaging principles, and image analysis. They will be involved in

• collecting thermographic and hyperspectral data in vascular angio or theatre settings
• analysing imaging datasets and correlating with clinical outcomes
• contributing to statistical and visual data interpretation
• observing vascular surgery and interventional radiology procedures to understand the clinical context of CLI management

This project provides exposure to cutting-edge imaging technologies in vascular medicine, hands-on research experience, and opportunities for presentation and publication within a growing field of translational vascular imaging.

Ethics requirements

Secondary data or tissue samples: UREC or NHS REC ethics approval already received for the intended research project

Should decisions relating to elective surgery for diverticular disease be based on health-related quality of life assessment?

We hypothesise that patient reported QoL measurements should be considered as a basis for deciding who should be offered surgery. To support this assertion, we aim to describe the QoL burden of this patient group and compare it to the QoL of patients undergoing surgery.

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Supervisors

Mr Tim Wilson (tim.wilson1@nhs.net)     

Mr Daniel Ashmore (dlashmore1@sheffield.ac.uk) 

Abstract and methodology

Diverticular disease (DD) is a common surgical problem that can result in bouts of inflammation affecting the colon (diverticulitis). Surgery can reduce this risk and has been shown to improve the quality of life (QoL) of selected patients. However, this operation is not without risk and is used relatively sparingly. There is no clear consensus about which patients should be operated upon.

A systematic review will be conducted to extract published QoL in the medical literature from patients with DD participating in clinical trials or observational studies. Data will be extracted from studies measuring QoL in unselected cohorts of patients following an episode of diverticulits. Separate data will be extracted from studies measuring QoL in patients undergoing surgery for DD. These two data sets will be analysed for patterns of change and compared to each other, as well as population normal data. Meta-analysis will be used to combined data where applicable.

This study is expected to improve our understanding of the QoL burden in patients with diverticular disease and may help to inform us how we can make more objective choices regarding the use of surgery for this condition. It is expected that the outcomes of the study will be presented to national conferences and may be suitable for publication if sufficient data was collected. 

Type of project

Qualitative, non-lab-based project

Additional training or teaching

This project would suit any trainee with an interest in surgery or anaesthetics. The project will be supervised from Doncaster, but will largely be library/online based. Specific training will be provided in systematic reviews, including development of a search strategy, data extraction and meta-analysis. Regular supervision meetings will be organised to guide the student through each stage of this research project. As part of the BSc, there are extensive opportunities for clinical experience in the surgical department.

Ethics requirements

Not known: contact Carolyn Staton in the first instance.

Are large language artificial intelligence (AI) models able to advise surgical patients? 

The aim of this study is to evaluate the accuracy, completeness, and readability of information produced by large language AI models in response to typical patient queries concerning common colorectal surgical procedures.

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Supervisors

Evri Tokidis (evripidis.tokidis2@nhs.net) 

Mr Tim Wilson (tim.wilson1@nhs.net)     

Abstract and methodology

Artificial intelligence is prominent in healthcare information systems, with large language models (LLMs) such as ChatGPT and Gemini, routinely accessed by the public to obtain medical explanations. These tools generate human-like, contextually responsive text that can appear authoritative, even when the underlying content lacks clinical rigour. 

The aim of this study is to evaluate the accuracy, completeness, and readability of information produced by large language models in response to typical patient queries relating to common surgical procedures. LLM-generated responses to a series of standardised patient-style prompts will be generated and then compared to explanations from official authoritative sources (eg Royal College of Surgeons of England) using a descriptive framework grounded in human evaluation methodology derived from the QUEST framework. This model provides a structured basis for assessing LLM outputs in healthcare across five principal domains: Quality of Information, Understanding and Reasoning, Expression Style and Persona, Safety and Harm, and Trust and Confidence. Readability will also be assessed using validated tools.

It is anticipated that this study will reveal notable differences between AI and official information sources that will have practical implications for clinical consultations with surgical patients.

Type of project

Qualitative, non-lab-based project

Additional training or teaching

This project would suit any trainee with an interest in surgery or anaesthetics. The project will be supervised from Doncaster, but will largely be library/online based. Specific training will be provided in systematic reviews, including development of a search strategy, data extraction and meta-analysis. Regular supervision meetings will be organised to guide the student through each stage of this research project. As part of the BSc, there are extensive opportunities for clinical experience in the surgical department.

Ethics requirements

Not known: contact Carolyn Staton in the first instance.