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Developing a novel international undergraduate surgical masterclass during a financial crisis: our 4-year experience
  1. Michail Sideris1,
  2. John Hanrahan2,
  3. Georgios Tsoulfas3,
  4. Iakovos Theodoulou2,
  5. Fatema Dhaif4,
  6. Vassilios Papalois5,
  7. Savvas Papagrigoriadis6,
  8. George Velmahos7,
  9. Patricia Turner8,9,
  10. Apostolos Papalois10
  1. 1 Women’s Health Research Unit, Queen Mary University of London, London, UK
  2. 2 Faculty of Life Sciences and Medicine, King’s College London, London, UK
  3. 3 Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
  4. 4 Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  5. 5 Department of Surgery, Imperial College London, London, UK
  6. 6 International Society for Pelvic Surgery, London, UK
  7. 7 Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Harvard Medical School, Boston, Maryland, USA
  8. 8 American College of Surgeons, Chicago, Illinois, USA
  9. 9 Department of Surgery, Section of General Surgery, The University of Chicago, Chicago, Illinois, USA
  10. 10 Experimental Research Centre ELPEN, Athens, Greece
  1. Correspondence to John Hanrahan, Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK; john.hanrahan{at}


Background Essential Skills in the Management of Surgical Cases (ESMSC) is a novel 3-day international undergraduate surgical masterclass. Its current curriculum (Cores integrated for Research—Ci4R) is built on a tetracore, multiclustered architecture combining high-fidelity and low-fidelity simulation-based learning (SBL), with applied and basic science case-based workshops, and non-technical skills modules. We aimed to report our experience in setting up ESMSC during the global financial crisis.

Methods We report the evolution of our curriculum’s methodology and summarised the research outcomes related to the objective performance improvement of delegates, the educational environment of the course and the use of mixed-fidelity SBL. Feedback from the last three series of the course was prospectively collected and analysed using univariate statistics on IBM SPSS V.23.

Results 311 medical students across the European Union (EU) were selected from a competitive pool of 1280 applicants during seven series of the course between 2014 and 2017. During this period, curriculum 14 s evolved to the final Ci4R version, which integrates a tetracore structure combining 32 stations of in vivo, ex vivo and dry lab SBL with small group teaching workshops. Ci4R was positively perceived across different educational background students (p>0.05 for any comparison).

Conclusions ESMSC is considered an innovative and effective multidisciplinary teaching model by delegates, where it improves delegates objective performance in basic surgical skills. Our experience demonstrates provision of high-quality and free surgical education during a financial crisis, which evolved through a dynamic feedback mechanism. The prospective recording and subsequent analysis of curriculum evolution provides a blueprint to direct development of effective surgical education courses that can be adapted to local needs.

  • medical education
  • undergraduate surgical education
  • simulation-based learning
  • financial crisis
  • surgery

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  • MS and JH contributed equally.

  • Contributors MS and JH have equal contribution and drafted the manuscript. GT edited part of the manuscript. FD performed statistical analysis. IT performed data collection. MS and AP are leaders of the ESMSC project and both conceived the study. GV, PT, SP and VP offered senior editing and feedback on the manuscript and are all acting as senior authors.

  • Funding This research is supported by a research grant from the Experimental Research Centre ELPEN.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The ESMSC course is compatible with the current 3R principles for animal-model simulation (refinement, replacement and reduction). Application of ethical approval met directive 63/2010, PD 56/April 2013 declaration, according to local policy. The license reference number is 884 28/4/2015, MS, AP et al.

  • Provenance and peer review Not commissioned; internally peer reviewed.