BOSTiC 2021

The 6th annual Bristol Oxford Surgical Trials Course (BOSTiC) was held in Bristol this year at Engineer’s House, University of Bristol. Excitingly, this was the first in-person conference that many of the attendees and faculty had been to since the advent of the COVID-19 pandemic.

The course is primarily aimed at surgical trainees who are interested in clinical research, with an emphasis on design and conduct of randomised control trials. The course is delivered by a multi-disciplinary team from the Bristol and Oxford Surgical Trials Units who are supported by the Royal College of Surgeons of England. BOSTiC was attended by surgical trainees from a wide variety of specialities and locations including the lion’s share of England and even Scotland! 

The course ran over three days in September. A variety of teaching methods were utilised to maintain audience engagement and participation such as lectures tutorials and small group forums. The faculty maintain the view that “no question is a bad question” and provide a very supportive environment for learning. The diversity in experiences and levels of training led to rich contributions and discussions. 

An exciting background to the three days of intense learning around randomised trials was that each group (with 6 members) was allocated to design a trial, working up to a dragon’s den pitch at the end of the three days. It provided a great opportunity to put in to practice all the key elements candidates learnt about randomised trial design throughout the course, whilst the competition provided the focus that was essential to “making the knowledge stick”. A brief breakdown of the days:

Day 1

Professor Jane Blazeby set the scene for the course and gave expert insight into the role of randomised trials in advancing evidence-based medicine.  Candidates learnt the essentials of trial design via a series of presentations that covered research question design (Professor David Beard), trial design (Professor Jonathan Cook), and optimising recruitment (Dr Leila Rooshenas & Dr Marcus Jepson). This was supplemented by expert talks including the experience of being a new PI (Dr Joanna Wills). A particularly notable part of the day was a workshop where Prof Blazeby and Prof Beard delivered mock examples of good and poor trial recruitment methods, providing the course plenty of entertainment! The day finished with group presentations and feedback surrounding their initial trial question and design. This was rounded off with an excellent dinner in the Aqua restaurant Clifton which provided a great networking opportunity for all the candidates.  

Day 2

This built on talks from the previous day and featured talks on alternative trial designs, pilot studies, experiences of a CI and selecting, measuring and reporting primary and secondary outcomes by Professor Jonathan Cook, Professor David Beard and Dr Kerry Avery. Miss Deena Harji gave an insightful talk on the experiences of a new CI. Professor Chris Rogers summarised key statistical concepts and provided the opportunity for delegates to calculate power and sample sizes for a study. The delegates also continued to work in groups to design their RCTs for presentation on the final day. 

Day 3

This proved to be the most exciting day of the course, with the majority of the time spent prepping presentations before the final dragon’s den pitch. Essential talks that proved to be useful in pitch preparation included talks on designing protocols for trials from Miss Natalie Blencowe and the practicalities of how to run a clinical trial by Dr Lucy Culliford. The course ended with a dragons’ den pitch from each of the 6 groups on their finalised trial design. 

The winning group designed a trial called the BURN study, which evaluated “Immediate endoscopic removal versus watch-and-wait for asymptomatic gastric BUtton batteries in childReN: a randomised control trial”.

Feedback from the course has once again been excellent with 100% of delegates rating the quality of teaching excellent or very good and 97% rating the course overall as excellent. Below are some of the quotes from the delegates:

“The best money I have spent on a course.  Fantastic!”

“Excellent course - very well organised. Lovely staff - learnt heaps!”

For me, an early-stage trainee, the course was a great introduction to randomised trials, which until then had only been briefly covered in medical school. It gave all the essential information that helped me to understand the core elements of optimising trial design, whilst providing a supportive and welcoming environment. Particularly, it was encouraging to hear the stories of career academics and the hurdles they had to overcome along the way to becoming CIs/PIs. After hearing these stories getting involved in trials seems less out of reach. Coupling this with the excitement of working on a trial design makes this course not one to miss!

Next year’s course will be in Oxford – make sure you sign up!

Dr Connor Moore

Academic F2 – Centre for Surgical Research