The 5th annual Bristol Oxford Surgical Trials Course (BOSTiC) was held in Oxford this year at Worcester College, University of Oxford. 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. This year the course was attended by surgical trainees from a wide variety of specialities across the UK and even two participants from Portugal!
The format of the course is residential over 3 days. A variety of teaching methods were utilised to maintain audience engagement and participation such as lectures, tutorials and small group forums. Audience participation and involvement is encouraged. An informal atmosphere is a feature of the course. There was great diversity in terms of the surgical specialities of the participants (general surgery, obstetrics and gynaecology, orthopaedics, neurology, plastics, vascular, ear, nose and throat [ENT]), which also helped in the sharing of ideas and experiences.
Day 1 started with a series of presentations from Professor Jane Blazeby, Professor David Beard and Professor Jonathan Cook around the need for evidence-based surgery, how to formulate a research question and the key elements required for randomised trial design. Following this, there were a series of talks on optimising trial recruitment from Dr Leila Rooshenas and Dr Marcus Jepson. Dr Antony Palmer also shared his experiences as a new Chief Investigator (CI) in designing the Femoroacetabular Impingement Trial (FAIT). During the day, the groups met with their mentors and initial trial ideas were discussed. The day finished with a course dinner at Mamma Mia Pizzeria restaurant in Jericho.
The morning sessions on day 2 built on from the previous day and featured talks on alternative trial designs, experiences of a CI and selecting, measuring and reporting primary and secondary outcomes by Professor Jonathan Cook, Professor Andrew Carr and Dr Ines Rombach. Mr Veeru Kasivisvanathan also gave an insightful talk on being a CI as a trainee. Professor Chris Rogers summarised key statistical concepts and provided the opportunity for delegates to calculate power and sample sizes for a study. Dr Natalie Blencowe presented on quality assurance of surgical interventions in trials. The delegates also continued to work in groups to design their RCTs for presentation on the final day.
BOSTiC aims to provide a foundation of surgical trial methodology for broader purposes but also equips delegates with the skills to begin real world trial design in their own area. It is hoped many will become CI’s. Day 3 started with Professor Michael Douek providing insights into device trials and tribulations that come with this type of trial and Professor Jane Blazeby covering pilot and feasibility studies. This was followed by a valuable talk by Ms Cushla Cooper on her top tips of trial conduct and how to manage a trial. The course ended with a dragons’ den style presentation with each of the delegate groups presenting their designed RCT which they had worked upon throughout the course. Experienced mentors from both Oxford and Bristol Universities helped guide delegates throughout this process. The winning group designed a trial looking at women with bladder pain syndrome and seeing if hydrodistention compared with cystoscopy alone improves the O’Leary-Sant score.
Feedback from the course has once again been extremely positive with 100% of delegates rating the quality of teaching and the course overall as excellent or very good. Below are some of the quotes from the delegates:
‘Excellent course! Well run, great experts, loved the practical aspects of designing your own trial. Good admin support. Will recommend to colleagues.’
‘Probably the best course I've ever been on.’
‘This has definitely exceeded my expectations.’