Safer Surgery part 10. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 64 Safer Surgery OSATS over the last two years prior to the formal requirement of OSATS within the new training and education programme. In other disciplines there has been some cynicism towards competency based surgical assessment which has required our concerted efforts to overcome in implementing the study. However this does appear to be changing over time and with the opportunities provided by the study for training assessors and trainees. The method we used to fully understand the systems and processes adopted by each specialty has been to spend several weeks working with the specialty in advance of assessments. This has enabled us to maximize recruitment of cases not only through an appreciation of the practical listing of surgical cases but by engaging with the working practices and culture of each surgical team. Lessons Learnt and Suggested Learning Points Consider the specific nature of context for implementing studies in the surgical workplace. Spend time working with surgical teams to maximize the success of the research. Future Research Directions The use of video recordings has potential in providing trainees with additional feedback on their surgical performance. Feedback using videos is well established within general practice. Videotaped patient consultations are used for training Pendleton et al. 1984 and assessment purposes with videotaped consultations forming part of the current summative assessment for GP training the new Membership of the Royal College of General Practitioners Royal College of General Practitioners 2008 . They have been shown to be valid and reliable as an assessment method for trainees Campbell et al. 1995 and for practising general practitioners Ram 1999 . We aim to develop the use of videoed operative cases for providing surgical trainees with feedback. There is reliability evidence for video assessment of some surgical procedures. Beard et al. 2005a showed good inter-rater reliability between direct and video assessment of
