CHAPTER 10: Surgical Education

INTRODUCTION (FIGURE 10-1)

• High-quality patient care, cutting-edge research, and comprehensive educational programs form the pillars of academic surgery departments

• Modern surgical education requires innovative curricular design, clearly defined assessment metrics, and dedicated educators with strong mentoring skills

• Similar to the field of transplantation, a multidisciplinary, team-based approach to surgical education is highly effective

• Developing successful, lifelong surgical learners requires a significant commitment of time and resources

CURRICULAR DEVELOPMENT (FIGURE 10-2)

• The traditional large-group lecture format is unsuitable for many adult learners

• Current educational trends emphasize more interactive vs. passive teaching environments

• Self-directed learning with an active role in gathering, synthesizing, and teaching course content helps build confidence and facilitate knowledge retention

• Rote memorization of scientific facts often lacks sufficient clinical context to apply to patient care situations rapidly

• Integration of basic scientific principles and concepts with realistic, case-based presentations enhances critical thinking and clinical reasoning skills

• Web-based technological tools and materials can enhance the overall learning process

GRADING AND ASSESSMENT (FIGURE 10-3)

• Traditional grading metrics during undergraduate and graduate medical education include clinical assessments of team performance and multiple-choice exams

• Drawbacks to clinical assessments include subjectivity, personality conflicts between individuals interfering with the educational evaluation, maintaining reproducibility and standards between multiple evaluators and learners, and imparting to graders the skills necessary to critically evaluate learners

• Limitations to multiple-choice exams include reduced ability to evaluate clinical reasoning skills and challenges with resolving poor test-taking ability vs. poor acquisition of knowledge

• Expanding grading methods to include more objective metrics and techniques to evaluate practical knowledge application may improve the overall assessment of learners and educational programs in general

• These can include administration of short answer/essay exams, simulated patient-care scenarios utilizing standardized patient actors, oral examinations, and small-group sessions where learners are assessed on demonstrating knowledge of disease pathophysiology and management.

• From a structural standpoint, assessment methods should be calibrated so that each individual component has an equitable and reasonable influence on the overall grade of the learner

• Transparency between the educator and learner regarding the determination of specific grading metrics is essential to build trust and avoid conflicts that can hinder the educational process

SURGICAL SIMULATION (FIGURE 10-4)