2022, Number 42
<< Back Next >>
Inv Ed Med 2022; 11 (42)
Teaching surgical skills: relevant educational theories (part two)
Gaxiola-García MÁ, Kushida-Contreras BH, Sánchez-Mendiola M
Language: Spanish
References: 57
Page: 95-105
PDF size: 495.41 Kb.
ABSTRACT
Introduction: In the context of medical education, surgical
education is an area with its own characteristics.
Multiple concepts, models and theories have been developed
to characterize surgical education; however, most
have been reported in isolated manner.
Objective: To identify the main concepts and theories
used in surgical education and describe them in a sequential
and integrated overview.
Method: As part of a scoping review of the surgical education
literature, the relevant concepts and their potential
relationships were identified. The analysis continued as
follows: non-traditional models for surgical education,
technological strategies for surgical education such as
simulation, online learning or use of social networks, and
assessment in surgical education including technical and
non-technical skills.
Results: In this second half of the report, alternatives to
the traditional Osler and Halsted apprentice model for
surgical education are described. The knowledge and
implementation of these models rests on proven theoretical
bases in some contexts. The use of technology for
surgical education is more feasible when it is consistent
with the learning models, integrated into the curricular
design, and the multiple available options are considered.
There are multiple tools that allow assessment of students’
psychomotor skills as part of a formative assessment
strategy. Also, the assessment of non-technical skills is an
increasingly important component of surgical education.
Conclusions: Directors of surgical education programs
should privilege a theoretically grounded approach in the
planning and implementation stages. This will allow the
definition of goals and strategies for educational achievement,
in the context and formality of a structured program,
beyond a merely scheduled one.
REFERENCES
Nicholls D, Sweet L, Muller A, Hyett J. Teaching psychomotor skills in the twenty-first century: Revisiting and reviewing instructional approaches through the lens of contemporary literature. Med Teach. 2016;38(10):1056-1063. doi:10.3109/ 0142159X.2016.1150984
Krautter M, Weyrich P, Schultz JH, et al. Effects of Peyton’s four-step approach on objective performance measures in technical skills training: A controlled trial. Teach Learn Med. 2011;23(3):244-250. doi:10.1080/10401334.2011.586917
Nikendei C, Huber J, Stiepak J, et al. Modification of Peyton’s four-step approach for small group teaching - A descriptive study. BMC Med Educ. 2014;14(1):1-10. doi:10.1186/1472- 6920-14-68
Zhou NJ, Kamil RJ, Hillel AT, et al. The Role of Preoperative Briefing and Postoperative Debriefing in Surgical Education. J Surg Educ. 2020:1-7. doi:10.1016/j.jsurg.2020.11.001
McKendy KM, Watanabe Y, Lee L, et al. Perioperative feedback in surgical training: A systematic review. Am J Surg. 2017;214(1):117-126. doi:10.1016/j.amjsurg.2016.12.014
Roberts NK, Williams RG, Kim MJ, Dunnington GL. The Briefing, Intraoperative Teaching, Debriefing Model for Teaching in the Operating Room. J Am Coll Surg. 2009;208(2): 299-303. doi:10.1016/j.jamcollsurg.2008.10.024
Timberlake MD, Mayo HG, Scott L, Weis J, Gardner AK. What Do We Know about Intraoperative Teaching? Ann Surg. 2017;266(2):251-259. doi:10.1097/SLA.0000000000002131
Janssen-Noordman AMB, Merriënboer JJG, van der Vleuten CPM, Scherpbier AJJA. Design of integrated practice for learning professional competences. Med Teach. 2006;28(5):447- 452. doi:10.1080/01421590600825276
Vandewaetere M, Manhaeve D, Aertgeerts B, Clarebout G, Van Merriënboer JJG, Roex A. 4C/ID in medical education: How to design an educational program based on whole-task learning: AMEE Guide No. 93. Med Teach. 2015;37(1):4-20. doi:10.3109/0142159X.2014.928407
Alken A, Luursema JM, Weenk M, Yauw S, Fluit C, van Goor H. Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much? Am J Surg. 2018;216(2):369-374. doi:10.1016/j.amjsurg.2017.08.011
Darosa DA, Zwischenberger JB, Meyerson SL, et al. A theorybased model for teaching and assessing residents in the operating room. J Surg Educ. 2013;70(1):24-30. doi:10.1016/j. jsurg.2012.07.007
George BC, Teitelbaum EN, DaRosa DA, et al. Duration of faculty training needed to ensure reliable or performance ratings. J Surg Educ. 2013;70(6):703-708. doi:10.1016/j.jsurg.2013.06.015
George BC, Teitelbaum EN, Meyerson SL, et al. Reliability, validity, and feasibility of the zwisch scale for the assessment of intraoperative performance. J Surg Educ. 2014;71(6):e90- e96. doi:10.1016/j.jsurg.2014.06.018
Sawyer T, White M, Zaveri P, et al. Learn, See, Practice, Prove, Do, Maintain: An Evidence-Based Pedagogical Framework for Procedural Skill Training in Medicine. Acad Med. 2015;90(8):1025-1033. doi:10.1097/ACM.0000000000000734
Nicholls D, Sweet L, Müller A, Hyett J. Teaching a complex skill in ultrasound: Attempt with caution! Ultrasound Med Biol. 2019;45(Ci):S30-S31. doi:10.1016/j.ultrasmedbio. 2019.07.509
Evans CH, Schenarts KD. Evolving Educational Techniques in Surgical Training. Surg Clin North Am. 2016;96(1):71-88. doi:10.1016/j.suc.2015.09.005
Pellegrini CA. Surgical education in the United States 2010: Developing intellectual, technical and human values. Updates Surg. 2012;64(1):1-3. doi:10.1007/s13304-011-0113-4
Stefanidis D, Sevdalis N, Paige J, et al. Simulation in Surgery: What’s Needed Next? Ann Surg. 2015;261(5):846-853. doi:10.1097/SLA.0000000000000826
Sadideen H, Alvand A, Saadeddin M, Kneebone R. Surgical experts: Born or made? Int J Surg. 2013;11(9):773-778. doi:10.1016/j.ijsu.2013.07.001
Bjerrum F, Thomsen ASS, Nayahangan LJ, Konge L. Surgical simulation: Current practices and future perspectives for technical skills training. Med Teach. 2018;40(7):668-675. doi:10.1080/0142159X.2018.1472754
Jayakumar N, Brunckhorst O, Dasgupta P, Khan MS, Ahmed K. E-Learning in Surgical Education: A Systematic Review. J Surg Educ. 2015;72(6):1145-1157. doi:10.1016/j. jsurg.2015.05.008
Maertens H, Madani A, Landry T, Vermassen F, Van Herzeele I, Aggarwal R. Systematic review of e-learning for surgical training. Br J Surg. 2016;103(11):1428-1437. doi:10.1002/ bjs.10236
El Boghdady M, Ewalds-Kvist BM, Alijani A. A review of online platforms in training and surgical education. Eur Surg - Acta Chir Austriaca. 2015;51(2):41-48. doi:10.1007/ s10353-019-0569-x
Qayumi K, Vancouver. Surgical skills lab: A hub for competency training. J Investig Surg. 2010;23(1):48-56. doi:10.3109/08941930903469391
Ovaere S, Zimmerman DDE, Brady RR. Social Media in Surgical Training: Opportunities and Risks. J Surg Educ. 2018;75(6):1423-1429. doi:10.1016/j.jsurg.2018.04.004
Petrucci A, Chand M, Wexner S. Social Media: Changing the Paradigm for Surgical Education. Clin Colon Rectal Surg. 2017;30(04):244-251. doi:10.1055/s-0037-1604252
Ding C, Li S, Chen B. Effectiveness of flipped classroom combined with team-, case-, lecture- And evidence-based learning on ophthalmology teaching for eight-year program students. BMC Med Educ. 2019;19(1):1-9. doi:10.1186/s12909- 019-1861-y
Liebert CA, Lin DT, Mazer LM, Bereknyei S, Lau JN. Effectiveness of the Surgery Core Clerkship Flipped Classroom: A prospective cohort trial. Am J Surg. 2016;211(2):451-457. e1. doi:10.1016/j.amjsurg.2015.10.004
Chick RC, Clifton GT, Peace KM, et al. Using Technology to Maintain the Education of Residents During the COVID-19 Pandemic. J Surg Educ. 2020;77(4):729-732. doi:10.1016/j. jsurg.2020.03.018
Apramian T, Cristancho S, Watling C, Ott M, Lingard L. Thresholds of principle and preference: Exploring procedural variation in postgraduate surgical education. Acad Med. 2015;90(11 Association of American Medical Colleges Medical Education Meeting):S70-S76. doi:10.1097/ ACM.0000000000000909
Memon MA, Brigden D, Subramanya MS, Memon B. Assessing the Surgeon's Technical Skills: Analysis of the Available Tools. Acad Med. 2010;85(5):869-880. doi:10.1097/ ACM.0b013e3181d74bad
Sandher S, Gibber M. Assessing Surgical Residents; Challenges and Future Options. MedEdPublish. 2017;6(4):1-9. doi:10.15694/mep.2017.000177
Thomas W. Teaching and assessing surgical competence. Ann R Coll Surg Engl. 2006;88(5):429-432. doi:10.1308/003588406X116927
Asch DA. Evaluating Obstetrical Residency Programs Using Patient Outcomes. JAMA. 2009;302(12):1277. doi:10.1001/ jama.2009.1356
The General Surgery Milestone Project. J Grad Med Educ. 2014;6(1s1):320-328. doi:10.4300/JGME-06-01s1-40.1
Fritz T, Stachel N, Braun BJ. Evidence in surgical training- A review. Innov Surg Sci. 2019;4(1):7-13. doi:10.1515/iss-2018- 0026
Hurreiz H. The evolution of surgical training in the UK. Adv Med Educ Pract. 2019;10:163-168. doi:10.2147/AMEP. S189298
Farcas MA, Azzie G. Performance assessment - The knowledge, skills and attitudes of surgical performance. Semin Pediatr Surg. 2020;29(2):150903. doi:10.1016/j.sempedsurg.2020.150903
Agha RA, Fowler AJ, Sevdalis N. The role of non-technical skills in surgery. Ann Med Surg. 2015;4(4):422-427. doi:10.1016/j.amsu.2015.10.006
Dawe SR, Pena GN, Windsor JA, et al. Systematic review of skills transfer after surgical simulation-based training. Br J Surg. 2014;101(9):1063-1076. doi:10.1002/bjs.9482
Hoffmann H, Oertli D, Mechera R, et al. Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education. J Surg Educ. 2017;74(1):37-46. doi:10.1016/j.jsurg.2016.07.013
Reznick R, Regehr G, MacRae H, Martin J, McCulloch W. Testing technical skill via an innovative “bench station” examination. Am J Surg. 1997;173(3):226-230. doi:10.1016/ S0002-9610(97)89597-9
Roberts NK, Williams RG, Schwind CJ, et al. The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings. Am J Surg. 2014;207(2):170-178. doi:10.1016/j.amjsurg. 2013.06.016
Niitsu H, Hirabayashi N, Yoshimitsu M, et al. Using the Objective Structured Assessment of Technical Skills (OSATS) global rating scale to evaluate the skills of surgical trainees in the operating room. Surg Today. 2013;43(3):271-275. doi:10.1007/s00595-012-0313-7
Robertson ER, Hadi M, Morgan LJ, et al. Oxford NOTECHS II: A modified theatre team non-technical skills scoring system. PLoS One. 2014;9(3):1-8. doi:10.1371/journal. pone.0090320
Jung JJ, Borkhoff CM, Jüni P, Grantcharov TP. Non-Technical Skills for Surgeons (NOTSS): Critical appraisal of its measurement properties. Am J Surg. 2018;216(5):990-997. doi:10.1016/j.amjsurg.2018.02.021
Doyle JD, Webber EM, Sidhu RS. A universal global rating scale for the evaluation of technical skills in the operating room. Am J Surg. 2007;193(5 SPEC. ISS.):551-555. doi:10.1016/j.amjsurg.2007.02.003
Clancy CM, Tornberg DN. TeamSTEPPS: Assuring Optimal Teamwork in Clinical Settings*. Am J Med Qual. 2019;34(5):436-438. doi:10.1177/1062860619873181
Mackay S, Datta V, Chang A, Shah J, Kneebone R, Darzi A. Multiple Objective Measures of Skill (MOMS). Ann Surg. 2003;238(2):291-300. doi:10.1097/01.sla.0000080829.29028.c4
Lin J, Reddy RM. Teaching, Mentorship, and Coaching in Surgical Education. Thorac Surg Clin. 2019;29(3):311-320. doi:10.1016/j.thorsurg.2019.03.008
Drossard S. Structured surgical residency training in Germany: An overview of existing training programs in 10 surgical subspecialties. Innov Surg Sci. 2019;4(1):15-24. doi:10.1515/iss-2018-0033
Swendiman RA, Hoffman DI, Bruce AN, Blinman TA, Nance ML, Chou CM. Qualities and Methods of Highly Effective Surgical Educators: A Grounded Theory Model. J Surg Educ. 2019;76(5):1293-1302. doi:10.1016/j.jsurg.2019.02.011
Khan N, Khan MS, Dasgupta P, Ahmed K. The surgeon as educator: Fundamentals of faculty training in surgical specialties. BJU Int. 2013;111(1):171-178. doi:10.1111/j.1464- 410X.2012.11336.x
Sadideen H, Alvand A, Saadeddin M, Kneebone R. Surgical Experts – Born or Made ? Int J Surg. 2013;11:773-778. doi: 10.1016/j.ijsu.2013.07.001
Meyerson SL, Sternbach JM, Zwischenberger JB, Bender EM. Resident Autonomy in the Operating Room: Expectations Versus Reality. Ann Thorac Surg. 2017;104(3):1062-1068. doi:10.1016/j.athoracsur.2017.05.034
Khan S, Mian A. Medical education: COVID-19 and surgery. Br J Surg. 2020;107(8):e269. doi:10.1002/bjs.11740
Ellison EC, Spanknebel K, Stain SC, et al. Impact of the COVID- 19 Pandemic on Surgical Training and Learner Well- Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators. J Am Coll Surg. 2020;231(6): 613-626. doi:10.1016/j.jamcollsurg.2020.08.766