Changing surgical education strategies in an environment of changing health care delivery systems (original) (raw)
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Surgical education in the new millennium: the university perspective
Surgical Clinics of North America, 2004
This is a particularly auspicious time to have the opportunity to comment on surgical education. A number of forces have combined to mandate a major paradigm shift in the way we educate surgical residents, and the final word is not yet in, to say the least. At the same time that we have begun to systematically look at ways of insuring patient safety, we have been mandated to cut resident work hours to 80 hours per week. This has forced us to develop alternative approaches to patient care that do not involve resident participation at various times. The widespread use of what we call ''clinical surgical specialists,'' nonphysician health care providers, has introduced an entirely new set of issues with which we as surgical educators must deal. The restriction in resident work hours has caused us to focus very specifically on the balance, or lack thereof, between service and education. Whereas in the past the education often took a back seat to the service role of the resident, the reduced hours residents are allowed to work today have given us the opportunity to focus on the education component, where our efforts should have been directed all along. The changing demographics of students entering medical school has also mandated a change in the way we think about surgical education. Now that medical school classes are comprised of at least 50% women, a group that classically has not flocked to surgery as a profession, we are under increasing pressure to make the specialty more attractive, starting with the education component. Students entering medical school today have a different set of values than students who entered 20 years ago. There is more of a global perspective, and an increasing awareness of service, as opposed to the desire to generate a large income. Students in medical school today cite lifestyle issues as the single most important influence in choosing a specialty. The next generation of
International Journal of Surgery, 2020
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The Contemporary Context of Surgical Education
Advancing Surgical Education, 2019
Overview The development of a competent surgeon has evolved over centuries from a predominantly apprenticeship model to one that incorporates modern theories of learning accompanied by increasing awareness of the significant contribution from the hidden curriculum. Increasing public awareness and demands from educators and trainees have emphasised the importance of nontechnical competencies. The Royal Australasian College of Surgeons has determined nine core competencies as a basic requirement for surgical training. It has responded to emerging demands by the introduction of formal educational processes supporting the development of an educationally aware surgical teaching community. A challenge for surgical training is to balance the increasing demands on the surgical education workforce while delivering an expanded surgical curriculum that best serves the modern community. This chapter explores the changing field of surgical education and provides an overview of the future challenges.
Surgical Education in the Internet Era
Journal of Surgical Research, 2009
Technological advancements, along with economic and political issues, have resulted in major changes in surgical education. The development of high fidelity simulators and the widespread availability of the Internet have allowed learning to be shifted away from the operating room. Furthermore, the Internet provides an opportunity for surgical educators to standardize general surgery training and assessment and to develop collaborations nationally and globally. This paper highlights presentations about the challenges as well as the rewards of surgical education in the age of the Internet from the
Journal of Surgical Education, 2010
The SCORE curriculum defines surgical operations/procedures that residents are expected to be competent with by the end of the residency. The purpose of this study was to conduct a gap analysis to determine how well the operative experience in a general surgery residency program approximates the expectations of the SCORE curriculum, especially regarding those procedures considered essential to general surgical training. Final ACGME resident operative experience reports of recent Northwestern University general surgery program graduates (n = 15) were compared with the specific procedures and procedure levels (ie, Essential-Common, Essential-Uncommon, Complex) defined in the SCORE curriculum. The average numbers of individual SCORE procedures and procedures per SCORE procedure level performed per resident were summarized using descriptive statistics. During their 5 years of training general surgery residents logged a mean of 1025.7 (SD 152.9) primary procedures per resident. We were able to match 87.1% of these ACGME logged procedures with specific procedures identified in the SCORE curriculum. On average, of the Essential-common procedures, 23 (35%) were performed >10 times and 35 (53%) were performed >five times. Conversely, the number of Essential-uncommon and Complex procedures performed >five times were 3 (5%) and 10 (7%), respectively. Several procedures identified in the SCORE curriculum were performed at very low frequency during residency training. This experience suggests that leadership at SCORE and the ACGME need to make the curriculum and logging system compatible and that surgical residents need to be better educated with regards to case logging. Despite these issues, important differences appeared to exist between actual resident operative experiences and expectations set by the SCORE curriculum. Based on these finding we advocate that similar gap analyses be performed at other surgical residency training programs to identify discrepancies between program experience and SCORE curriculum expectations.
Review of Influential Articles in Surgical Education: 2002–2012
Journal of Graduate Medical Education, 2013
Background Exploring the trends in surgical education research offers insight into concerns, developments, and questions researchers are exploring that are relevant to teaching and learning in surgical specialties.