Teaching, Learning, and Performance in the Surgical Workplace: Insights From the Examination of Intraoperative Interactions

Abstract

This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Central Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. These thoughts explore the value of examining intraoperative interactions among attending surgeons and residents for enhancing instructional scaffolding; entrustment decision making; and distinguishing teaching, learning, and performance in the workplace.

Teaching Surgical Model Development in Research by Using Situated Learning and Instructional Scaffolding

“…4 Situated learning is directly applicable to the teaching of surgical models and is the long-time foundation of both veterinary and human clinical education. 23 Surgical skills are acquired through 3 consecutive learning stages: cognitive, associative, and autonomous. 20 Teaching surgical skills through consecutive learning stages utilizes the concept of instructional scaffolding, in which learning objectives are broken down into smaller packets of learning that, when combined, result in the ability to identify and solve a complex problem.…”

“…Surgical training is composed of many iterations of these interactions that combine intellectual acuity with physical coordination and cooperation between mentors and trainees. 23 Furthermore, surgical training is an ongoing and continuous process, given that surgeons must stay abreast of new and refined methods, analgesics, and anesthetics. This constant evolution of the field is why it is critical for a training plan to teach trainees how to think and act as surgeons so that they can adapt and grow rather than only to ensure technical competency in a specific model.…”

“…We typically use this device to move mice from cage to induction chamber when performing microCT analysis on operated mice. 23 Once a mentor is confident in a trainee's ability to perform the surgery successfully with minimal instruction and to provide postoperative care, trainees can progress to the next stage.…”

The 3‐Dimensional Temporal Bone Dissection Manual: Operable Stepwise Models for Teaching Otologic Surgery

“…1 A procedure can be broken down into simpler tasks (task deconstruction) and then appropriate instruction is made available to guide the novice (instructional scaffolding). 2,3 We propose a novel use of 3-dimensional (3D) models in surgical training: stepwise models that are operable, both to demonstrate an unfolding operation as a 3D dissection guide, but also to allow for practice of the operation, with the option to practice any specific step repeatedly and in any order. The objective of this study was to develop and pilot test a process for creating reproducible stepwise surgical 3D models that are patient and surgical educator specific.…”

“…For example, operative textbooks and dissection manuals break down surgeries into smaller steps that are put together to demonstrate the progression of the surgery 1 . A procedure can be broken down into simpler tasks (task deconstruction) and then appropriate instruction is made available to guide the novice (instructional scaffolding) 2,3 …”