The Contemporary Context of Surgical Education
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.
KeywordsSurgical education Nontechnical competencies Hidden curriculum Social obligation Professionalism
- 1.Flexner, A. (1910). Medical education in the United States and Canada – A report to the Carnegie Foundation for the advancement of teaching.Google Scholar
- 2.Scott, S. V. (2014). Practising what we preach: Towards a student-centred definition of feedback. Teaching in Higher Education, 19(January 2015), 49–57. https://doi.org/10.1080/13562517.2013.827639.
- 4.Hull, L., Arora, S., Aggarwal, R., Darzi, A., Vincent, C., & Sevdalis, N. (2012). The impact of non-technical skills on technical performance in surgery: A systematic review data sources. Journal of the American College of Surgeons, 214(2), 214–230. https://doi.org/10.1016/j.jamcollsurg.2011.10.016.CrossRefGoogle Scholar
- 5.Flin, R., O’Connor, P., & Crichton, M. (2008). Safety at the sharp end: A guide to non-technical skills (1st ed.). Hampshire: Ashgate Publishing Ltd..Google Scholar
- 6.RACS. (2012). Becoming a competent and proficient surgeon: Training standards for the nine RACS competencies.Google Scholar
- 7.Wong, B., Ackroyd-Stolarz, S., Bukowskyj, M., Calder, L., Ginzburg, A., Microys, S., … Wallace, G. (2014). The CanMEDS 2015 patient safety and quality improvement expert working group report.Google Scholar
- 9.Cooper, W. O., Guillamondegui, O., Hines, O. J., Hultman, C. S., Kelz, R. R., Shen, P., … Hickson, G. B. (2017). Use of unsolicited patient observations to identify surgeons with increased risk for postoperative complications. JAMA Surgery, 37212, E1–E8. https://doi.org/10.1001/jamasurg.2016.5703.
- 10.Kennedy, I. (2002). Learning from Bristol.Google Scholar
- 11.RACS. (2015). Expert advisory group expert advisory group report to RACS on discrimination, bullying and sexual harassment expert advisory group expert advisory group report to RACS. Retrieved from http://www.surgeons.org/about/building-respect,-improving-patient-safety/expert-advisory-group/
- 12.Fnais, N., Soobiah, C., Chen, M. H., Lillie, E., Perrier, L., Tashkhandi, M., … Tricco, A. C. (2014). Harassment and discrimination in medical training: A systematic review and meta-analysis. Academic Medicine, 89(5), 817–827. https://doi.org/10.1097/ACM.0000000000000200.
- 14.Cruess, S. R., & Cruess, R. L. (2009). The cognitive base of professionalism. In Teaching medical professionalism (pp. 1–27).Google Scholar
- 16.Hodges, B. D., Ginsburg, S., Cruess, R., Cruess, S., Delport, R., Hafferty, F., … Holtman, M. (2011). Assessment of professionalism: Recommendations from the Ottawa 2010 Conference. Medical Teacher, 33(5), 354–363. https://doi.org/10.3109/0142159X.2011.577300.
- 17.Bearman, M., O’Brien, R., Anthony, A., Civil, I., Flanagan, B., Jolly, B., … Nestel, D. (2012). Learning surgical communication, leadership and teamwork through simulation. Journal of Surgical Education, 69(2), 201–207. https://doi.org/10.1016/j.jsurg.2011.07.014.
- 18.Rao, R., Dumon, K. R., Neylan, C. J., Morris, J. B., Riddle, E. W., Sensenig, R., … Brooks, A. D. (2016). Can simulated team tasks be used to improve nontechnical skills in the operating room? Journal of Surgical Education, 73(6), e42–e47. https://doi.org/10.1016/j.jsurg.2016.06.004.
- 20.Cruess, R., Mcilroy, J. H., Cruess, S., Ginsburg, S., & Steinert, Y. (2006). The professionalism mini-evaluation exercise: A preliminary investigation. Academic Medicine, 81(10), 574–578.Google Scholar
- 21.RACS. (2011b). Surgical workforce projection to 2025: Volume 1 the Australian workforce (Vol. 1).Google Scholar
- 22.HWA. (2012). Health workforce 2025 doctors , nurses and midwives – volume 1 (Vol. 1).Google Scholar
- 23.Young, C. (2011). International medical graduate – can we do better? General Surgeons Australia Newsletter, 12(3), 2.Google Scholar
- 24.RACS. (2011a). Surgical workforce 2011 census report.Google Scholar
- 25.Commonwealth of Australia. (2012). Medical training review panel fifteenth report.Google Scholar
- 26.McIhenny, C., & Pitts, D. (2014). Royal College of Surgeons of Edinburgh, Faculty of Surgical Trainers: Standards for Surgical Trainers.Google Scholar
- 27.GMC. (2015). Promoting excellence: Standards for medical education and training.Google Scholar
- 30.Australian Health Ministers’ Advisory Council. (2015). Review of medical intern training.Google Scholar
- 31.RACS. (2016). Diversity & inclusion plan.Google Scholar
- 32.Khoury, A., Mendoza, A., & Charles, A. (2012). Cultural competence: Why surgeons should care. Bulletin of the American College of Surgeons, 97, 13–18.Google Scholar
- 33.Australian Medical Council. (2015). Standards for assessment and accreditation of specialist medical education programs and professional development programs. Retrieved from https://amc-cms-prod.s3.amazonaws.com/files/fc6e591a9a87c6c2b45e1d744eafa41e5499717d_original.pdf