Surgical skills training for practicing surgeons founded on established educational theories and frameworks

Abstract

Following completion of structured training in residency or fellowship programs, surgeons need to acquire new skills throughout their careers to address changes in their surgical practices, and to perform new procedures and use new technologies as these are developed. The opportunities available to surgeons to acquire the new skills, safely introduce these skills into surgical practice, and then maintain the skills, vary greatly and may not fully support a surgeon’s needs. The article shares background information relating to the vexing problems, and describes established educational theories and frameworks as well as specific frameworks relating to surgical skills training and verification that may be used in designing and implementing comprehensive and impactful surgical skills training programs aimed at practicing surgeons. A number of practical strategies based on these theories and frameworks are highlighted. National professional organizations and academic medical centers need to play a critical role in pursuing such efforts, which will remain pivotal in supporting the professional work of surgeons and in providing optimal surgical care well into the future.

Keywords:

• Skills acquisition by practicing surgeons
• surgical skills courses
• educational theories and surgical skills training
• CPD

Disclosure statement

The authors report no conflict of interest.

GLOSSARY

• Preceptorship – Preceptoring of a surgeon learner after participation in a skills course should involve an expert surgeon observing the surgeon learner’s skills in the real environment, such as the operating room, providing technical help as needed, and sharing specific feedback regarding the performance, with the goal of addressing the gaps identified. This process should continue until the surgeon learner has achieved the requisite level of skills verified through the preceptor’s assessments that are conducted using contemporary educational methods that yield data supported by multiple sources of strong validity evidence.

• Proctoring – Proctoring involves summative and high stakes assessments of the skills of a surgeon learner by an expert surgeon using contemporary methods that yield data supported by multiple sources of rigorous validity evidence. The proctor does not participate in the performance of the task, nor provides advice or guidance. The principal responsibility of the proctor is to share the results of the assessments with the Department Chair, Division Chief, or other institutional officials involved with credentialing and privileging of surgeons.

Additional information

Funding

The authors report there are no competing interests to declare.

Notes on contributors

Ajit K. Sachdeva

Ajit K. Sachdeva, MD, FACS, FRCSC, FSACME, MAMSE, is Founding Director of the Division of Education at the American College of Surgeons, and is Adjunct Professor of Surgery at the Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Ara Tekian

Ara Tekian, PhD, MHPE, is Professor of Medical Education in the Department of Medical Education and Associate Dean in the Office of International Education at the University of Illinois College of Medicine, Chicago, Illinois, USA.

Yoon Soo Park

Yoon Soo Park, PhD, is the Ilene B. Harris Endowed Professor and Head of the Department of Medical Education at the University of Illinois College of Medicine, Chicago, Illinois, USA.

Jeffrey J. H. Cheung

Jeffrey J. H. Cheung, PhD, is Assistant Professor in the Department of Medical Education at the University of Illinois College of Medicine, Chicago, Illinois, USA.