How to Teach Surgical Residents during Damage Control Surgery
Purpose of Review
Damage control can be difficult to teach. Residents have few operative trauma experiences. During damage control situations, the resident’s education may be lost in the stressful and fast, paced operating room due to patient care taking priority. Fortunately, there are numerous other opportunities to teach this important concept outside of the operating room.
Damage control can be taught in a three step cycle from war games to intraoperative teaching during a crisis and ending with an after action review. This process is also applicable to other intraoperative crises and acute medical conditions such as a code event.
This manuscript describes multiple opportunities for education both in and outside the operating room when during the stressful moment, patient care takes priority.
KeywordsDamage control Resident education War games Intraoperative teaching After action review
Compliance with Ethical Guidelines
Conflict of interest
Lisa L. Schlitzkus, Brett H. Waibel, and Paul J. Schenarts declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance
- 1.Napolitano LM, Biester TW, Jurkovich GJ, Buyske J, Malangoni MA, Lewis FR Jr. Members of the Trauma, Burns and Critical Care Board of the American Board of Surgery. General surgery resident rotations in surgical critical care, trauma, and burns: what is optimal for residency training? Am J Surg. 2016;212(4):629–37.CrossRefPubMedGoogle Scholar
- 2.The American Board of Surgery Booklet of Information Surgery. Available at https://www.absurgery.org/xfer/BookletofInfo-Surgery.pdf. Accessed on 9 Apr 2018.
- 9.•Tainter CR, Wong NL, Cudemus-Deseda GA, Bittner EA. The “Flipped Classroom” Model for Teaching in the Intensive Care Unit. J Intensive Care Med. 2017;32(3):187–96. This pilot study provides a concise overview of the advantages of the flipped classroom.Google Scholar
- 21.Brookfield SD. Understanding and facilitating adult learning. San Francisco: Jossey-Bass Publishers; 1990.Google Scholar
- 24.••Butvidas LD, Anderson CI, Balogh D, Basson MD. Disparities between resident and attending surgeon perceptions of intraoperative teaching. Am J Surg. 2011;201(3):385–9. This study compares attending and residents’ recall of positive and negative intraoperative teaching experiences and demonstrates that while each agree on the effectiveness of various methods, the frequency of these opportunities based on recall is highly variable.Google Scholar
- 30.A Leader’s Guide to After-Action Reviews. Training Circular 25-20, United States Army. http://www.au.af.mil/au/awc/awcgate/army/tc_25-20/tc25-20.pdf Accessed 9 Apr 2018.
- 32.Schwarz R. The “Sandwich Approach” Undermines Your Feedback. Harvard Business Review, April 19, 2013. https://hbr.org/2013/04/the-sandwich-approach-undermin. Accessed 9 Apr 2018. This article describes the failures of the “Sandwich Approach” and an alternative approach with a case scenario.
- 33.Von Bergen CW, Bressler MS, Campbell K. The sandwich feedback method: not very tasty. Journal of Behavioral Studies in Business. http://www.aabri.com/manuscripts/141831.pdf. Accessed 9 Apr 2018.
- 34.An Illustrated Guide to the Feedback Sandwich—Tasty or Bitter? http://www.businesszone.co.uk/blogs/knowledgetrain/project-management-21st-century/illustrated-guide-feedback-sandwich-tasty-or-bi. Accessed 9 Apr 2018.
- 35.Wood, A. The Feedback Sandwich—Tasty or Bitter? In: Project Community. May 7, 2013. Available at http://projectcommunityonline.com/the-feedback-sandwich-tasty-or-bitter.html. Accessed 9 Apr 2018.