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The Contemporary Context of Surgical Education

  • Adrian AnthonyEmail author
  • Vijayaragavan Muralidharan
Chapter
Part of the Innovation and Change in Professional Education book series (ICPE, volume 17)

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.

Keywords

Surgical education Nontechnical competencies Hidden curriculum Social obligation Professionalism 

References

  1. 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. 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.
  3. 3.
    Kneebone, R., & Fry, H. (2011). The environment of surgical training and education. In H. Fry & R. Kneebone (Eds.), Surgical education – theorising and emerging domain (Vol. 2, 1st ed., pp. 3–17). Dordrecht: Springer.  https://doi.org/10.1007/978-94-007-1682-7.CrossRefGoogle Scholar
  4. 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. 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. 6.
    RACS. (2012). Becoming a competent and proficient surgeon: Training standards for the nine RACS competencies.Google Scholar
  7. 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
  8. 8.
    Arora, S., Sevdalis, N., Nestel, D., Woloshynowych, M., Darzi, A., & Kneebone, R. (2010). The impact of stress on surgical performance: A systematic review of the literature. Surgery, 147(3), 318–330.e6.  https://doi.org/10.1016/j.surg.2009.10.007.CrossRefGoogle Scholar
  9. 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. 10.
    Kennedy, I. (2002). Learning from Bristol.Google Scholar
  11. 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. 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.
  13. 13.
    Arora, S., Sevdalis, N., Suliman, I., Athanasiou, T., Kneebone, R., & Darzi, A. (2009). What makes a competent surgeon?: Experts’ and trainees’ perceptions of the roles of a surgeon. American Journal of Surgery, 198(5), 726–732.  https://doi.org/10.1016/j.amjsurg.2009.01.015.CrossRefGoogle Scholar
  14. 14.
    Cruess, S. R., & Cruess, R. L. (2009). The cognitive base of professionalism. In Teaching medical professionalism (pp. 1–27).Google Scholar
  15. 15.
    Paice, E. (2009). Identification and management of the underperforming surgical trainee. ANZ Journal of Surgery, 79(3), 180–184.; ; discussion 185.  https://doi.org/10.1111/j.1445-2197.2008.04837.x.CrossRefGoogle Scholar
  16. 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. 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. 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.
  19. 19.
    Irby, D. M., & Hamstra, S. J. (2016). Parting the clouds: Three professionalism frameworks in medical education. Academic Medicine, 91(12), 1606–1611.  https://doi.org/10.1097/ACM.0000000000001190.CrossRefGoogle Scholar
  20. 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. 21.
    RACS. (2011b). Surgical workforce projection to 2025: Volume 1 the Australian workforce (Vol. 1).Google Scholar
  22. 22.
    HWA. (2012). Health workforce 2025 doctors , nurses and midwives – volume 1 (Vol. 1).Google Scholar
  23. 23.
    Young, C. (2011). International medical graduate – can we do better? General Surgeons Australia Newsletter, 12(3), 2.Google Scholar
  24. 24.
    RACS. (2011a). Surgical workforce 2011 census report.Google Scholar
  25. 25.
    Commonwealth of Australia. (2012). Medical training review panel fifteenth report.Google Scholar
  26. 26.
    McIhenny, C., & Pitts, D. (2014). Royal College of Surgeons of Edinburgh, Faculty of Surgical Trainers: Standards for Surgical Trainers.Google Scholar
  27. 27.
    GMC. (2015). Promoting excellence: Standards for medical education and training.Google Scholar
  28. 28.
    Silbert, B. I., Lam, S. J. P., Henderson, R. D., & Lake, F. R. (2013). Students as teachers. Medical Journal of Australia, 199(3), 4–5.  https://doi.org/10.5694/mja12.10970.CrossRefGoogle Scholar
  29. 29.
    Sobral, D. T. (2006). Influences on choice of surgery as a career: A study of consecutive cohorts in a medical school. Medical Education, 40(6), 522–529.  https://doi.org/10.1111/j.1365-2929.2006.02482.x.CrossRefGoogle Scholar
  30. 30.
    Australian Health Ministers’ Advisory Council. (2015). Review of medical intern training.Google Scholar
  31. 31.
    RACS. (2016). Diversity & inclusion plan.Google Scholar
  32. 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. 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

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Upper Gastro-Intestinal Unit, The Queen Elizabeth Hospital, Department of Surgery, Discipline of SurgeryUniversity of AdelaideAdelaideAustralia
  2. 2.Board of Surgical Education & TrainingRoyal Australasian College of SurgeonsMelbourneAustralia
  3. 3.HPB & Transplant Unit, Austin HealthMelbourneAustralia
  4. 4.Department of SurgeryThe University of Melbourne, Austin HealthMelbourneAustralia
  5. 5.Board in General SurgeryRoyal Australasian College of SurgeonsMelbourneAustralia

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