David E. Beck, Steven D. Wexner, Tracy L. Hull, Patricia L. Roberts, Theodore J. Saclarides, Anthony J. Senagore, Michael J. Stamos and Scott R. Steele (eds.)The ASCRS Manual of Colon and Rectal Surgery2nd ed. 201410.1007/978-1-4614-8450-9_54
© Springer Science+Business Media New York 2014
54. Surgical Education
(1)
Department of Colon and Rectal Surgery, Lahey Health and Medical Center, Burlington, MA, USA
Abstract
Surgical education is undergoing exciting and challenging major transformational change within the broader context of healthcare reform, physician shortages, and financial uncertainty.
The traditional “see one, do one, teach one” paradigm of bygone years is no longer feasible; patients do not expect a partially trained and sleep-deprived resident to practice on them without supervision.
Traditional “modern” surgical residencies are generally attributed to Halsted, who initiated the competitive pyramidal system.
Background
Surgical education is undergoing exciting and challenging major transformational change within the broader context of healthcare reform, physician shortages, and financial uncertainty.
The traditional “see one, do one, teach one” paradigm of bygone years is no longer feasible; patients do not expect a partially trained and sleep-deprived resident to practice on them without supervision.
Traditional “modern” surgical residencies are generally attributed to Halsted, who initiated the competitive pyramidal system.
Objections to the Halsted model revolved around the master/apprentice relationship and thus the total reliance on the master without regard for validation of the qualities of the teacher.
Churchill abolished the pyramid of Halsted and replaced it with a “rectangular” plan; those who wished to pursue academic careers would need to pursue extra experience outside the residency period.
Cognitive Learning
The need to develop and teach a standardized basic body of knowledge was stimulated in part by the Accreditation Council for Graduate Medical Education (ACGME), the various Residency Review Committees (RRC) and certifying boards.
Curriculum may be “syllabus based,” meaning a list of topics that forms the basis of what is being studied.
This is convenient but treats the learner as a passive recipient.
“Objectives-based” curricula are predicated on the faculty identifying behavioral objectives and creating learning-based activities and evaluation tools based on these objectives.
More complex is “curriculum as process,” requiring continuous interaction between teacher and learner.
Its main advantage is the active participation of the learner in the process.
It is much more challenging for the faculty.Related posts:
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