Cross-Sectional Survey of Effective Educational Techniques of a Master Surgeon
*Winston L. Trope, *Zane Hellmann, John W. Kunstman
Department of Surgery, Section of Surgical Oncology, Yale School of Medicine, New Haven, CT, United States.
Background Surgical oncology is a challenging subspecialty to learn and teach, requiring application of multiple surgical skillsets. A surgical oncologist at our center performed over 1,000 pancreatoduodenectomies and won ten Chief Resident teaching awards during his career. This study identified teaching practices this surgeon used to effectively share his knowledge of this subspecialty with a wide range of trainees. It also characterized how his teaching impacted students, with the understanding that all trainees, even those not specializing in surgical oncology, still benefit from instruction in a complex discipline. Perioperative photographs were correlated with teaching practices to make them more adaptable for other surgical educators. Study Design An open-response 6 question survey querying teaching principles was distributed to trainees who completed a surgical oncology rotation from 2014-2023. Respondents received targeted questions based upon self-identified characteristics, including level of training and surgical subspecialty. Surveys were analyzed for frequently noted behaviors and trends. Curated surgical photographs were obtained with consent. Images were reviewed and correlated with the behaviors observed following survey analysis. Results 8 trainees and 7 attending surgeons completed the survey (response rate, 39.5%). Replies were categorized into patient care, technical skill, operative planning, and educational considerations. 100% (15/15) of respondents noted a specific technical skill from the surgeon, such as dissection technique. 93% (14/15) mentioned planning, including breaking operations into steps and discussing those steps with the team. 80% (12/15) of respondents mentioned education, highlighting the surgeon?s intentional focus on skills that would serve trainees well, regardless of specialty. 40% (6/15) also mentioned patient care, such as drawing diagrams of procedures for patient understanding (Figure). Trainees were more likely than attending surgeons to highlight the importance of graded autonomy (p=0.031). This development of surgical autonomy was correlated in multiple study photos. There was a trend towards trainees being more likely than attending surgeons to mention educational considerations (p=0.077). There was also a trend towards attending surgeons noting specific dissection techniques as important in their current surgical practice (p=0.051). Conclusions Learner?s priorities and reflections on teaching change as they progress from trainee to attending surgeon. Lessons provided during residency may not be fully understood until later in a surgeon?s career. Nevertheless, the ability to effectively envision and plan a procedure remains critical throughout an individual?s progression. Images capturing a teacher?s strengths in the operative room may serve as effective didactic aids for junior faculty members seeking to hone their teaching techniques and understand which practices are most valued by trainees.
Images correlating considerations frequently noted in surveys, including graded autonomy, technical skills, and imaging review and team planning.
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