As part of the introduction of the “LSI pilot in
Understanding Patients with Reproductive and Surgical Needs”, we presented to
the Departments of Surgery, Obstetrics and Gynecology, and Anesthesiology a
brief talk on “Improving Education in the Operating Room.” Many surgeons,
including some of our own, have contributed to this body of work, with multiple
surgical journals regularly publishing research in surgical education.
Hampton et al
describe four categories of OR learning for all students:
- Development of a foundation of clinical knowledge
- Surgical technique and skill acquisition
- Personal insight into career choice
- Surgical culture and OR functioning
There are several basic ways to improve teaching and
learning in the operating room for both students and residents:
- Trainees and faculty work together to establish learning
goals for each per case or day. These should be discussed before the case and
then evaluated (“debriefed”) after the case in a manner that is honest but
educational and not punitive.
Without this type of plan, education may easily take a back seat to stress,
efficiency and purely technical description, and what is taught will tend to
vary widely and be unfocused.
- Students and residents must read about and meet the patient
preoperatively and read about the disease process, planned operation,
anesthetic and post-operative care.
- All members of the team should learn and use each other’s
names.
- Teachers should talk about decisions they are making and how
they make them, as opposed to strictly giving technical directions (e.g., “hold
this”, “stop”, “turn this up,” etc.)
Mental Practice is a technique of preparation by detailed visualization.
This is much more detailed than reviewing basic steps and can be guided by a
script that includes sight, sound, and textures beyond a simple checklist. In
its formal application, this technique has proven to be effective in improving
performance and decreasing trainee stress.
However, even a self-guided, informal visualization is likely to improve one’s performance
as well.
Like many things, paying attention to teaching in the
operating room is an excellent first step. Beyond that is an evolving science
of education that is ripe to be joined by interested faculty and trainees
alike.
