Strides in Development of Medical Education

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Clinical Teaching of Residents in Operating Room: A Review of Methods and Strategies for Strengthening Teaching and Learning

Document Type : Review

Authors

1 1 Candidate in Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Urology, Medical Education Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background The operating room is considered a learning platform for technical and non-technical skill training. Training in operating rooms helps learners from different groups, especially surgery residents, acquire the necessary clinical competence. Nevertheless, operating room training is only effective if it is accompanied by efficient and applicable teaching methods. Objectives The current study aimed at reviewing the strategies and methods to enhance teaching and learning of residents in operating room settings. Methods The current review study was conducted based on library studies and review of the literature. PubMed, SID, and MagIran databases, as well as Google Scholar search engine, were searched using relevant phrases and keywords. A total of 60 articles were retrieved, out of which 22 articles were identified as consistent with the study objectives. Results The data obtained from the literature review were categorized into three sections: “General structure of training in the operating room”, “strategies and methods to strengthen teaching and learning in the operating room”, and “structured training models in the operating room”. Finally, application of these strategies in clinical teaching was summarized in three stages: Before operation, during operation, and after operation. Conclusions The operating room is a clinical facility with specific characteristics, which can challenge teaching in this setting. However, application of effective strategies and methods, as well as efficiently structured training based on the proposed models can facilitate teaching and learning enhancement in operating rooms.

Keywords

References
  1. Zundel S, Wolf I, Christen HJ, Huwendiek S. What supports students’ education in the operating room? A focus group study including students’ and surgeons’ views. Am J Surg. 2015;210(5):951–9. doi:10.1016/j.amjsurg.2015.03.011. [PubMed: 26072189].
  2. Kanashiro J, McAleer S, Roff S. Assessing the educational environment in the operating room-a measure of resident perception at one Canadian institution. Surgery. 2006;139(2):150–8. doi:10.1016/j.surg.2005.07.005. [PubMed: 16455322].
  3. Kieu V, Stroud L, Huang P, Smith M, Spychal R, Hunter-Smith D, et al. The operating theatre as classroom: A qualitative study of learning and teaching surgical competencies. Educ Health (Abingdon).

2015;28(1):22–8. doi: 10.4103/1357-6283.161845. [PubMed: 26261110].

  1. Vikis EA, Mihalynuk TV, Pratt DD, Sidhu RS. Teaching and learning in the operating room is a two-way street: Resident perceptions. Am J Surg. 2008;195(5):594–8. discussion 598. doi:10.1016/j.amjsurg.2008.01.004. [PubMed: 18367140].
  2. Jeffree RL, Clarke RM. Ten tips for teaching in the theatre tearoom: Shifting the focus from teaching to learning. World J Surg.2010;34(11):2518–23. doi: 10.1007/s00268-010-0719-6. [PubMed:20652699].
  3. Sullivan SA, Anderson BM, Pugh CM. Development of technical skills: Education, simulation, and maintenance of certification. J Craniofac Surg. 2015;26(8):2270–4. doi:10.1097/SCS.0000000000002213.

[PubMed: 26501974].

  1. Champagne BJ. Effective teaching and feedback strategies in the or and beyond. Clin Colon Rectal Surg. 2013;26(4):244–9. doi: 10.1055/s0033-1356725. [PubMed: 24436685]. [PubMed Central:PMC3835457].
  2. Spencer J. Learning and teaching in the clinical environment. BMJ. 2003;326(7389):591–4. doi:10.1136/bmj.326.7389.591. [PubMed:12637408]. [PubMed Central: PMC1125480].
  3. Schwind CJ, Boehler ML, Rogers DA, Williams RG, Dunnington G, Folse R, et al. Variables influencing medical student learning in the operating room. Am J Surg. 2004;187(2):198–200. doi:10.1016/j.amjsurg.2003.11.024. [PubMed: 14769304].
  4. Roberts NK, Brenner MJ, Williams RG, Kim MJ, Dunnington GL. Capturing the teachable moment: A grounded theory study of verbal teaching interactions in the operating room. Surgery. 2012;151(5):643–50.doi: 10.1016/j.surg.2011.12.011. [PubMed: 22244182].
  5. van der Houwen C, Boor K, Essed GG, Boendermaker PM, Scherpbier AA, Scheele F. Gynaecological surgical training in the operating room: An exploratory study. Eur J Obstet Gynecol Reprod Biol. 2011; 154(1): 90–5.doi: 10.1016/j.ejogrb.2010.08.014. [PubMed: 20950925].
  6. Lyon P. A model of teaching and learning in the operating theatre. Med Educ. 2004;38(12):1278–87. doi: 10.1111/j.1365-2929.2004.02020.x. [PubMed: 15566539].
  7. Swanwick T. Understanding medical education: Evidence, theory and practice. New Jersey: John Wiley and Sons; 2013.
  8. Hu YY, Mazer LM, Yule SJ, Arriaga AF, Greenberg CC, Lipsitz SR, et al. Complementing operating room teaching with video-based coaching. JAMA Surg. 2017;152(4):318–25. doi:10.1001/jamasurg.2016.4619.

[PubMed: 27973648].

  1. Leung Y, Salfinger S, Mercer A. The positive impact of structured teaching in the operating room. Aust N Z J Obstet Gynaecol. 2015;55(6):601–5. doi: 10.1111/ajo.12392. [PubMed: 26287274].
  2. Dedy NJ, Fecso AB, Szasz P, Bonrath EM, Grantcharov TP. Implementation of an effective strategy for teaching nontechnical skills in the operating room: A single-blinded nonrandomized trial. Ann Surg.

2016;263(5):937–41. doi: 10.1097/SLA.0000000000001297. [PubMed:26079900].

  1. Hampton BS, Craig LB, Abbott JF, Buery-Joyner SD, Dalrymple JL, Forstein DA, et al. To the point: Teaching the obstetrics and gynecology medical student in the operating room. Am J Obstet Gynecol. 2015;213(4):464–8. doi: 10.1016/j.ajog.2015.04.002. [PubMed:25857571].
  2. Schenarts PJ, Flowers K. Too many excuses for not teaching in the operating room and one simple solution: Faculty feedback. JAMA Surg. 2013;148(10):923. doi: 10.1001/jamasurg.2013.2154. [PubMed:23945761].
  3. DaRosa DA, Zwischenberger JB, Meyerson SL, George BC, Teitelbaum EN, Soper NJ, et al. A theory-based model for teaching and assessing residents in the operating room. J Surg Educ. 2013;70(1):24–30. doi:10.1016/j.jsurg.2012.07.007. [PubMed: 23337666].
  4. Snyder RA, Tarpley MJ, Tarpley JL, Davidson M, Brophy C, Dattilo JB. Teaching in the operating room: Results of a national survey. J Surg Educ. 2012;69(5):643–9. doi: 10.1016/j.jsurg.2012.06.007. [PubMed:22910164].
  5. Skoczylas LC, Littleton EB, Kanter SL, Sutkin G. Teaching techniques in the operating room: The importance of perceptual motor teaching. Acad Med. 2012;87(3):364–71. doi:10.1097/ACM.0b013e31824484a0. [PubMed: 22373633].
  6. Yule S, Flin R, Paterson-Brown S, Maran N. Non-technical skills for surgeons in the operating room: A review of the literature. Surgery. 2006;139(2):140–9. doi: 10.1016/j.surg.2005.06.017. [PubMed:16455321].
  7. Cox SS, Swanson MS. Identification of teaching excellence in operating room and clinic settings. Am J Surg. 2002;183(3):251–5. [PubMed:11943121].
  8. Roberts NK, Williams RG, Kim MJ, Dunnington GL. The briefing, intraoperative teaching, debriefing model for teaching in the operating room. J Am Coll Surg. 2009;208(2):299–303. doi:10.1016/j.jamcollsurg.2008.10.024. [PubMed: 19228544].
  9. Meyer R, Van Schalkwyk SC, Prakaschandra R. The operating room as a clinical learning environment: An exploratory study.Nurse Educ Pract. 2016;18:60–72. doi: 10.1016/j.nepr.2016.03.005. [PubMed:27235567].
  10. Mirbagher Ajorpaz N, Zagheri Tafreshi M, Mohtashami J, Zayeri F. [Mentoring in training of operating room students: A systematic review]. J Nurs Educat. 2016;5(3):47–54. Persian.
  11. Lyon PM. Making the most of learning in the operating theatre: Student strategies and curricular initiatives. Med Educ. 2003;37(8):680–8. [PubMed: 12895247].
  12. Putnam LR, Levy SM, Kellagher CM, Etchegaray JM, Thomas EJ, Kao LS, et al. Surgical resident education in patient safety: Where can we improve? J Surg Res. 2015;199(2):308–13. doi:10.1016/j.jss.2015.06.024. [PubMed: 26165614].
  13. Aminian A, Chaudhry RM, Khorgami Z, Andalib A, Augustin T, Rodriguez J, et al. A Challenge between trainee education and patient safety: Does fellow participation impact postoperative outcomes following bariatric surgery? Obes Surg. 2016;26(9):1999–2005. doi:10.1007/s11695-016-2073-8. [PubMed: 26815984].
  14. Clynes MP, Raftery SE. Feedback: An essential element of student learning in clinical practice. Nurse Educ Pract. 2008;8(6):405–11. doi:10.1016/j.nepr.2008.02.003. [PubMed: 18372216].
  15. Haghani F, Rahimi M, Ehsanpour S. [An investigation of " perceived feedback" in clinical education of midwifery students in Isfahan University Of Medical Sciences]. Iranian J Med Educ. 2014;14(7):571–80. Persian.
  16. Rahimi M, Ehsanpour S, Haghani F. The role of feedback in clinical education: Principles, strategies, and models. J Med Educ Dev. 2016;10(4):264–77.
  17. Quinton S, Smallbone T. Feeding forward: Using feedback to promote student reflection and learning: A teaching model. innov educ teach int. 2010;47(1):125–35. doi:10.1080/14703290903525911.
  18. Aronson L, Niehaus B, Hill-Sakurai L, Lai C, O’Sullivan PS. A comparison of two methods of teaching reflective ability in year 3 medical students. Med Educ. 2012;46(8):807–14. doi: 10.1111/j.1365-

2923.2012.04299.x. [PubMed: 22803758].

  1. Wald HS, Davis SW, Reis SP, Monroe AD, Borkan JM. Reflecting on reflections: Enhancement of medical education curriculum with structured field notes and guided feedback. Acad Med. 2009; 84(7): 830–7. doi: 10.1097/ACM.0b013e3181a8592f. [PubMed: 19550172].
  2. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: A systematic review. Adv Health Sci Educ Theory Pract. 2009;14(4):595–621. doi: 10.1007/s10459-007-9090-2. [PubMed: 18034364].
  3. Muir F, Scott M, McConville K, Watson K, Behbehani K, Sukkar F. Taking the learning beyond the individual: How reflection informs change in practice. Int J Med Educ. 2014;5:24–30. doi:10.5116/ijme.52ec.d21f. [PubMed: 25341208]. [PubMed Central: PMC4207185].
  4. Mamede S, Schmidt HG. The structure of reflective practice in medicine. Med Educ. 2004; 38(12): 1302–8. doi: 10.1111/j.1365-2929.2004.01917.x. [PubMed: 15566542].
  5. Stronge JH. Evaluating teaching: A guide to current thinking and best practice. California: Corwin Press; 2005.
  6. Ravindra P, Fitzgerald JE, Bhangu A, Maxwell-Armstrong CA. Quantifying factors influencing operating theater teaching, participation, and learning opportunities for medical students in surgery. J Surg Educ. 2013;70(4):495–501. doi: 10.1016/j.jsurg.2013.02.011. [PubMed:23725937].
  7. Berman L, Rosenthal MS, Curry LA, Evans LV, Gusberg RJ. Attracting surgical clerks to surgical careers: Role models, mentoring, and engagement in the operating room. J Am Coll Surg. 2008; 207(6): 793–800. 800 e1-2. doi: 10.1016/j.jamcollsurg.2008.08.003. [PubMed: 19183524].
Strides in Development of Medical Education
Volume 15, Issue 1
December 2018
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