Strides in Development of Medical Education

Published by: Kowsar

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

Masoumeh Rahimi 1 and Majid Shirani 2 , *
Authors Information
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
Article information
  • Strides in Development of Medical Education: December 31, 2018, 15 (1); e85367
  • Published Online: October 24, 2018
  • Article Type: Review Article
  • Received: April 12, 2018
  • Revised: September 27, 2018
  • Accepted: October 8, 2018
  • DOI: 10.5812/sdme.85367

To Cite: Rahimi M, Shirani M. Clinical Teaching of Residents in Operating Room: A Review of Methods and Strategies for Strengthening Teaching and Learning, Strides Dev Med Educ. 2018 ; 15(1):e85367. doi: 10.5812/sdme.85367.

Copyright © 2018, Strides in Development of Medical Education. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Methods
3. Results
4. Discussion
  • 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].
  • 4. 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].
  • 5. 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].
  • 6. 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].
  • 7. Champagne BJ. Effective teaching and feedback strategies in the or and beyond. Clin Colon Rectal Surg. 2013;26(4):244-9. doi: 10.1055/s-0033-1356725. [PubMed: 24436685]. [PubMed Central: PMC3835457].
  • 8. 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].
  • 9. 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].
  • 10. 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].
  • 11. 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].
  • 12. 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].
  • 13. Swanwick T. Understanding medical education: Evidence, theory and practice. New Jersey: John Wiley and Sons; 2013.
  • 14. 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].
  • 15. 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].
  • 16. 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].
  • 17. 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].
  • 18. 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].
  • 19. 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].
  • 20. 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].
  • 21. 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].
  • 22. 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].
  • 23. Cox SS, Swanson MS. Identification of teaching excellence in operating room and clinic settings. Am J Surg. 2002;183(3):251-5. [PubMed: 11943121].
  • 24. 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].
  • 25. 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].
  • 26. 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.
  • 27. 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].
  • 28. 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].
  • 29. 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].
  • 30. 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].
  • 31. 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.
  • 32. 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.
  • 33. 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.
  • 34. 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].
  • 35. 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].
  • 36. 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].
  • 37. 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].
  • 38. 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].
  • 39. Stronge JH. Evaluating teaching: A guide to current thinking and best practice. California: Corwin Press; 2005.
  • 40. 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].
  • 41. 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].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .
Readers' Comments