12 2
an attending surgeon because it might seem unintelligent would be more easily
asked of a resident due to this near-peer relationship [ 3 ]. Being in generational prox-
imity may accordingly promote educational dialog for the resident educator and
serve as an advantage in comparison to a faculty teacher.
Faculty Time Pressure
Changes in modern healthcare including pressures for efficiency, cost control,
volume production, duty hour reform as referenced above, and quality have fos-
tered an environment in which attending surgeons manage their workflow priori-
ties in a fashion often counterproductive to the teaching of novice learners. Critics
state that with medical school budgets becoming tighter and more reliant on clini-
cal volume and related revenue, attending surgeons are obligated to spend more
time in patient care and less time in traditional and more pure or focused teaching
venues [ 5 , 13 ]. These forces may cause attendings to spend more of their time in
direct clinical and administrative pursuits, limiting their availability and flexibil-
ity for teaching especially more junior learners and increasing the scenarios in
which residents are the sole or predominant remaining educators available for
medical students.
Summary
Recognizing that for all these reasons, residents may be better suited and/or avail-
able for student education, it is clear that resident teaching of students and more
junior house staff is a vital component of contemporary surgical education. Many
residents enjoy and embrace the opportunity of this teaching role and would like
to become better educators themselves during their training years [ 1 ]. Accordingly,
a number of surgical programs around the nation have developed, or begun to
develop, curricula that incorporate teaching skills into the fabric of residency
training. Morrison et al. have shown that a teaching skills curriculum improves
teaching effectiveness of residents when compared to residents with no teaching
guidance [ 5 , 14 ].
Beyond the importance of residents in teaching junior learners, it is also recog-
nized that educational skill is fundamental to a resident’s long-term career activities
even in nonacademic settings. This is apparent when one considers the fundamental
role of a professional as an educator for those whom they serve as patients, col-
leagues, or clients. Given the strategic importance of educational development as
part of a resident’s training, the remainder of this chapter will focus on some of the
tools and strategies which can be used to equip resident teachers for these purposes.
Pertinent to this theme, we will review current cognitive science regarding learning
and retention and then review specific strategies which may be used in the clinical
setting to facilitate teaching effectiveness.
J. Feimster et al.