Surgeons as Educators A Guide for Academic Development and Teaching Excellence

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a very integral part of establishing the learning environment. It may include the
following:

• Have you done this case before and how many?

Advantage Disadvantage

Identifies if resident has participated in a

similar case

Previous participation does not guarantee retention

of concepts/skills demonstrated or taught

Can serve as a rough marker for resident

familiarity and comfort with case

Number of cases scrubbed may not be a metric of

familiarity and comfort

• What are the indications, potential approaches, positioning, and preparatory
  considerations?

Advantage Disadvantage

Identifies if resident has reviewed patient chart Having reviewed patient chart may not

give the resident insight into alternatives

and decision-making

Identifies if resident has reviewed available

resources like surgical texts and videos. Faculty can

assess if resources being utilized are appropriate.

For more advanced teaching environments, this can

lead to standardization in case preparation resources

Surgical approaches are not tailor-made,

and preparatory considerations involve

higher level of thinking like potential for

blood loss, postoperative pain control,

etc.

• Outline the steps of the case

Advantage Disadvantage

Identifies if resident has reviewed surgical atlas,

texts, and videos

Previous participation does not guarantee

retention of concepts/skills demonstrated or

taught

Enables resident to demonstrate being able to

articulate steps of a case in discrete and

anatomical terms. For advanced residents,

selection of instruments and surgical technique

can be incorporated into this approach

May not translate into surgical skill, comfort

with technique, as well as instrument

selection. Being able to identify surgical

tasks may not lead to accomplishing surgical

goals

• Which parts of the case are you comfortable performing and which require addi-
  tional coaching?

Advantage Disadvantage

Identifies if resident has engaged in

self-assessment

Subjective assessment of residents’ own skills may

not be accurate

Resident training in the operating room tends to be highly focused on operative
techniques, as the goal is to successfully complete the technical aspects of a surgi-
cal procedure. Performing a needs assessment with the residents cannot be limited
to technical aspects and speaks to a larger need for a comprehensive

8 Teaching in the Operating Room