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Paramount to the Surgical Skills Center’s success has been its steadfast commit-
ment to fostering a culture of continuous improvement. Pursuant of this progres-
sion, the Surgical Skills Center has focused on increasing the frequency of direct
observation and effective feedback learners receive in a realistic environment to
enhance surgical skill in the operating room [ 27 ]. By establishing specific perfor-
mance metrics within an educational framework similar to what is taught periopera-
tively, a student first talks through critical steps of the procedure during a briefing of
the learning module, subsequently receives “intraoperative” coaching if necessary,
and undergoes a debriefing following to review performance and identify opportu-
nities for improvement [ 28 ]. Unique to the Surgical Skills Center relative to the
operating room, performance targets enable a student to safely struggle through
critical growth experiences void of any concern for patient safety risk. This approach
works to virtually eliminate the amount of guiding often seen in the operating room
as it uses autonomy to empower a learner and their facilitator to identify potential
gaps in their skill set [ 29 ].
The directive of the Surgical Skills Center has been to work closely in conjunc-
tion with attending physicians to foster a continuum between the operating room
and the surgical skills lab for students, residents, and fellows as yet another learning
environment in which faculty-learner collaborations are increased. By minimizing
the minutiae of a learning module, the Skills Center empowers the surgeon as edu-
cator to focus on coaching skills such as economy of motion, counter-traction, and
safe tissue handling, among others. The Surgical Skills Lab better informs assess-
ment of its learners by routinely performing video-based coaching, well supported
in the literature to enhance the surgical skills performance of its learners [ 30 ]. Based
on prior studies of performance, reliable operative assessment for residents should
have 20 ratings per year from at least 10 different raters [ 31 ]. By acquiring addi-
tional data to monitor resident’s progress in the Surgical Skills Center, tracking
performance and using standardized benchmarks have enabled surgeons as educa-
tors to identify those in need of focused remediation. This assessment is essential in
identifying and correcting technical deficiencies before they become engrained in a
learner’s skill set [ 32 ].
By supporting faculty development in this dyad model between the Surgical
Skills Center and its faculty, surgeons as educators have more time to devote to not
only the performance evaluation of their learners but also for themselves [ 33 ].
Preparing faculty for learning modules in anticipation of logistics, educational
objectives, and potential challenges of a skills lab ensures faculty maintain learners’
engagement within the scope of the learning module [ 34 ]. By supporting this aspect
of the learning module development, additional time has been allotted for faculty to
focus on instructional improvement. Consistent evaluations of training and educa-
tors as shown below in Fig. 12.2 have led to significant initiatives for improvement
in education and evaluation in the Surgical Skills Center. Meeting with program
directors routinely to review these assessments has proved pivotal in improving
coaching for the better learning of residents.
Vital to providing this curriculum and continuing to meet the learning needs of
the Department of Surgery and School of Medicine is the Surgical Skills Center
M.R. Romanelli et al.