Surgeons as Educators A Guide for Academic Development and Teaching Excellence

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Teaching Leadership to Surgeons Using Cases

Some surgeons may believe that leadership is something that comes naturally. They
have clocked in so many hours in the operating room; they know how to lead. While
that may be true to some extent, there is also a need for self-reflection against some
objective criteria.
Perhaps the best way to explore how to teach surgeons about leadership is to ask:
How do we combine leadership knowledge with surgical practice? This is funda-
mental according to Alfred North Whitehead:

“What the faculty have to cultivate is activity in the presence of knowledge. What the stu-

dents have to learn is activity in the presence of knowledge...”^31

Whitehead goes on to say that passive learning that shields the classroom from real-
world activities is misplaced. Application is part of knowledge. This seems to align
with the basic idea in medical education—see one, do one, teach one. The case method
is one way to take real-world problems and translate them into classroom pedagogy.

The Case Method of Instruction

In educating future surgical leaders, the case method has been recognized as a pri-
mary pedagogy. Books on teaching medical professionalism advocate case vignettes
as a vehicle for bringing real-life situations into the classroom.^32
Cases are pedagogical tools designed and formulated for classroom learning and
post-class discussions. A formal definition of the case comes from one of the true
masters of the case method, Professor C. Roland Christianson:

A case is a partial, historical, clinical study of a situation which has confronted a practicing

administrator or managerial group. Presented in narrative form to encourage student

involvement, it provides data—substantive and process—essential to an analysis of a spe-

cific situation, for the framing of alternative action programs, and for their implementation

recognizing the complexity and ambiguity of the practical world.^33

Cases combine historical, verbal, numerical, visual, and graphical data allowing a fresh
process of discovery with each discussion. A case discussion not only teaches people
how to think in the situation described in the case but also in diverse situations.
Therefore, cases are not about teaching a solution or a way to behave, but cases are
about teaching leaders how to think.
In a “good” case, the leaders are facing a complex or novel real-world problem
or opportunity. Students are told to prepare the case and make a recommendation.
Offering questions in advance such as:

• What are the facts and key issues? What went right? What went wrong?


• Describe the key events. How did the events evolve? What are your assumptions?

(^31) Whitehead [ 61 ].
(^32) Steinert [ 53 ].
(^33) Christensen and Hansen [ 15 ].
J.A. Chilingerian