Surgical training has long been confined to traditional models of Halstedian apprenticeship, where trainees are guided—but also potentially limited—by their superiors. Within this dynamic, the transfer of knowledge from expert to learner is dependent on individual educators, which can then be easily affected by personal circumstances and potential unconscious biases.
Physicians are often busy and rightly focused on patient care, but this can lead to uncaptured and delayed feedback for residents trying to progress their learning. As a result, gatekeeping of knowledge can occur without the educator even knowing.
More pressingly, the Association of American Medical Colleges has projected a shortage of between 54,100 to 139,000 physicians in the U.S. by 2033, making the next ten years vital for solving a looming public health crisis. Technology has been recognized as a potential solution for expanding the reach of health care, but it’s also possible it could improve the efficiency of medical education too. Expanding the talent pipeline through diversity and inclusion measures is also noted as a way to combat the shortage.
The question is then: How can we make surgical training more effective and equitable?
Let’s take a look at how new technologies are being used to accelerate resident learning and make a much-needed difference in surgical education.
Digital transformation has occurred rapidly across health care. However, within surgical training, innovation has been slow. Unfortunately, electronic health records (EHR) were designed more for billing than for patient care. As a result, they are not naturally geared towards educational value.
Additionally, many cases in surgical education go under-reported because of the lack of integration between EHR technologies, educational databases, and accreditation systems. any surgeons still manage their case histories manually with pen and paper. Both residents and medical experts must navigate ineffective systems and waste valuable time in doing so.
There’s also the problem that feedback from educators can take weeks, by which time residents may have moved on to other training rotations or the memory of the case is not as fresh in their minds. And feedback is often only shared orally between surgeons, meaning important information is easily lost and not easily referenced in the future.
In response, web-based accelerated learning platforms are proven to enable educators to deliver timely and capturable feedback. They do this by automatically offering evaluation options depending on the case to speed up and ease the process. Feedback can be formative rather than summative, as students have more time to build on what they’ve learned before they are required to move on.
Using a learning platform creates the opportunity to collect and manage resident learning data to better understand the progress of training from an objective viewpoint. Technology helps education to be tailored to individual needs and gives insight into the effectiveness of the teaching.
Currently, emphasis on individual educators is weakening the surgical training process. Educators naturally hold biases (unconscious or otherwise) that restrict residents’ capacity to learn in a comprehensive way.
The pathway to becoming a surgeon has been compared to a leaking pipeline, where residents from minority backgrounds fall by the wayside. Similarly, while more women may be graduating, the culture in surgical training is still male-dominated and can deter women from entering the field. Residents, therefore, may face barriers to training when they don’t see themselves reflected in the surgical culture.
Conversely, web-based platforms enable transparency as they record resident case histories and attached feedback, so it is easily accessible by both the learner and their educators. With better transparency, feedback objectivity and quality are improved as educators are made more accountable for their responses.
Having access to their feedback empowers learners to measure their own progress and see their learning journey comparably with the anonymized learning curves of their peers. Subsequently, residents can focus their attention on areas that need improvement, and learning accelerator platforms can also provide aid by recommending further study material.
Once training is optimized through digitalization, wider implications can also be considered. For instance, with a broader understanding of surgical learning, global health could be improved by forming surgical training partnerships with lower to middle-income countries, raising the standard of medical learning worldwide.
Overcoming new challenges
New tools come with new challenges for the medical community. Thankfully, accelerated learning platforms help guide educators to better understand the process of learning and how to support residents with technological advancements in the OR.
Artificial intelligence (AI) and virtual reality (VR) are already providing 3D imaging to help students learn and retain anatomy information faster, while cloud-powered knowledge exchange is expanding the chance for medical collaboration and research within the digital global arena. However, as innovations such as robotically-assisted surgeries increase, so does the need to refine and measure how students become familiar with these new tools.
For instance, computer vision with a microscope during surgery can show the pathway a resident has made. But, whether they had assessed the available options and chosen correctly or incorrectly (or didn’t know all options) is vital to knowing residents’ true cognitive understanding.
With this kind of collected data around new, sophisticated tools, accelerated learning platforms allow educators to identify where curricula need to be restructured to ensure learning is effective.
AI and digital transformation are helping prioritize human-centric learning experiences that are supportive rather than testing. Accelerated learning platforms are the natural evolution of surgical training to address the existing model’s inefficiencies and keep pace with a broader medical sphere that has made huge strides in recent years.
Ruchi Thanawala is a cardiothoracic surgeon.