Surgeons as Educators : A Guide for Academic Development and Teaching Excellence

526 Pages·2018·9.27 MB·English

by  Tobias S. Köhler

Surgeons as
Educators
A Guide for Academic
Development and
Teaching Excellence
Tobias S. Köhler
Bradley Schwartz
Editors
123
Surgeons as Educators
Tobias S. Köhler • Bradley Schwartz
Editors
Surgeons as Educators
A Guide for Academic Development
and Teaching Excellence
Editors
Tobias S. Köhler Bradley Schwartz
Urology Department of Surgery, Urology
Mayo Clinic Southern Illinois University School
Rochester, MN of Medicine
USA Springfield, IL
USA
ISBN 978-3-319-64727-2 ISBN 978-3-319-64728-9 (eBook)
https://doi.org/10.1007/978-3-319-64728-9
Library of Congress Control Number: 2017959585
© Springer International Publishing AG 2018
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“Upon the subject of education, not presuming to dictate any plan or system
respecting it, I can only say that I view it as the most important subject which we
as a people can be engaged in… For my part, I desire to see the time when
education, and by its means, morality, sobriety, enterprise and industry, shall
become much more general than at present, and should be gratified to have it in
my power to contribute something to the advancement of any measure which might
have a tendency to accelerate the happy period.”
– Abraham Lincoln, March 9, 1832
Dr. Köhler would like to dedicate this book to his parents and to all of his former
mentors and teachers that are too numerous to name. He would also like to thank
all of the medical students, residents, and fellows with whom he had the
opportunity to teach and indeed learn from in turn.
Dr. Schwartz would like to dedicate this book to his parents and his two sons for
always emphasizing the value of both teaching and learning, thereby making him
better at both. Also, to all of the students he has taught over the years, most
notably his urology residents, for being given the opportunity to influence both
physicians and patients for generations leaving an indelible carbon footprint.
Preface
“Let each become all that he or she is capable of being through education.” – Anonymous
The average surgeon may operate on 5000–10000 patients if he or she is lucky
enough to have a healthy and fruitful career. But a surgeon educator who teaches,
trains, and mentors medical students, residents, and fellows easily influences an
exponentially greater number of patients. Thus it is paramount that surgeons have
the skills to teach the next generation of surgeons – not only on how to tie a knot,
but also how to handle the unexpected, how to remain calm under pressure, how to
be professional, and when and when not to operate.
Yet, many surgeons have had no formal training in how to teach. Further, current
surgical educators are dealing with ever-increasing challenges to teach more in less
time. A few of these challenges include the restriction on resident duty hours, edu-
cational core competencies, ever-changing science and technology, generational
differences, electronic health records, patient safety, and pay for performance
criteria.
This book is designed to help the reader (surgeons, program directors, or anyone
involved in medical student, resident, or fellow education) understand the principles
of contemporary surgical education and skills and is laid out into 3 main sections.
Section 1 “Foundations of Teaching” provides the reader with an introduction to
teaching and lays a foundation for subsequent chapters on which the reader can
build. From basic principles of how we learn to how we assess complex medical
procedures, the reader gains insight on the basics of teaching. Section 2 “Program
Optimization” describes how to assess and assure quality in both clinical practice
and in teaching. Section 3 “Lessons and Insights of Surgical Education” details how
to actually teach and provides examples of the art of teaching in the surgical field.
The ultimate goal of this book is to prepare the reader to excel in education and
thus be able to positively influence patient care well beyond that of any one indi-
vidual and hopefully perpetuate the teaching and learning culture in our field for
generations.
Rochester, MN, USA Tobias S. Köhler
Springfield, IL, USA Bradley Schwartz
vii
Contents
Part I Foundations of Teaching
1 “See One, Do One, Teach One?” A Story of How Surgeons Learn . . . . 3
Anna T. Cianciolo and Joseph Blessman
2 Surgical Curriculum Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Carol F. McCammon and Kurt McCammon
3 Curriculum Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Elspeth M. McDougall and Bradley Schwartz
4 Measurement in Education: A Primer on Designing Assessments . . . 35
Collin Hitt
5 Performance Assessment in Minimally Invasive Surgery . . . . . . . . . . 53
Evalyn I. George, Anna Skinner, Carla M. Pugh,
and Timothy C. Brand
6 Crowdsourcing and Large-Scale Evaluation . . . . . . . . . . . . . . . . . . . . 93
Jessica C. Dai and Mathew D. Sorensen
7 T eaching Residents to Teach: Why and How . . . . . . . . . . . . . . . . . . . . 119
James Feimster, Alexandria D. McDow, and John D. Mellinger
8 T eaching in the Operating Room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Moben Mirza and Joel F. Koenig
Part II Program Optimization
9 R esident Duty Hours in Surgical Education . . . . . . . . . . . . . . . . . . . . 163
David J. Rea and Matthew Smith
10 Generational Differences and Resident Selection . . . . . . . . . . . . . . . . 189
Alison C. Keenan, Thomas G. Leffler, and Patrick H. McKenna
11 The Role of Educators in Quality Improvement . . . . . . . . . . . . . . . . . 199
Sevann Helo and Charles Welliver
ix
x Contents
12 Role of the Surgeon Educator in Leading Surgical Skills
Center Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Michael R. Romanelli, Jennifer Bartlett, Janet Ketchum,
and Bradley Schwartz
13 Modern Theory for Development of Simulators
for Surgical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Yasser A. Noureldin and Robert M. Sweet
14 The Surgical Workplace Learning Environment:
Integrating Coaching and Mentoring . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Jeanne L. Koehler and Emily Sturm
15 Optimizing Research in Surgical Residents
and Medical Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Danuta I. Dynda, Bradley Holland, and Tobias S. Köhler
16 Promoting Professionalism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Hilary Sanfey
17 Optimizing Success for the Underperforming Resident . . . . . . . . . . . 275
Karen Broquet and Jamie S. Padmore
Part III Lessons and Insights of Surgical Education
18 Surgeons’ Reactions to Error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Melanie Hammond Mobilio and Carol-anne Moulton
19 Quality Improvement and Patient Safety . . . . . . . . . . . . . . . . . . . . . . . 323
Ethan L. Ferguson and Chandru P. Sundaram
20 Teaching Surgeons How to Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
Jon A. Chilingerian
21 Teaching Surgical Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Sabha Ganai and Karen M. Devon
22 Surgical Ergonomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387
Carrie Ronstrom, Susan Hallbeck, Bethany Lowndes,
and Kristin L. Chrouser
23 Evaluation and Management Documentation,
Billing, and Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Tobias S. Köhler
24 Simulation in Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Wesley Baas, Matthew Davis, and Bradley F. Schwartz
25 Resident Physician Burnout: Improving the Wellness
of Surgical Trainees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Laura M. Douglass and Amanda C. North
26 Preparations Beyond Residency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499
Nikhil K. Gupta, Sumeet Batra, and Tobias S. Köhler
Index ......................................................... 521
Contributors
Wesley Baas, MD Southern Illinois University, Carbondale, IL, USA
Jennifer Bartlett, ST J Roland Folse MD Surgical Skills Center at Southern
Illinois University School of Medicine, Springfield, IL, USA
Sumeet Batra, MD, MPH Cook Children’s Healthcare System, Fort Worth,
TX, USA
Joseph Blessman, MSII Southern Illinois University School of Medicine,
Springfield, IL, USA
Timothy C. Brand, MD, FACS Madigan Army Medical Center, Tacoma,
WA, USA
Karen Broquet, MD, MHPE Southern Illinois University School of Medicine,
Springfield, IL, USA
Jon A. Chilingerian, PhD Brandeis University, Heller School, Waltham,
MA, USA
Public Health and Community Medicine at Tufts School of Medicine, Boston,
MA, USA
Organizational Behavior and Health Care Management at INSEAD,
Fontainebleau, France
Kristin L. Chrouser, MD, MPH Minneapolis VA Health Care Center,
University of Minnesota, Department of Urology, Minneapolis, MN, USA
Anna T. Cianciolo, PhD Southern Illinois University School of Medicine,
Department of Medical Education, Springfield, IL, USA
Jessica Dai University of Washington, Department of Urology, Seattle, WA, USA
Matthew Davis, MD Southern Illinois University, Carbondale, IL, USA
xi
xii Contributors
Karen M. Devon, MD, MSc, FRCSC Department of Surgery,
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Joint Center for Bioethics, Dalla Lana School of Public Health,
University of Toronto, Toronto, ON, Canada
Women’s College Hospital, Toronto, ON, Canada
University Health Network, Toronto, ON, Canada
Laura M. Douglass Montefiore Medical Center, Bronx, NY, USA
Danuta I. Dynda, MD Division of Urology/Center for Clinical Research,
Southern Illinois University School of Medicine, Springfield, IL, USA
James Feimster, MD General Surgery, Southern Illinois University School
of Medicine, Springfield, IL, USA
Ethan L. Ferguson Department of Urology, Indiana University, Indianapolis,
IN, USA
Sabha Ganai, MD, PhD, FACS Department of Surgery, Southern Illinois
University School of Medicine, Springfield, IL, USA
Evalyn I. George, BS Henry M. Jackson Foundation/Madigan Army Medical
Center, Tacoma, WA, USA
Nikhil K. Gupta, MD Rutgers-Robert Wood Johnson Medical School,
Piscataway Township, NJ, USA
Susan Hallbeck, PhD, PE, CPE Department of Health Sciences Research,
Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
Mayo Clinic, Rochester, MN, USA
Department of Surgery, Mayo Clinic, Rochester, MN, USA
Sevann Helo, MD Surgery, Division of Urology, Albany Medical College,
Albany, NY, USA
Collin Hitt, PhD Department of Medical Education, Southern Illinois University
School of Medicine, Springfield, IL, USA
Bradley Holland, MD Division of Urology/Center for Clinical Research,
Southern Illinois University School of Medicine, Springfield, IL, USA
Tobias S. Köhler, MD, MPH, FACS Urology, Mayo Clinic, Rochester, MN, USA
Alison C. Keenan Department of Urology, University of Wisconsin-Madison,
Madison, WI, USA
Janet Ketchum, CST J Roland Folse MD Surgical Skills Center at Southern
Illinois University School of Medicine, Springfield, IL, USA